2024 Is the Year of the Dragon

According to the Chinese New Year website, Chinese New Year 2024 falls on Saturday, February 10th, 2024, and celebrations culminate with the Lantern Festival on February 24th, 2024. Celebrations last up to 16 days, but only the first 7 days are considered a public holiday (February 10th–February 16th, 2024). Chinese New Year marks the transition between Chinese zodiac signs, with 2024 being the Year of the Dragon. The Lunar New Year is observed in numerous Asian cultures including Chinese, South Korean, Vietnamese, Singaporean, Malaysian, Filipino, and Indonesian traditions. Each culture has its own name for the new year. For instance, Lunar New Year in China is called the Spring Festival, or chūnjié. South Korea refers to the Lunar New Year as Seollal. In Vietnam, Lunar New Year is called Tết, which is short for Tết Nguyên Đán. Like the Western New Year, Lunar New Year symbolizes letting go of the past and ringing in the present. Celebrations are focused on removing the bad and the old and welcoming the new and the good. The Lunar New Year is also an important time for spending time with family to show one's love and gratitude. People pay their respects to their ancestors and older family members. 

February 12-14, 2024 in Washington, DC

The American Medical Association (AMA) National Advocacy Conference (NAC) brings the power of organized medicine to our nation’s capital. Attendees are provided opportunities to connect with industry experts, members of Congress and the administration, and others about federal efforts to improve health care and advocate on crucial health care issues affecting physicians and patients. Featured speakers include:

• Donna Brazile, renowed political strategist and commentator, former interim chair of the Democratic National Committee.
• Ana Navarro, GOP strategist, political contributor to CNN and Telemundo, and co-host of ABC's The View.

The President's Lecture will be presented by Brian Miller, MD, MBA, MPH, Commissioner on the Medicare Payment Advisory Commission, practicing hospitalist at the Johns Hopkins Hospital, Assistant Professor of Medicine at the Johns Hopkins University School of Medicine, and nonresident fellow at the American Enterprise Institute. The AMA Awards Ceremony Host will be Geoff Bennett, PBS NewsHour co-anchor.

MSD will be represented by Janice E. Tildon-Burton, MD, Delaware AMA Delegation Chair; Robert J. Varipapa, MD, MSD President; and Mark B. Thompson, MHSA, Executive Director.

Updated Rules Allow Take-Home Methadone, Telehealth Use to Initiate Treatment

As part of a broader overdose prevention strategy, changes were announced to decades-old federal rules, which aim to simplify and expand access to addiction treatment in order to save more lives. Specifically, the final rule, issued by HHS, makes permanent pandemic-era flexibilities that allow eligible patients with an opioid use disorder (OUD) to receive take-home methadone doses. Studies have suggested that take-home doses improve treatment adherence and reduce patients' risk of illicit opioid use, according to a Substance Abuse and Mental Health Services Administration (SAMHSA) press release.

The new final rule also includes the following additional provisions:

• Allows the use of telehealth to initiate treatment for an OUD and to reduce transportation barriers; for treatment with methadone, audio-visual telehealth is allowed, and for treatment using buprenorphine, audio-only technologies are permitted
• Allows nurse practitioners and physician assistants to order medications in opioid treatment programs, where state laws permit such a practice
• Eliminates "stringent admission criteria," which previously restricted eligibility for treatment to those with at least a 1-year history of addiction
• Increases access to "interim treatment" by enabling patients to start medications while waiting for additional services to become available

Importantly, in January 2023, the X-waiver requirement was eliminated for clinicians who use medications to treat patients with substance use problems.

Plan to Join Your Colleagues at the Smyrna Opera House

Registration is now open 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 or not sure if you are 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. Please email resolutions to Mary.LaJudice@medsocdel.org. Plan to attend this year!

To register go to: https://reg.planetreg.com/INTERIM2024. Registration deadline is Friday, April 12 by end of business day.

Zepbound Not Listed on Shortage List

Eli Lilly & Co.’s diabetes drug Mounjaro, which is commonly used off-label for weight loss, is again in short supply due to increased demand. There will be limited availability of higher doses of the treatment (10, 12.5 and 15 milligram) through early March with lower doses shown to be available, according to the Food and Drug Administration database that tracks shortages. So far, the agency does not list Zepbound (Mounjaro's sister drug), which is approved for weight loss, on its shortage list, though the two contain the same active ingredient.

