2023 is the Biennial Physician Medical Licensure Renewal Year

Delaware law requires that, in order for medical professionals to renew their license, they must attest that they have completed training on:

• how to recognize child sexual and physical abuse, exploitation and domestic violence
• your reporting obligations under the Medical Practice Act and Regulatory Provisions Concerning Public Health

The 2023 Mandatory Reporting Training for Medical Professionals is available as of January 1, 2023, and features videos from professionals within the child welfare field that walk participants through how to detect and respond to child abuse and neglect.

Licensed physicians must take the 2023 Mandatory Reporting training even if they recently completed mandatory reporting training. This training must be completed before every medical license renewal. Physicians are required to attest to completing the training on their renewal application. Failure to do so will delay the renewal of the medical license.  

This training is provided by the Office of the Child Advocate. To complete the training, go to https://stateofdelaware.csod.com/default.aspx?c=courts-oca to create an account. If you already have an account, just click the “login in” icon and sign in User ID and Password. Once training is completed, medical professionals can then reapply for licensure through the Division of Professional Regulation's website at https://delpros.delaware.gov/OH_HomePage.

For Those Working with Adult Patients or in the Field of Gerontology

The Board of Medical Licensure and Discipline and the Board of Nursing are responsible for establishing continuing education requirements for medical professionals licensed by these Boards. Senate Bill 283 requires practitioners who treat adults to take continuing education on the diagnosis, treatment, and care of patients with Alzheimer’s or other dementias. MSD opposed this legislation on all fronts (read the MSD/DNA Joint letter of opposition). The legislation passed both chambers and was signed by the Governor on September 8, 2022, changing the law governing continuing education requirements for medical professionals.

According to the Delaware Board of Medical Licensure and Discipline, the following requirement must be completed during each biennial medical license renewal period beginning with the 2025 renewal cycle. Senate Bill 283 requires all medical professionals who work with adult patients or in the field of gerontology in a health care setting to complete at least one (1) hour of continuing education on the topic of diagnosis, treatment, and care of patients with Alzheimer's disease or other dementias. During license renewal in 2023, you will be required to acknowledge your understanding that, you will have to complete this mandatory CE requirement starting in renewal cycle 2025, if you work with adult patients or in the field of gerontology in a health care setting.

MSD will be working closely with the Delaware Board of Medical Licensure & Discipline to obtain further clarification on how this will effect specific practices and specialties prior to the 2025 renewal cycle. Please continue to watch your communications from MSD.

Some Retail Pharmacies Will Be Permitted to Dispense Abortion Pills

Retail pharmacies that meet certain rules will be allowed to offer abortion pills in states that permit abortion under a regulatory change made on Tuesday this week by the U.S. Food and Drug Administration (FDA). The pills were previously available only at clinics, directly from physicians, or by mail from a handful of mail-order pharmacies. Under the new rules, patients will still be required to have a prescription from a certified health care professional for mifepristone. Those pharmacies and mail-order companies that will be allowed to dispense mifepristone will be required to go through a certification process.

In other similar news, the FDA updated Plan B One-Step labeling to support that it is an emergency contraception method to prevent pregnancy and not for routine contraceptive use. Plan B One-Step works prior to release of an egg from the ovary and, as a result, usually stops or delays ovulation rather than by preventing a fertilized egg from implanting in the uterus. Abortion opponents argued that the medication causes abortions and should be restricted.

CDC Projected 41% of Confirmed COVID Cases Are Caused by XBB.1.5 Strain

A new version of omicron has taken hold in the U.S., according to the most recent data from the Centers for Disease Control and Prevention (CDC). The subvariant of omicron, named XBB.1.5, has raised concerns about another potential wave of COVID-19 cases following the busy holiday travel season. The CDC projected that about 41% of confirmed U.S. COVID-19 cases are caused by the XBB.1.5 strain, up from 20% projected just a week prior. In the Northeast, about 75% of confirmed cases are reported to be XBB.1.5. Dr. Barbara Mahon, Director of CDC’s Coronavirus and Other Respiratory Viruses Division, suggested there’s no indication this subvariant causes more severe illness than any other omicron virus. The COVID Omicron XBB.1.5 variant is rapidly becoming dominant in the U.S. because it is highly immune evasive and appears more effective at binding to cells than related subvariants, scientists say.

While overall COVID-19 hospitalizations are rising around the country, areas such as the Northeast that have seen high levels of the new variant have not experienced a disproportionate increase in hospitalizations. There’s a lot that’s still unknown about the latest subvariant, including whether it’s more contagious than other forms of omicron.

