Health Care Reform: What Inquiring Medical Writers Need to Know
By Lori De Milto
The Affordable Care Act (ACA) is reshaping health care delivery and payment structures in the U.S. and is creating more opportunities for medical writers. A health economist, the head of a local business coalition on health, and an employee of an insurance company provided attendees of DVC's May 15, 2013, meeting in Ft. Washington, PA, an inside look at the ACA.
Responses to Health Care Reform
"We spend nearly $1 in $5 of gross domestic product on health care and we have crappy outcomes compared to other developed nations that spend less than we do," said health economist and management consultant Jane Sarasohn-Kahn, MA, MHSA.
In response to the increased costs of health care, employers have been adopting consumer-directed health care with higher deductibles and health savings plans. Employees now have incentives to shop around and become consumers, or as Sarasohn-Kahn calls them, "health citizens." Although entrepreneurs are stepping in to provide online tools and applications to help consumers be better health shoppers, digital literacy and health literacy are prevailing issues, she added.
Opportunities for Medical Writers
For medical writers, this means opportunities to help consumers learn about drugs, health plans, and identifying trusted sources of information online (digital literacy). "It's your job to help people be active health shoppers," Sarasohn-Kahn said. Findings from recent surveys illustrate the need:
- Forty percent of Americans don't know that the ACA is real (Kaiser Family Foundation health tracking poll)
- Fifty-four percent of working people who are insured don't want to buy a health plan; they want their employer to "feed" them a plan (Aflac®)
Additionally, disinformation, mis-information, and scare-mongering abound. People who qualify for a subsidy under the ACA are especially in need of education about health insurance and using health insurance exchanges1. "This is a full-employment act for medical writers," Sarasohn-Kahn said.
Implications of the ACA
While the ACA is far from perfect, it is a step in the right direction. "It tries to move us off the spot where a significant portion of the population doesn't have access to health care," said Neil I. Goldfarb, executive director of the Greater Philadelphia Business Coalition on Health. Goldfarb is hopeful that the kinks in the ACA will be worked out over the next few years.
At present, Goldfarb believes that employers will "stay in the health insurance game," and that they do not have much to gain by dumping employees on federal health care exchanges. He fears, however, that consumers will foolishly choose the less expensive options that offer less coverage. "There is a need to educate consumers on how to buy health insurance," Goldfarb said, who also noted opportunities to provide well-written materials for employers, who must now provide more incentives for healthy behaviors.
Insurance Companies Work with Consumers
In response to the ACA, insurance companies are getting ready to connect with the exchanges and are altering their small group products, said Dyana Tanasy, director of Strategic Initiatives at Horizon Blue Cross and Blue Shield of New Jersey. Insurance companies are concentrating efforts to avoid raising rates by 15% yearly, she said.
Insurance companies will also need to deal with consumers-a major change for them. "This is difficult because no one likes their insurance company," said Tanasy. Steps by Horizon to do this include:
- Building a retail center to give consumers information
- Putting information in plain language
- Targeting messages to specific groups.
The individual market will grow because of the ACA, but many of the uninsured who will now be covered have undiagnosed chronic conditions and do not know how to use the healthcare system. Horizon's focus groups found that uninsured people:
- Will not be able to afford silver plans
- Do not want high deductible plans.
Twenty percent of participants chose paying the penalty over buying an insurance plan. "Educating these people is so important," said Tanasy, who suggested that medical writers focus on myth busting and educating people.
An Informative Meeting for Attendees
"Panelist Jane Sarasohn-Kahn's comment that we are having a 'health citizen moment' really struck me. The healthcare landscape is changing and medical writers have an important role in this moment."
- Amy Rovi, Medivor, LLC
"The impact of the ACA is something that we need to know more about, both as medical writers and as health care consumers ourselves. The panel really emphasized the important role medical writers can play in educating consumers and businesses about how to navigate the new system and obtain or provide affordable insurance. I must say I am a bit skeptical about how much education can accomplish. The truth is that for a lot of people there really aren't good, affordable options, even with the health insurance exchanges, and no amount of education will change that. But education is still an important first step."
- Kira Belkin, PhD, freelance medical writer
About the Speakers
Sarasohn-Kahn's strategic health consultancy THINK-Health focuses at the nexus of health care and technology (visit her health policy blog: http://healthpopuli.com/).
The Greater Philadelphia Business Coalition on Health is a membership organization of employers focused on improving the value of health benefit spending by enhancing health-care quality and reducing costs.
Tanasy is developing consumer-focused capabilities to enable Horizon Blue Cross and Blue Shield of New Jersey to meet the needs of its changing customer base.
Goldfarb and Tanasy both noted that their comments were personal and did not represent their organizations.