Highlighting February as American Heart Month

According to the Center for Disease Control (2023), greater than 356,000 people experience According to the Center for Disease Control (2023), greater than 356,000 people experience cardiac arrest outside of a health care facility in the United States annually, and about 60% to 80% will die before reaching the hospital. To highlight February as American Heart Month, we are announcing “The Cardiac Compression Challenge." This event is sponsored by University of Delaware (UD) Honors College, UD Nursing, and MSD's charitable foundation, the Delaware Medical Education Foundation and will take place on Sunday, February 25th from 9 a.m. to 12:00 p.m. at the STAR Health Sciences Complex Atrium in Newark. Those making it to the second round will compete after 12:00 p.m. There is no fee to register, but you must register for a 20-minute time slot in "Daysmart" registration system. Click here for scheduling instructions.

Each registrant will receive a $20 entry donation to be given to a charitable organization, such as B+, Honors College, UD Nursing, UD PT Marquette Challenge, or MSD's Delaware Medical Education Foundation.

Based on the number of compressions completed in their 20-minute session, registrants move up and then compete in the "Playoff Bonus Money - 2nd Round." The winner of this round will receive $1,000 for 1,000 compressions to be given to the charitable organization of their choice (must be a 501c3 organization). A practice station will be set up in the Health Sciences Complex Atrium from January 22nd to February 23rd. Participants may bring knee pads (recommended) and wear wrist supports.

DEADLINE TO REGISTER IS FRIDAY, FEBRUARY 16TH. Click to schedule for a time slot.

Alternating May Produce a More Powerful Immune Response

You may want to reconsider presenting the same arm for every dose of a particular vaccine. A study published in the Journal of Clinical Investigation suggests that alternating arms may produce a more powerful immune response. Investigators studied responses to the first two doses of COVID-19 vaccines and found that those who alternated arms showed a small increase in immunity over those who got both does in the same arm.

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.

There is Still Time to Register

The Physician Emeritus Section of the Medical Society of Delaware was organized to facilitate the social and educational needs of senior and/or retired physicians and their spouses. 

If you received an invitation to attend the Physician Emeritus luncheons for this year and have not yet returned your form to attend, there is still time! We have extended the deadline to RSVP to Friday March 1. If you are a member of the Physicians Emeritus Section and have not received information about the 2024 luncheons, please contact Michelle Seymour or Katie Hamilton (see contact information below).

You can call, email, fax or mail your forms and payment. We would love to see you there. Using either the Dues Paying Member form (you pay annual membership renewal fees to MSD) or the Dues Exempt form (you are exempt from paying annual membership renewal fees), you may choose to register for 1, 2, 3, 4 or all 5 event dates. A guest is also included in the fee.  Should you have any questions, please contact:

Michelle Seymour at (302) 224-4905 or via email at Michelle.Seymour@medsocdel.org; or Katie Hamilton at (302) 224-5192 or via email at Katie.Hamilton@medsocdel.org. 

Not All Flood Policies Are Equal

More than 50 years ago in the U.S., Congress entered the flood insurance arena by passing the Flood Insurance Act of 1968. This legislation established the National Flood Insurance Program (NFIP). Unfortunately, flood is a costly natural disaster. Global warming and severe weather events only increase frequent, billion-dollar losses. The NFIP’s offerings are limited and often leave homeowners with expenses to pay out of pocket. Homeowners, therefore, need to know their risk and proactively take steps to manage it. Read more.

Attract the Best and Brightest Young Talent by Joining My Green Doctor

Attracting the best young professionals to your practice is essential for your long term success. It is not enough anymore simply to offer a high salary and a reasonable work schedule. This month, the Medical Society of Delaware’s My Green Doctor explains this in a three-minute blog, “I’ll Be Joining an Environmentally Friendly Practice.”

My Green Doctor is a free money-saving membership benefit from MSD. Members use the "Meeting-by-Meeting Guide" to learn how to adopt environmental sustainability, save resources, and help create healthier communities. The program adds just five minutes to each regular office staff meeting or weekly office "huddle," making small changes at each meeting that over time really add up. Everyone in your practice can register as Partner Society members at www.MyGreenDoctor.org or at www.MyGreenDoctor.es (si, en espanol). Use the discount code MGDMSD to get full free access to My Green Doctor, save $60 instantly, and save $1,000s in the first year. Register today and watch the "Three Minute Video" that explains how easy it is to add My Green Doctor to your next agenda. You can do this!

Tackling Hypertension at the Population Level

With a patient registry, your practice can examine your entire patient population with a focus on a chronic condition, such as hypertension. The registry will aggregate the status of all the patients with that condition, making proactive care easier. Make the registry available to all clinicians during patient encounters, so your practice can see any gaps in care. Build workflows and train your entire team to use the registry.

