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In this Issue:
- Message from the Governor
- ACP-New Mexico Health and Public Policy Committee Update
- Spring 2023 Resolution Feedback Requested
- ACP Early Career Physicians Webinar Series
- Join the New Mexico Chapter of the American College of Physicians at Leadership Day 2023 in Washington, D.C.
- How ACP Members Can Support Current Disaster Recovery and Aid Efforts
- New Video Series Highlights DEI Grant Projects Funded in Partnership with ACP
Heather C. Brislen, MD, FACP, ACP Governor
Message from the Governor
Dear Colleagues –
If you are reading this, you do not need to hear from me that our health care system has major flaws, and that our local health resources are strained – sometimes to the breaking point. As we emerge from the COVID public health emergency, it's heartbreaking to see that things that were never truly adequate have become scarcer – that familiar struggles are in many ways even more difficult.
On the other hand, I find the legislative sessions to be consistently exciting, reassuring, and a cause for optimism. The number of passionate stakeholders from all over the state that are willing to volunteer their time and energy to try to improve the way that New Mexico runs is a good thing! (Even if we don't always agree on what needs to be done.)
This newsletter is a compilation of current events and happenings. I hope that you will find it interesting and informative.
Before diving in – please take a moment to SAVE THE DATE! Our annual Internal Medicine Scientific Meeting – will be November 10-11, at the El Dorado Hotel, in Santa FE.
A past ACP-NM governor, Dr. Howard Gogel FACP, is also a long-time member and councilor to the New Mexico Medical Society and Greater Albuquerque Medical Association. Below, he shares a letter to the editor of the Albuquerque Journal which was published Monday, January 30, 2023.
NM needs to act quick to attract and keep physicians - State lawmakers need to shore up Patient Compensation Fund
BY HOWARD K. GOGEL, M.D.
SOUTHWEST GASTROENTEROLOGY
Access to medical care in New Mexico is inadequate. This is a longstanding problem, but now may well be at a tipping point.
The first step in solving a problem is recognizing and accepting its severity. It is quite difficult for many New Mexicans to get and keep a primary care doctor. According to the NM Health Care Workforce Committee 2022 annual report, as of 2021, there are 308 fewer primary care physicians in New Mexico today than in 2013 and 711 fewer than in 2017. And, compared to 2013, obstetric care 37 fewer doctors; surgery, 20 fewer general surgeons; and behavioral health, 12 fewer psychiatrists; are also difficult to access.
These decreases are despite a modest population increase coupled with aging, COVID, obesity and increases in medical technology. Twenty-five percent of New Mexicans have a personal health care provider, state rank No. 43. The average age of physicians in New Mexico is 53, so we can predict increasing shortages as retirements occur.
Certain specialties are exceedingly difficult to access: neurology, endocrinology, rheumatology, and several pediatric specialties, to name a few. Shortages are more severe in rural areas. In urban counties, some specialties meet benchmark numbers, but these numbers do not take into account all of the folks who drive into town for care.
Wealthy New Mexicans often go to neighboring states for medical care. Because of physician shortages, we have a two-tier system. New Mexicans who are not wealthy should be able to get what they deserve right here: timely access to quality, affordable care.
While there are doctors who have been practicing in N.M. and have stayed for years, this is only part of the equation. We need health care professionals to want to come to New Mexico, and we need those who are trained here to stay after graduation. Only 40% of New Mexico residency graduates stay in New Mexico. The national average is 47%, and we rank No. 37 as a state in retaining our graduates.
Hospitals and clinics have a hard time recruiting. Online medical magazines rank New Mexico in the bottom five among states for “best states to practice medicine.”
It should be agreed that changes are required. While universal health care is an interesting and promising approach, we should work hard to fix the shortfalls of our present system as, at best, it will take time to establish functional universal care. And universal coverage will not mean universal access if there are not enough health care professionals.
The second step in problem solving is recognizing specific steps and urgency. There are several areas relevant to physician recruiting and retention that require urgent attention: 1) the medical malpractice environment in New Mexico, state funding for the Patient Compensation Fund deficit and accurate classification of health care facilities are important steps; 2) increased funding for Medicaid; 3) eliminating the gross receipts tax on medical care, New Mexico is one of only two states with this tax; 4) delays in physician credentialing; 5) preauthorization requirements; 6) improvement in residency graduate retention; 7) student loan forgiveness; and 8) practice establishment support.
Some of these are being engaged by our Governor and Legislature, but all of these areas deserve positive action. The complexity is necessary and important, and the outcomes of these considerations will affect the health of New Mexicans for years to come.
Copyright (c) 2023 Albuquerque Journal, Edition 1/30/2023
ACP-New Mexico Health and Public Policy Committee Update
Amanda Collar, PhD, MSII, co-chair
All policy has the potential to be health policy, affecting the wellbeing of our patients. With a month left in the New Mexico 56th Legislature session (ending March 18, 2023) and numerous bills that affect our medical practices, we'd like to provide an abbreviated overview of legislature that has been introduced. If you'd like to contact your state representatives in support or opposition to a particular bill, you can find their contact information here. You can also see the status of any of these bills here.