The XBB.1.5 is a relative of the omicron XBB variant, which is a recombinant of the omicron BA.2.10.1 and BA.2.75 subvariants. Combined, XBB and XBB.1.5 make up 44% of cases in the U.S., crowding out other versions of omicron. The World Health Organization (WHO) has indicated that XBB has been found in at least 70 countries and has caused surges of infection in some parts of Asia, including India and Singapore, in October.

CDC Issues Health Advisory

The Centers for Disease Control and Prevention (CDC) issued an advisory to notify physicians and public health authorities of a recent increase in pediatric invasive group A streptococcal (iGAS) infections. In November 2022, CDC was notified of a possible increase in iGAS infections among children at a hospital in Colorado. Potential increases in pediatric iGAS cases in other states were subsequently noted by contributors to the Infectious Diseases Society of America’s provider-based Emerging Infections Network and by certain jurisdictions participating in CDC’s Active Bacterial Core Surveillance System (ABCs). This increased number of pediatric iGAS cases in some jurisdictions has occurred in the setting of increased circulation of respiratory syncytial virus (RSV), influenza viruses, SARS-CoV-2, and other respiratory viruses. While the overall number of cases has remained relatively low and iGAS infections remain rare in children, CDC is investigating these reports.

For Adults with Limited Treatment Options

The U.S. Food and Drug Administration (FDA) approved Sunlenca (lenacapavir), a new type of antiretroviral medication for adult patients living with human immunodeficiency virus type 1 (HIV-1), whose HIV infections cannot be successfully treated with other available treatments due to resistance, intolerance, or safety considerations. After the starting dose is completed, Sunlenca is administered as subcutaneous (under the skin) injections once every six months, allowing convenient dosing for patients. Sunlenca is the first of a new class of drugs called capsid inhibitors to be FDA-approved for treating HIV-1. Sunlenca works by blocking the HIV-1 virus’ protein shell (the capsid), thereby interfering with multiple essential steps of the viral lifecycle. Sunlenca’s starting dose is given as oral tablets and subcutaneous injections, followed by maintenance injections every six months; Sunlenca is given in combination with other antiretroviral(s). 

Due to Product Mix-Up (Attention: Dermatologist and Pediatricians)

The U.S. Food and Drug Administration (FDA) announced that Accord Healthcare is recalling a single lot of Daptomycin for Injection 500 mg/vial, and Daptomycin for Injection 350 mg/vial product contained in cartons imprinted with lot # R2200232 Exp: 01/2025 to the consumer/user level. This product is being recalled because Accord received a product complaint report from a hospital pharmacy that vials labeled as “Daptomycin for Injection 500 mg/vial” were found in cartons labeled as “Daptomycin for Injection 350 mg/vial”. Administration of Daptomycin 500 mg/vial to the population most at risk, which are children or patients with renal impairment, has a reasonable probability that the likelihood of the labeled warnings can potentially be increased if a higher than the intended dose is used which could lead to serious adverse health consequences. If these reactions occur, they may require medical treatment such as hemodialysis and systemic glucocorticoids. Read the recall.

Many Young People Under Age 20 Likely to be Impacted

The number of young people under age 20 with diabetes in the United States is likely to increase more rapidly in future decades, according to a new modeling study published recently in Diabetes Care. Researchers forecasted a growing number of people under age 20 newly diagnosed with diabetes during 2017–2060. This expected upward trend may lead to as many as 220,000 young people having type 2 diabetes in 2060 —a nearly 700% increase -and the number of young people with type 1 diabetes could increase by as much as 65% in the next 40 years. Even if the rate of new diabetes diagnoses among young people remains the same over the decades, type 2 diabetes diagnoses could increase nearly 70% and type 1 diabetes diagnoses could increase 3% by 2060. Type 1 diabetes remains more common in U.S. youth, but type 2 diabetes has substantially increased among young people over the last two decades. In addition to the overall predictions, analyses of these data by race and ethnicity predicted a higher burden of type 2 diabetes for Black, Hispanic/Latino, Asian, Pacific Islander, and American Indian/Alaska Native youth. There could be several explanations for the rise in type 2 diabetes, including the increasing prevalence of childhood obesity. The presence of diabetes in people of childbearing age might be another important factor, because maternal diabetes increases risk of diabetes in children. These findings come from the SEARCH for Diabetes in Youth study, funded by the Centers for Disease Control and Prevention and the National Institutes of Health.