LEARN MORE:

Toolkits:

• Patient Care Registries
• Panel Management

Resource:

• Example Chronic Care Registry Report

Podcast:

• Hypertension Digital Medicine Program

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

Traits That Make Great Doctors and Residents Can Develop

Resident physicians often aspire to be walking encyclopedias, but medical knowledge isn't the be-all and end-all of competency. Instead of aspiring to be a medical encyclopedia, resident physicians should be aiming for what’s called system citizenship. The concept is loosely defined as having the critical thinking skills and mindset to contribute to the holistic needs of individual patients, populations of patients, and the health system to achieve the best outcomes. Physicians who are system citizens, the thinking goes, are going to be most effective in the evolving system of care. Read more.

Predictions for Multiple New and New-ish Issues

Various members of the Saul Ewing LLP health law group have made their bold 2024 health care legal predictions. The group has made predictions for multiple new and new-ish issues (e.g., artificial intelligence, price transparency, and cannabis), evolving technologies (cardiac catheterizations), tried and true health law subjects (antitrust, real estate, tax, potential appellate issues, and bankruptcy), and some older health law issues (telehealth and HIPAA) that continue to evolve from an enforcement standpoint. Read the Saul Ewing LLP Health Law Practice Group 2024 predictions from various members of their practice group. Members of the firm help interested parties in the health care delivery system with transactional, regulatory, compliance and litigation issues at the federal and state level. 

What Will Health Care Look Like in a Decade?

Each year, TDC Group looks ahead to health care trends over the next decade, focusing on challenges, key lessons, and emerging risks and are committed to serving those who provide care by delivering insights into health care’s evolution to help guide the actions of medical leaders making critical decisions. This examination, though certainly not exhaustive, lays out some of the most pressing issues medical professionals must address as we look ahead. Their 2022 analysis examined the impacts of the pandemic, health equity challenges, and health care costs on the changing landscape.

Membership Renewal Was Due January 1, 2024

MSD membership renewals were due as of January 1, 2024. A reminder notice was mailed this week to those who have not yet remitted payment. Please call if you would like to set up installment payments or if your practice hours have decreased, as you may be eligible for a reduced dues rate. You can also conveniently submit payment online (login required). Your membership is important, and MSD is here to help. Contact Michelle Seymour at Michelle.Seymour@medsocdel.org or (302) 224-4905.

Velma P. Scantlebury, MD

Bayhealth hosted ‘Behind Every Wall: A Global Diversity Awareness Month celebration’ featuring guest speaker Velma Scantlebury, MD. Dr. Scantlebury is the first African-American female transplant surgeon in the United States. She has received a great deal of honors throughout her career including the “Gift of Life Award” from the National Kidney Foundation as well as the Woman of Spirit Award. To wrap up the event, Dr. Scantlebury held a Q&A along with a book signing for those in attendance. With the help of Bayhealth’s DEI Manager, Debbie Smith, and Dr. Scantlebury, Bayhealth was able to create a diverse, yet unified, speaking engagement. Dr. Scantlebury rejoined MSD in 2022 and is one of the co-founders of the Delaware Health Equity Coalition. Picture courtesy of VPScantleburyMD.com.

Brintha F. Vasagar, MD

The American Medical Association (AMA) took time to talk with Dr. Brintha Vasagar, founding director of the Bayhealth Family Medicine Residency Program. The interview discussed how she built and advanced graduate medical education at Bayhealth, the challenges she faced in establishing the residency program, how she worked to address two key health concerns, and her receipt of the Mid-Career Faculty Achievement Award in November 2023 from the Family Medicine Education Consortium. As an MSD member, Dr. Vasagar served two terms as the Young Physician representative on the Delaware AMA Delegation, as well as serving the past two terms on the MSD Council as the Bayhealth Medical Staff representative. Read the AMA interview.

Stacey M. Kuhfahl, DO - Direct Primary Care, Delta Health and Wellness

Matthew Wiltshire, MD - Anesthesia Associates, PA

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

Information on Recent Product Recalls

High Frequency Transport Phasitron Breathing Circuit Kits

Percussionaire is recalling their High Frequency Transport Phasitron Breathing Circuit Kits due to a product defect that causes over-pressurization. There are two parts of the Phasitron kit that must be pressed together during manufacturing. If one part is angled incorrectly and pressed, the part can become deformed. This causes the PEEP (positive end expiratory pressure) valve to be stuck in the closed position. When the valve is stuck, there is no way to manually release the valve. The airway may become over-pressurized potentially leading to barotrauma. The FDA has identified this a Class I recall, the most serious type of recall. Use of these devices may cause serious injuries or death.

