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News & Information From El Paso County Medical Society

March 2012

Greetings!   

The El Paso County Medical Society invests our time and resources to be a resource to you.  Local initiatives and national headlines is what we have for you in this issue.

Public Health

Did you know that in 2011 child abuse deaths that came to Memorial Health System increased 700% from the previous year? Would you like to be a part of the community that puts a stop to this rise? The El Paso and Teller County Child Abuse Task Force is working rapidly to address this crisis.

There is a hospital and physician system subcommittee collaborating to create a standard of care for all families so they can learn how to handle a crying baby, choose appropriate caregivers, and reach out for help when necessary. If you would like to be an active participant or be on an email list for further information, please call or email Sally Duncan at 719.365.6978 or sally.duncan@memorialhealthsystem.com

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Healthy Technology 

Check-Up: SGR

Physicians will receive a ten month reprieve from a 27 percent Medicare pay cut under legislation approved by Congress on February 17, 2012. The cut was scheduled to go into effect March 1st, and the payment freeze (and current conversion factor of $34.0376) will remain in effect through December 31, 2012.

Only $20 billion of the cost was covered in the bill with the remainder to be paid for through higher cuts in future years, including a 32 percent cut in 2013. The AMA, Colorado Medical Society, and El Paso County Medical Society have consistently called on Congress to repeal the flawed SGR formula.

Colorado Senators Mark Udall and Michael Bennet both voted to pass this bill, which is expected to be signed into law By President Obama. Representative Doug Lamborn voted no on this bill. 

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What's News With You

These physicians recently added their voice to EPCMS, and became members of this dynamic, local medical society.  Click To Continue

Committee Corner

By Stephen C. Telatnik, M.D., Member EPCMS Ethics Committee and Pikes Peak Forum for Health Care                      

In every primary care physician's practice there may be frail elderly or chronically ill patients who have physician orders for life-sustaining issues not written by their current provider. These orders may have been initiated during admission to nursing facility or hospital.  The document, Medical Orders for Scope of Treatment (MOST), has been introduced to these institutions since August 2010 when the state statute went into effect.  All physicians should become familiar with this effective tool to assure patient's wishes regarding end of life issues.

The one page, two-sided MOST form summarizes patient preferences in four areas of medical treatment which might be relevant to an emergency or end-of-life situation: CPR, scope of treatment, artificial nutrition/hydration, and antibiotics. Check-box choices are offered by which persons may refuse treatment, request full treatment, or specify limitations.

The MOST form is intended for use by individuals who are in frequent contact with healthcare providers due to a chronic, serious, advanced, or terminal illness.

When signed by a physician, advance practice nurse, or physician's assistant, this summary of patient preferences becomes "portable" medical orders which "travel" with the patient and are honored by any provider in any healthcare setting: by EMS at home, in the community or a nursing facility; in the ER; in the hospital; in rehab or long term care.

The portability of the form allows seamless documentation of treatment preferences and closes gaps as patients transfer from setting to setting or experience delays in access to providers. The latitude of authorized signers (physician/NP/PA) allows prompt documentation of preferences in rural regions or areas where physicians and healthcare services are scant.

The original is brightly colored for easy identification, but photocopies, faxes, and electronic scans are also valid. A section on the back prompts patients and providers to regularly review, confirm, or update choices based on current conditions.

The MOST does not replace advance directives. Living wills or Medical Durable Powers of Attorney may contain instructions on issues not addressed in the MOST. The MOST form should be completed and updated to be consistent with any advance directives. In case of any conflict between a person's MOST form and his or her advance directive, the most recent document prevails. The MOST may be revoked at any time by the person or, if the person lacks capacity to make decisions, by his or her agent.

The MOST is based on the POLST (Physician's Orders for Life Sustaining Treatment) Program which was pioneered and is sustained in Oregon. Colorado's MOST Program was recently endorsed by the National POLST Paradigm Task Force. The Colorado Advance Directives Consortium (CADC) was instrumental in investigating POLST, tailoring the program to the needs of Colorado, and bringing MOST before the Colorado legislature successfully. The EPCMS Ethics Committee was actively involved in CADC deliberations regarding MOST. Many organizations, including the Pikes Peak Forum for Health Care, are working state wide with CADC to provide education and support of MOST. Visit the CADC website  for further information.

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Medical Office Furnishings For Sale. AgeWell Medical Associates has an EKG machine, waiting room chairs, task chairs, artwork, etc. , available.  For more information, contact Lori at 719.471.7160 or email lorit@cssm.us

Allergy practice looking to expand into Briargate area two days per week only.  Beginning late-spring 2012, we would like to sub-lease your Briargate clinic space long-term for two full days a week.  Call Dave Root at 634-1741 or e-mail AllergyDrs@AACOS.com