Statement From Karen Hacker, MD

The Centers for Disease Control and Prevention (CDC) released new, extended growth charts for assessing growth and treatment of children with severe obesity. Physicians are encouraged to use the extended growth charts as a tool when working with children and adolescents with severe obesity. Intervening early is critical to improving the health of children as they grow into adults. Prior to this release, the growth charts did not extend high enough to plot BMI for the increasing number of children with severe obesity. The new growth charts coupled with high-quality treatment can help optimize care for children with severe obesity. The Extended BMI-for-Age Growth Charts allow physicians to track growth and visualize high BMI percentiles with families. This can help optimize care for children and adolescents aged 2 – 19 with severe obesity. Severe obesity is defined as a BMI greater than or equal to 120% of the 95th percentile on BMI-for-Age growth charts. Physicians can work with families on a comprehensive care plan to address childhood obesity. Safe and effective treatment options include Family Healthy Weight Programs, which are comprehensive behavioral treatment programs, and additional evidence-based medical treatment. Existing growth charts for children and adolescents without obesity will not change. These extended growth charts can replace current severe obesity growth charts in Electronic Health Records. They will be useful for anyone treating severe childhood obesity.

Guidance Will Allow Alternative Benefits in Medicaid Managed Care Plans

Under guidance issued this week by the Centers for Medicare & Medicaid Services (CMS), states will be able to introduce an innovative option to employ in Medicaid managed care programs to reduce health disparities and address unmet health-related social needs, such as housing instability and nutrition insecurity, through alternative benefits that tackle social needs in lieu of more traditional services offered by state plans. Alternative benefits can be utilized by states and their managed care plans to strengthen access to care by expanding settings options and address certain Medicaid enrollees' health-related social needs in order to reduce the need for future costly state plan-covered services. This is an effort to help improve population health, reduce health inequities, and lower overall health care costs in Medicaid.

OverC Multi-Cancer Detection Blood Test for Early Detection of Cancer Types

The U.S. Food and Drug Administration (FDA) has granted a Breakthrough Device Designation to the OverC Multi-Cancer Detection Blood Test (MCDBT) for the early detection of cancers (esophageal, liver, lung, ovarian, and pancreatic cancers) in adults aged 50 to 75 years with average risk. OverC™ MCDBT demonstrated a 69.1% rate of sensitivity and 98.9% rate of specificity in the case-control study, THUNDER, and will be further validated in prospective interventional studies among asymptomatic population. Test results of "Detected" with the top one or two predicted tissues of origin of cancer-associated signals may indicate the presence of cancer and should be followed up by diagnostic tests in accordance with professional guidelines. Test results of "Undetected" do not rule out the presence of cancer, and individuals should continue with guideline-recommended standard of care screening tests. Liquid biopsy-based early detection technology will be an important supplement to the current cancer screening methods, especially for ovarian, pancreatic and other cancers that have no effective screening methods up to now. The Breakthrough Device Designation granted for OverC™ MCDBT would pave the way for a clearer registration path through confirmative performance validation and utility establishment.

MSD/DE-ACP/DAFP - A Collaborative Effort for Advocacy Education

The American College of Physicians Delaware Chapter, the Medical Society of Delaware, and the Delaware Academy of Family Physicians are pleased to present a virtual Town Hall-style event with key Delaware legislators on Wednesday, February 8th from 6:00 - 7:30 p.m.

This event is being jointly sponsored to bring the physician community together in dialogue. You are invited to join to share your thoughts and ask questions as they relate to the issues surrounding primary care, prior authorization, climate change, and nutrition. We anticipate a robust discussion followed by an opportunity for members to engage one another. There is no charge to participate, however, registration is required. We look forward to you joining us on February 8th!

Updated Content-Specifically for Delaware Physicians, Nurses & Pharmacists

Join us for this live webinar on Tuesday, February 28, 2023, from 6:30-9:00 p.m. ET.

SCOPE of Pain is an in-depth training that focuses on:

• Effective communication skills and the potential risks and benefits of opioids for managing acute and chronic pain
• The assessment of opioid misuse risk and recognition and treatment of opioid use disorder
• Helping you safely and effectively manage patients with acute and/or chronic pain, when appropriate, with opioid analgesics

SCOPE of Pain is provided by Boston University Chobanian & Avedisian School of Medicine; Department of Health and Human Services; national collaborators include the Council of Medical Specialty Societies and the Federation of State Medical Boards.