Elevated Lead, Chromium Levels in Cinnamon Applesauce Pouches

Ecuadorian officials in Agencia Nacional de Regulación, Control y Vigilancia Sanitaria (ARCSA) have reported that Carlos Aguilera of Ecuador, the processor of the ground cinnamon supplied by Negasmart to Austrofoods and later used in recalled apple cinnamon products, is the likely source of contamination and is not in operation at this time. Additionally, according to ARCSA, the unprocessed cinnamon sticks used in recalled products were sourced from Sri Lanka and were sampled by ARCSA and found to have no lead contamination. ARCSA’s investigation and legal proceedings to determine ultimate responsibility for the contamination are still ongoing. The FDA has limited authority over foreign ingredient suppliers who do not directly ship product to the U.S. This is because their food undergoes further manufacturing/processing prior to export. Thus, the FDA cannot take direct action with Negasmart or Carlos Aguilera. FDA has no indication that this issue extends beyond these recalled products and does not have any confirmed reports of illnesses or elevated blood lead level adverse events reported for other cinnamon-containing products or cinnamon. As of February 5, 2024, FDA has not received any additional confirmed complaints/reports of adverse events potentially linked to recalled product. To date, confirmed complainants, or people for whom a complaint or adverse event was submitted and met FDA’s complainant definition, are between zero and 53 years of age and the median age is one year old. Read the full update.

Arize Herbal Dietary Supplement Capsules

“Today The World” is recalling one lot, 2107, of Arize Herbal Dietary Supplement capsules because FDA analysis has found the products to contain undeclared nortadalafil (structurally similar to tadalafil). Nortadalafil is an active drug ingredient known for treatment of male erectile dysfunction. The presence of nortadalafil in Arize makes this an unapproved new drug for which the safety and efficacy has not been established and, therefore subject to recall. Consumption of products with undeclared nortadalafil may interact with nitrates found in some prescription drugs (such as nitroglycerin) and may cause a significant drop in blood pressure that may be life threatening.

Sustain and Schwinning Dietary Supplement Capsules

“Today The World” is recalling two lots, BTH:230551 and BTH: 230571, of Sustain herbal dietary supplement capsules and one lot, Lot 2108 of Schwinning capsules because FDA analysis has found the products to contain undeclared tadalafil and nortadalafil (structurally similar to tadalafil). Tadalafil and nortadalafil are active drug ingredients known for treatment of male erectile dysfunction. The presence of tadalafil and nortadalafil in Sustain capsules and Schwinning capsules makes them unapproved new drugs for which the safety and efficacy have not been established and, therefore subject to recall. Consumption of products with undeclared tadalafil or nortadalafil may interact with nitrates found in some prescription drugs (such as nitroglycerin) and may cause a significant drop in blood pressure that may be life threatening.

Bayhealth Hospital

February 10 - ChristianaCare's Under-Represented in Medicine Pre-Med Symposium, 10 a.m.-3 p.m., John H. Ammon Education Center, Christiana Care Newark Campus.

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.

February 22 - Frank M. and Robert R. Hoopes Medical/Dental Lecture 2024, 6-8:30 p.m., John H. Ammon Medical Education Center, ChristianaCare Newark Campus. This activity has been approved for a maximum of 1.25 AMA PRA Category 1 credit.

March 5 - 2024 State of the State Address by Governor Carney, 2:00 p.m., House of Representatives Chamber in Legislative Hall. The event will be livestreamed on de.gov/sots and on the Governor's YouTube channel.

March 9 - 28th Annual Diabetes Update, 8:00 a.m.-2:00 p.m., John H. Ammon Education Center, ChristianaCare Newark Campus. Registration deadline March 1st. This activity has been approved for a maximum of 4.75 AMA PRA Category 1 credit/4.75 ABIM MOC.

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 9 - SAVE THE DATE! Delaware Cancer Consortium Retreat, 8 a.m.-3:30 p.m., Bally's Dover Casino Resort.

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

April 17 - 18th Annual Delaware Healthy Mother & Infant Consortium Summit, 8:30 a.m.-4:00 p.m., Chase Center on the Riverfront.

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 from the My Healthy Community Website (updated on Thursdays) - https://myhealthycommunity.dhss.delaware.gov/portals/flu/locations/state/seasons/2023-2024/overview
• Find a Flu Shot

• 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)