- Menstrual Product Availability in Public Schools
HB 134 would require the Public Education Department provide free menstrual products in public school restrooms (including elementary schools, middle schools, junior high schools, and secondary school/high school), with an appropriation totaling $3 million. This would be a big step toward addressing period poverty in New Mexico. ACP has recognized that insufficient access to period products poses a threat to public health and supports access to affordable menstrual hygiene products. As I stated in an OpEd in the Albuquerque Journal, “Let's put our children first. Period.”
- Sexually Transmitted Infections
SB 132 aims to eliminate cost-sharing requirements for preventive care and treatment of sexually transmitted infections. New Mexico has higher rates of certain STIs like chlamydia and syphilis than the national average and disparities among those affected with STIs persist, with adolescence and young adults of reproductive age and racial minorities (like Indigenous and Black/African American) and Hispanic populations bearing the largest burden. ACP Internist published an article discussing the complacency, but also what Internists can do to help curb rising STI trends. Although the advice focuses on taking a comprehensive sexual history on all patients, any legislation that could reduce barriers to screening, prevention, and treatment could also make a difference.
- Reproductive Healthcare
HB 7 is an answer to many other state's legislature limiting reproductive healthcare by providing protect to access to comprehensive reproductive healthcare within the state of New Mexico. The bill includes language to protect psychological, behavioral, surgical, pharmaceutical and medical care, and services and supplies related to human reproductive services like preventing pregnancy, abortion, managing pregnancy loss, prenatal through postpartum health, menopause, fertility, cancer, and STIs. ACP believes in patient autonomy on matters affecting a patient's health and reproductive decision-making rights and agrees that women deserve access to comprehensive reproductive healthcare. An ACP Internist Q and A with Dr. Sue Bornstein discussing the effect of Dobbs v Jackson Women's Health Organization on medicine and an Ideas and Opinion piece by Amanda L. Collar have both been recently published.
- Gender-Affirming Healthcare
Likewise, HB 7 also answers attacks on gender-affirming and transgender healthcare, by providing protections within the state of New Mexico. The legislation defines gender-affirming healthcare as psychological, behavioral, surgical, pharmaceutical and medical care, services and supplies needed to support a person's gender identity. ACP recently discussed its appall at anti-LGBTQ+ legislation and legislation that bans gender-affirming care and opposes such restrictions.
- Malpractice Act & Physician Shortage
There are myriad bills related to these two issues. SB269/HB88 are the most crucial of those directed at fixing the malpractice act. See below for a summary of media coverage and physician statements) Others include:
SB7 Rural Health Care Delivery
HB 47 Rural Health Care Project Revolving Fund.
HB 278 Higher Education Funds to Address Physician Shortage.
SB 88 Medical Students Practicing in Underserved Communities.
SB 111 Temporary Suspension of Licensing Fees.
SB 245 Rural Emergency Hospital Designation.
The news media in Albuquerque and around the state has put out a ton of coverage related to health care since the session started this year. Below is a list of pieces related to flaws in our medical malpractice law and the physician shortage compiled by our colleagues at NMMS, including links to the articles or broadcasts.
(On a personal note, if you are not already a member of your county medical society and NMMS – please consider joining! It is a great way to build community with your physician colleagues beyond just internal medicine. These groups are wonderful for keeping up with local health care issues. More at NMMS.org )
January 30th - NM Needs to Act Quick to Attract and Keep Physicians – Howard K. Gogel, M.D. – Southwest Gastroenterology
February 4th – Doctors Flee New Mexico – And More Are Expected to Follow – Ryan Boetel, Journal Staff Writer
February 5th - Physicians say unless systemic changes are made, situation will only get worse - Ryan Boetel, Journal Staff Writer
February 5th – Untangling the Policies and Politics of New Mexico's Medical Malpractice Law – Dan McKay, Journal Staff Writer
February 5th – Recent Laws Are Driving Health Care Providers Out of New Mexic – Kristina Chongsiriwatana, M.D. – Albuquerque Physician
February 6th – Paying for Future Medical Care – Merilee Danneman – Carlsbad Current Argus
February 10th – 4 Investigates: Doctors Warn Malpractice Changes Could Drive Providers Out of New Mexico – Matt Grubbs, KOB Reporter
February 11th – NM Lawmakers Need to Stop Doctor Exodus to Resuscitate Health Care System – Albuquerque Editorial Board
February 12th – Trial-Attorney Win Hurts NM Doctors and NM Patients – Nathaniel Roybal, M.D., Albuquerque Physician
February 12th - HB 75, as is, will end affordable, life-saving kidney care in NM - Jayant Kumar MD, President , Renal Medicine Associates, Albuquerque
The NM Human Services Department (HSD) and Primary Care Council (PCC) are sharing updates and opportunities to participate in upcoming activities:
- The New Mexico Primary Care Council 2023 Strategic Plan can be accessed HERE. Public comment on the plan can be sent to nmhsd.oos@hsd.nm.gov
- The New Mexico Primary Care Payment Model Provider and Clinician Readiness Assessment can be accessed HERE. Public comment on the assessment can be sent to nmhsd.oos@hsd.nm.gov
- To sign up for email updates related to Medicaid Primary Care payment reforms, please go to: https://bit.ly/nmhsd_primarycareupdates
- To pre-register for a one-day Primary Care Medicaid Payment Workshop to be held June 2023, please go to: https://bit.ly/nmhsd_pcworkshop
- Frequently Asked Questions about Medicaid primary care payment reforms can be found HERE.