Planned in partnership with the Delaware Chapter of the American College of Physicians, the Delaware Academy of Family Physicians, and the Medical Society of Delaware.

Accreditation

Physicians: Boston University Chobanian & Avedisian School of Medicine designates this live activity for a maximum of 2.50 AMA PRA Category 1 Credits^TM.

AAFP: The AAFP has reviewed SCOPE of Pain: Safer/Competent Opioid Prescribing Education, and deemed it acceptable for AAFP credit. This session is approved for 2.50 AAFP Live Credits.

ABIM MOC Part II: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 2 MOC points and patient safety MOC credit in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program.

Registration is free, but required at scopeofpain.org.

A Medical Student Must - March 2-3, 2023, Washington, DC

Medical students will, by definition, shape the future of medicine. For the first time in three years, the upcoming AMA Medical Student Advocacy Conference (MAC) will be held in person. The conference offers physicians-in-training the opportunity to do so before they starting practicing medicine by meeting face to face with members of Congress and their staffers to advocate on issues directly affecting their future patients. The conference, which takes place March 2–3, gives medical students a remarkable opportunity to advocate for the future of medicine by:

• Attending training on how to be a public health advocate.
• Learning about issues affecting medical students.
• Meeting with their local legislators on Capitol Hill.

Learn four other big reasons why medical students should head to Washington and register to attend the conference.

MSDIS/USI Executive Series - Personal Risk Insights

Winter 2022-2023 is predicted to be a cold one for the U.S. According to the Farmers’ Almanac, much of the country will experience weather ranging from chilly to “hibernation zone.” As we settle into the winter months, a few safety recommendations and reminders are worthy of mention. Tips to prevent winter insurance claims.... Read more.

The Medical Society of Delaware Insurance Services (MSDIS)/USI team offers a full line of insurance coverages. MSDIS/USI's personal risk team is available to help you maximize asset protection and assist with all your personal risk management needs. To receive a comprehensive personalized plan, please contact Sharon Ruth at (302) 397-0173.

UC Irvine Researchers Studying Physician Marriages and Relationships

Researchers at the University of California at Irvine are studying physician marriages and relationships. In particular, they are looking at the impact of physician specialty, stage of training, practice setting, etc., on marriage happiness and success. In order to collect data and analyze interesting findings, they have developed a short (less than 5 minute) survey in which physicians (MD, DO, or MBBS degree) can participate. With good participation, the researchers are optimistic that the study can prove insightful for the profession.

If any questions about the survey arise, please feel free to contact me at the email address below. Thank you so much for your time and help: we are optimistic that the study can prove insightful for the profession and are earnestly grateful for your contribution to that goal.

Beebe Healthcare

Beebe Healthcare announced that laboratory and imaging services are now being offered at the newly opened Milford Health Center at 100 Silicato Way. Beebe Lab Express in Milford will offer a variety of resources from simple blood tests to more complex testing. X-rays will also be offered. To schedule an appointment for either, call 302-645-3278. Beebe’s fifth Walk-In Care Center is expected to open in the coming months at the facility. Hours are Monday through Friday from 6 a.m. to 2:30 p.m. for X-ray and Lab. Walk-In hours will be daily from 9 a.m. to 7 p.m.

ChristianaCare

ChristianaCare has been awarded a $2.4 million grant to expand Delaware’s health care workforce and ultimately improve access to care throughout the First State. Awarded through the U.S. Department of Health and Human Services and administered through the Delaware Academy of Medicine / Delaware Public Health Association (Academy/DPHA), the grant will help ChristianaCare’s Institute for Learning, Leadership and Development (iLEAD) expand and enhance medical education in Delaware and grow and strengthen the state’s multidisciplinary health care workforce. Initially, the grant will fund new training slots for psychiatrists, psychologists and advanced practice clinicians who specialize in primary care. The money also will expand training for medical assistants in order to increase the number of those professionals statewide.

For the seventh consecutive year, ChristianaCare has earned the “Most Wired” designation from the College of Healthcare Information Management Executives (CHIME), which assesses how effectively health care organizations apply core and advanced technologies to improve health and care in their communities.

ChristianaCare has earned the Transformational Leadership Award for excelling in its development and deployment of transformational information technology that improves the delivery of care and streamlines administrative services.