Lori De Milto is a freelance medical writer specializing in medical marketing communications who lives in Sicklerville, NJ.
1. Entities in states that will offer a choice of health plans, establish common rules on coverage and pricing. States that don't want to build an exchange will be part of a federal exchange. Insurers will offer four levels of coverage, each with minimum essential health benefits: Bronze, silver, gold and platinum.
Learn and Network at the 2013 Annual Conference
The 73rd AMWA Annual Conference, to be held November 6-9, 2013, in Columbus, Ohio, offers many opportunities for learning, skill building, and networking.
"I attend the AMWA Annual Conference to re-energize, connect with my colleagues, and learn about the latest issues, trends, and opportunities in the field of medical communications," said Cynthia L. Kryder, MS, CCC-Sp, an independent medical communications specialist. "This year's conference schedule is so packed with new session formats and timely topics that I'm having a hard time choosing which sessions to attend." Kryder served on the planning committee for the 2013 annual conference and is leading two sessions and two roundtables.
John Smith is a first-time attendee. "I look forward to expanding my network, and learning from the large variety of sessions and workshops," said Smith, the senior manager of Strategic Scientific Communications at Novo Nordisk. Smith is presenting a session on how clients, medical communication companies, and freelancers can optimize their working partnerships.
New Ways to Learn
AMWA has introduced several new formats this year. Most are free:
- Intensive seminars: 2.5-hour-long seminars with limited attendance to optimize interactivity, such as Create Visibility and Influence to Fast Track Your Career (nominal fee)
- Topic seminars: 1-hour sessions on critical issues, techniques, or processes
- Hands-on demonstrations: 30- or 60-minute sessions where participants can practice as they learn
- Encore presentations: Recent presentations from meetings of relevant organizations
- Pro/Con debates: 1-hour sessions on two sides of an issue
- Informal discussions: Focused on lighter topics and challenges in medical communication
- Roundtable lunches: Interactive discussions over lunch on Friday, along with the usual breakfast roundtables on Thursday (nominal fee).
The basic registration fee includes access to general sessions with award-winning speakers (a keynote and a closing general session), 70 open sessions, exhibit hall, and expanded networking events.
Registering online is quick and easy. Download the conference brochure at http://www.amwa.org/events_annual_conference to read about the many choices and then follow the link for registration.
|Strengthen Your Inner Coach to Be Stronger than Your Inner Critic|
By Kathy Molnar-Kimber, PhD
Possessing self-confidence and delivering accurate work on time boosts performance -- and for freelances, referrals and repeat business. Stress and self-doubt can slow medical writing and the meticulous tasks of editing and reorganization. Maintaining focus in spite of stress can reduce the amount of time needed to complete a project. Attendees at the AMWA-DVC Business Dinner Meeting on June 13, 2013 in Langhorne, PA, found out how to "Strengthen Your Inner Coach to Be Stronger than Your Inner Critic."
The Inner Critic
Some childhood experiences likely gave us an inner voice that "can cast doubt [on our abilities], and can focus on [our] insecurities, potential failures and disappointments," explained Jane Shure, PhD, LCSW, of the Resilience Group, which offers leadership development coaching, consulting, training, and other services and is based in Philadelphia and Narberth, PA.
This inner critic may recount previous trials and tribulations from family interactions, and with teachers and other prominent adults. While the inner critic helps to organize life's experiences and avoid life-threatening scenarios, it can misinterpret situations by focusing on a specific aspect and assuming that a new situation fits the same pattern.
Messages from the inner critic usually promote procrastination, reduce efficiency, and distract focus. Stress often awakens and feeds the inner critic. Causes of stress for medical writers include looming deadlines, multiple clients (external for freelances, internal for full-time employees), addressing reviewers' comments coherently and cohesively, writer's block, perfectionism, work-life balance, ambiguous project descriptions, and challenges in maintaining the voice of the author(s).
Self-criticism or distractions from the inner critic usually fall into three areas, Shure said:
- Inner criticism (eg, "never going to get all this done")
- Self-defeat (eg, "I don't have enough education")
- Inner invalidation (making mountains out of molehills).
The Inner Coach
"Fortunately, this inner critic can be tamed with a powerful inner coach," said Beth Weinstock, PhD, a clinical psychologist and leadership specialist at the Resilience Group. A strong inner coach:
- Neutralizes the inner critic
- Sets a context for the concern highlighted by the inner critic
- Encourages excellence but not perfectionism
- Is compassionate about hard realities
- Creates safety and self-confidence to receive feedback
- Promotes ownership of strengths
- Acknowledges significance of work
- Supports assertive behavior
- Helps expand one's capacity for noticing the positive comments
- Promotes resilience
- Counteracts the general negativity.