Questions about the Primary Care Council can be directed to Elisa Wrede, Project Manager, Food Security & Primary Care, Office of the Secretary -Human Services Department - 505-231-2630 (cell)
In closing, remember that you can have a role in advocacy that can big large or small. Talk to your patients about the frustrations you share. Contact your state representatives in support of - or opposition to – legislation that you find important here. Read below for spring ACP resolutions – the chapter needs your feedback so that we can advance the national policy platform of ACP. We want to hear from you! If there is anything you need from the chapter to help you get the best for your patients, please reach out.
Heather Brislen, ACP-NM chapter governor
Don't forget to SAVE THE DATE! Our annual Internal Medicine Scientific Meeting – will be VETERANS DAY WEEKEND – Friday and Saturday, November 10-11, at the El Dorado Hotel, in Santa FE.
Spring 2023 Resolution Feedback Requested
We would like to request your feedback regarding resolutions that will be considered at the Spring 2023 Board of Governors Meeting. The resolutions have been posted on ACP Online . for your review and cover an array of topics such as advocating for universal insurance coverage of obesity treatment, promoting research on the public health impact of extreme risk protection orders (ERPOs), and advocating for concurrent disease targeted and hospice care.
*click each individual resolutions to read/submit feedback
After considering the intent of each resolution and how it fits with the College's Mission and Goals, please provide your feedback on each resolution and indicate your support or opposition by completing the electronic response form by March 22. Your input will be used as part of testimony on behalf of the chapter.
ACP Early Career Physicians Webinar Series
Avoid Hemorrhaging Cash: How Your Employment or Service Agreement Should be Negotiated to Protect Your Finances, Family and Future.
March 22, 2023 Virtual Session @ 5:30pm MT
Save the Date for future webinars!
Building a Solid Financial Foundation on May 11th
Your Investment Portfolio: Taking a Strategic and Systematic Approach on May 25th
Join ACP New Mexico and Colorado Chapters at our Reception on Friday, April 28th at 6:00-8:00pm at Lou and Mickey's San Diego.
RSVP Here
Join the New Mexico Chapter of the American College of Physicians at Leadership Day 2023 in Washington, D.C.
May 23-24th, 2023
The New Mexico Chapter is again sponsoring members to attend. Attendees will receive up to $1250 travel stipends for up to two attendees from the following member categories: student, resident/fellow, early career physician (less than 10 years out of training) (2 Total Attendees) Participants receive a comprehensive orientation and briefing on ACP's top legislative priorities and then have an opportunity to meet with legislators and the staff on Capitol Hill.
To enter please submit your response (500 words or less) to the following: “Why is physician advocacy important to you? What do you hope to accomplish by attending ACP Leadership Day?”
Essays should be submitted no later than March 5, 2023.
Submission Link HERE
General information regarding Leadership Day 2023 can be found HERE
How ACP Members Can Support Current Disaster Recovery and Aid Efforts
The earthquakes in Turkey and Syria are being described as the worst in that area in a century. ACP members who wish to provide support in the recovery efforts can help via these organizations.
- The U.S. non-profit Bridge to Turkiye has a history of supporting cultural and educational initiatives in Turkey, and is working on providing food and water through the Turkish aid organization, Ahbap Association
- The Syrian American Medical Society, SAMS, a U.S.-based humanitarian agency that works in Syria and related regions, is providing medical aid to victims and hospitals in Northwest Syria.
New Video Series Highlights DEI Grant Projects Funded in Partnership with ACP
A new series of interview-style videos covers the progress of projects that have received grants from the American Board of Internal Medicine (ABIM) Foundation's 2021 Building Trust Through Diversity, Health Care Equity & Inclusion in Internal Medicine program. The grants are funded by the ABIM Foundation in partnership with ACP and other medical organizations.
The first video in the series features Dr. Karina Whelan discussing a new curriculum she is creating for the University of North Carolina that implements a health equity-focused quality improvement project for medical students. The first video is available to watch on the ABIM Foundation YouTube Channel .