Basilio N. Bautista, MD

It is with sadness we share that MSD member Basilio N. Bautista, MD passed away on December 22, 2022, at the age of 87. He was born in Camarines Norte, Philippines and was educated at the University of Santo Tomas in Manila. He did his internship at the Niagara Falls Memorial Medical Center and general surgery trainings at Hahnemann University Medical Center in Philadelphia, Malden Medical Center in Boston; and surgical oncologic training in Roswell Park Memorial Institute in Buffalo, New York. He trained under plastic surgery legend, Dr. Desmond Kernahan at the University of Manitoba Medical Center and Winnipeg General Children’s Hospital. He was southern Delaware and Dover’s first plastic surgeon with a successful 30 year practice. He was the first plastic surgeon to use LASER in his practice and establish the first non-hospital same-day surgery facility in Delaware. Dr. Bautista helped establish the HOPE Clinic to serve the uninsured in Delaware and also founded the Child HELP Foundation to help children with disabilities. He was an artist, writer, poet, photographer, and composer. The art gallery at the Schwartz Center for the Arts was named after him and he was honored as a recipient of Dover Mayor’s Arts Awards. In lieu of flowers, please consider donations to the Child HELP Foundation, 6 Wyncliff Lane, Newark, Delaware 19711. Read obituary.

Rebecca J. Newbrander, MD - OB/GYN, ChristianaCare Women's Health

MSD's Membership Department is pleased to announce the newest members of the Medical Society of Delaware. If you know someone interested in joining MSD, please contact Michelle Seymour at (302) 224-4905 or Michelle.Seymour@medsocdel.org with any questions. You could be eligible for a referral discount!

• DPH Flu Dashboard
• DPH Delaware Weekly Influenza Surveillance Reports by week.
• CDC https://www.cdc.gov/flu/weekly/index.htm
• WHO https://www.who.int/teams/global-influenza-programme/surveillance-and-monitoring/influenzaupdates/current-influenza-update

• Delaware "My Healthy Community" COVID-19 Dashboard (updated weekly on Wednesdays)
• COVID-19 by County Community Level Check (# hospital admissions and beds used and total number of new cases)
• COVID-19 Community Transmission (based on cases per 100,000 people and positivity rate, both measured over the last 7 days)
• Fact Sheet: Data Points on Bivalent COVID-19 Vaccination (November 16, 2022)
• DPH Public Health Alerts: de.gov/publichealthalerts
• DPH COVID-19 Booster Information: de.gov/boosters
• Federal website for information on navigating COVID: COVID.gov
• CDC COVID-19 Quarantine and Isolation Calculator
• COVID-19 Treatment Options
• Medical Provider Guidance for Administering Therapeutics
• COVID-19 Therapeutics Locator
• CDC COVID Data Tracker Weekly Review.
• For testing flyers (available in English, Spanish, Haitian Creole): https://covidmaterialsde.com/resources/community-organizer
• For all testing site referral locations, visit: de.gov/gettested
• For vaccination site referral locations, visit: de.gov/getmyvaccine
• Pfizer-BioNTech COVID-19 Vaccine Presentation Wall Chart (updated November 15, 2022)
• Pfizer/Moderna pediatric vaccine information: de.gov/youthvaccine
• 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
• Know the COVID-19 Community Level where you live
• DPH COVID-19 Vaccine Fact Check Page to help separate fact from fiction.
• Subscribe to the COVID-19 Update podcast - on Apple Podcasts or Simplecast.  

• DPH Public Health Alerts: de.gov/publichealthalerts
• DPH Hotline - (866) 408-1899 (Monday -Friday, 8:30 a.m. to 4:30 p.m.) or DPHCall@delaware.gov
• Reporting suspected monkeypox rash in Delaware: Contact DPH Office of Infectious Disease Epidemiology (OIDE), at 302-744-4990 (business hours) or 1-888-295-5156 (after hours).
• Delaware health care facilities that require specimen collection kits can order through OEMS@delaware.gov using a SHOC Request form.
• DPH website: de.gov/monkeypox
• DPH Social Channels: Facebook (@DEPublicHealth), Instagram (@depublichealth), DHSS Twitter (@Delaware_DHSS)
• FDA Monkeypox Response Website
• CDC Monkeypox Website
• CDC Case Definitions for 2022 Monkeypox Response
• CDC Considerations for Monkeypox Vaccination for the recommended use of vaccine in the U.S.
• CDC Monkeypox Treatment Information for Healthcare Professionals
• Specimen collection: Follow Lab Advisory: CDC Updates Specimen Collection Guidelines for Monkeypox Virus