Ways to Identify and Strengthen Your Inner Coach
Both Shure and Weinstock offered tips for identifying and strengthening your inner coach, including:
- Listening to the inner critic and noticing its patterns: the what, when, and how. The critic's conclusions may not apply to the moment. For example, a colleague using the word "resent" in an email may actually intend to have you read the word as "re-sent."
- Interrupting the negative self-talk.
- Practicing the positive messages of an inner coach.
Katherine Molnar-Kimber, PhD, is President of Kimnar Group, LLC.
DVC Announces Online Job Board
The AMWA-DVC website now includes a job board
. You can post or search for jobs and contract openings in our chapter's geographic area and for home-based positions. Anyone can see the postings at no cost. The fee for posting a job is $15 for members and $30 for non-members.
2013 Annual Business Meeting
Outgoing AMWA-DVC president Jennifer Maybin welcomed Joanne Rosenberg, MS, ELS, as president for 2013-2014 during the chapter's annual business meeting on June 13, 2013, in Langhorne, PA. Rosenberg, senior manager of Medical Writing Projects at Allergan, Inc., served as the chapter's president-elect this past year and has chaired the New Jersey Program Committee. "Joanne will bring leadership skills and a detailed approach to guiding our chapter in the coming year," said Maybin.
"Jen's leadership will be a model and inspiration to me in the coming year. Her tireless attention to detail has kept things running smoothly all year," said Rosenberg. "I look forward to working with the talented elected officers and enthusiastic chapter volunteers, and hope you'll join us in making this a successful year for AMWA-DVC."
Eileen McCaffrey is now president-elect and Amy Rovi is now treasurer. Maybin continues on as past-president.
McCaffrey has been a freelance medical writer and editor since 1993. Before that, she was editor of IM-Internal Medicine, a clinical review journal, and an account supervisor and medical services specialist in the healthcare group of an Omnicom agency (Porter/Novelli) in New York. She was also the first senior editor for AIDS Patient Care. McCaffrey has been an AMWA member since 1988. She has been an active member of the New Jersey program committee and was chapter secretary from 2010 to 2012.
Rovi has more than 20 years of experience in medical education, training, and corporate pharmaceuticals, and is currently owner of Medivor, a medical communications and consulting business. Prior to establishing her own business, she held many scientific, marketing, and management positions at Merck & Co., Inc. and Wyeth Pharmaceuticals. Rovi has been an active member of AMWA-DVC since 2007. She has served as editor of the chapter newsletter and designer/co-chair of the e-Communications committee, and has been a member of the finance and program committees as well. She has also facilitated roundtable discussions.
Rewarding Special Volunteers
Maybin presented awards to two DVC volunteers who have made considerable contributions to the chapter:
- Janet Manfre received the President's Award.
- Kate Casano received the Dollars & Sense Award.
As the chapter's website chair, Manfre worked double-time this year in response to many requests to create new areas of the website, including the Jobs section, and to make many other changes and updates. Manfre also worked closely with the E-Communications Committee, coordinating web postings about upcoming events. She was previously Pennsylvania Program Committee Chair. "What makes her dedication surprising is that Janet no longer physically resides in our chapter but has chosen to remain loyal to our DVC chapter because of her long-standing ties to the people and the area," said Maybin.
AMWA-DVC created the Dollars & Sense Award for Kate Casano, in recognition of her outstanding contribution to the chapter as treasurer for nearly four years and across the terms of more than three DVC presidents. "Kate has made reviewing the financial health of our chapter easy for our executive committee. This special award was created to thank Kate for her financial dedication as well as her common sense approach to other chapter business," said Maybin.
Recognizing 2012-2013 VolunteersDelawriter
Amy Rovi, Chair
Alan Struthers (Chair for part of year)
Nick Sidorovich, Co-Chair Brian Bass, Co-ChairDawn Salamon
Janet Manfre, Chair
Ana Maria Rodriguez-Rojas
Kate Casano, Chair
Julie Munden, Co-Chair
Dawn Salamon, Co-Chair
Lori De Milto
Cynthia L. Kryder
Cynthia M. Shaler
Karen Todd-Jenkins, Chair
Kent Steinriede, Chair
Darryl Z. L'Heureux-E-Communications
Jennifer Maybin, President
Joanne Rosenberg, President-Elect
Cyndy Kryder, Past President
Kate Casano, Treasurer
Beth Pulaski, Secretary
Volunteers received Amazon gift cards as a token of appreciation for their ongoing service to the chapter.
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Published quarterly by the American Medical Writers Association-Delaware Valley Chapter
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Editor: Lori De Milto
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