March 2022 - Medical Association of the State of Alabama

Discussion with House Candidate Dr. David Cole

Posted by Christina Flack on March 24, 2022

Dr. David Cole – a member of the Medical Association and a candidate supported by the Alabama Medical PAC (ALAPAC) – is running for Alabama House District 10 in the Huntsville/Madison area. HD 10 is an open seat as the incumbent is retiring. He is running unopposed in the republican primary and will face a democrat candidate in the November General Election. Dr. Cole is a military trained medical professional, with senior executive management experience in Occupational and Aerospace medicine. Cole earned his M.D. from the University of Arkansas and completed his surgical internship in general surgery at Walter Reed Army Medical Center. Cole is a highly decorated military veteran, with a history of service in several overseas missions. He held the position of Chief Medical Officer at Fox Army Health Center on Redstone Arsenal for four years before taking the position of Medical Director for Huntsville Hospital’s Occupational Health Group.

What first prompted you to consider running for office?

My adult life has been in service to the country through the military and as a physician. After doing that for 22 years, I thought that I had done my bit, but I think one of the things about being a physician and serving in the military is that we are unique and geared to service and that service mentality is engrained in our DNA. When I saw that Rep. Mike Ball was retiring and looked at some of the bills in the legislature and found out there is no physician in the house I decided to run for the 10^th district (after talking to my wife).

How will your background help serve you in the Legislature?

It comes from 2 perspectives – in the military there is a lot of collaborative work. You can’t get something done by yourself and so you have to learn to run your ideas by others and get them to agree – and if they don’t agree – you talk out your differences. Medicine is the same way. Medicine is an art as well as a science. Not everybody does things the same way, but the desired end result is the same. As long as you have a servant mentality you will be in a good place to help your constituents.

If elected you will be the only physician in the House, what impact do you think that will have?

One of the things I want to do is to be a sounding board for legislators who have health care related ideas. Health care is a broad topic. Being a physician is unique in health care because it incorporates a lot of different modalities and we have to have a holistic approach. Also, as a physician I will be able to give my professional opinion on major health care issues to my colleagues.

What are some of your legislative priorities if you are elected to office?

My top legislative priority is parents’ choice for school. I believe that parents have a right to decide things for their children. I also want to protect small business and state farmers. Also, improving and adding roads and infrastructure in my district. The Huntsville and Madison area is growing leaps and bounds.

What are some health-related issues important to your district?

We have a robust healthcare system in N. Alabama and the Huntsville area. I will say that it’s probably the largest after Birmingham. I’m very proud that there is a family practice and internal medicine residency in Huntsville. I would like to see more training programs for residencies in Huntsville. I think it can’t be stressed enough how proud I am of the health care professionals that endured through this pandemic in the face of so much adversity. Health care professionals in Alabama are the unsung heroes. I want to make sure that the primary care specialties are beefed up. As far as state wide, I think we need to get a preventive medicine program at UAB. I do know the Medical Association’s supported Telehealth legislation is also a good bill. Technology is evolving but, physicians still need to lay eyes on patients. In person visits are integral to health care.

What do you think people understand the least about our health care system?

Insurance. Is this certain thing covered, or not covered; is this a co-pay, or not a co-pay. Sometimes patients do not know if something is covered when they are receiving a treatment. Also, some patients’ expectations are based on a 1950s model. Patients are sometimes confused by what the 21st century healthcare model looks like.

If you could change anything about our state’s health care system, what would it be?

I see – and most physicians would agree – that some areas in the state lack access to health care. I think investing in rural health care is important for the future of Alabama. Area health care educational centers are becoming a big thing and other states are doing that. We should take a look at that with the help from congress and our federal government partners.

How can the Medical Association – and physicians statewide – help you address Alabama’s health challenges?

I think it is very unique that our specialty society’s have a wide depth of knowledge and work well together with the Medical Association. As a physician it helps to be armed with all the information. Also, I would really like to meet all the members and get more input from them.

What is the one thing you would like to say to physicians in your district?

I need your support, financially and at the voting booth. Health care is very tenuous in our state. As a physician and a member of the house I want to be the voice for them and for medicine in the Alabama Legislature. The November election will be tough and I will need all the support I can get.

To learn more about Dr. Cole’s campaign, please click here.

Posted in: Advocacy, ALAPAC

New Rules Replace Old Guidelines on Medical Record Management

Posted by Mallory Camerio on March 23, 2022

The Board of Medical Examiners and Medical Licensure Commission recently made substantial changes to their joint guidelines for medical record management, beginning with changing them from guidelines to rules. The new rules provide for more specific regulation of the management of medical records by Alabama physicians, including establishing a new minimum time frame for retention and appropriate methods for destruction of records, providing expanded criteria for patient notification when closing or leaving a practice, and detailing the steps for disposition of medical records in a variety of practice departure scenarios.

The previous guidelines recommended physicians retain patient medical records for “such period as may be necessary to treat the patient, and for such additional time as may be required for medical legal purposes,” without establishing a minimum time frame. The new rules provide that physicians must retain patient medical records, with some exceptions, for a minimum of seven years from the physician’s last professional contact with the patient. For records of minors, including immunization records that have not been transmitted to ADPH’s Immunization Registry, the rules require retention for the longer period of seven years from the last professional conduct or two years after the minor reaches the age of majority. Mammograms and reports must be retained for ten years, but x-rays and other imaging may be destroyed after five years if separate written reports exist.

Although the previous guidelines did address retention of records, if not in a detailed manner, they did not address destruction of medical records at all. The new rules list appropriate methods for destruction of records and also require the maintenance of a destruction log.

Recommendations for transfer or disposal of medical records in the previous guidelines included the responsibility of physicians to provide “reasonable notice” to “active patients” when the physician retired or otherwise left a medical practice. However, the guidelines provided no definition or detail for either of those terms. The new rules define “active patients” as any patients treated by a physician at least once in the preceding 36 months. “Notification” is defined as a HIPAA-compliant electronic message or form letter sent U.S. mail to the active patient’s last known address. The “reasonable” qualifier for notification from the previous guidelines has been quantified in the new rules as “no less than 30 days” before a qualifying event like retirement or after the death of a physician.

While the previous guidelines provided the same basic guidance for notification and disposal of records – reasonable notice to active patients – regardless of whether the qualifying event was retirement, termination from employment or otherwise leaving a practice, the new rules provide specifically for notification and disposition of medical records in the following circumstances: (1) Physician death; (2)Physician retirement; (3) License suspension or revocation; (4) Departure from a group; and (5) Sale of a medical practice. The new rules also require physicians to make arrangements for patients to access their records when voluntarily unavailable.

Physician members with questions on the new Board of Medical Examiners and Medical Licensure Commission Joint Rules on Medical Records Management can contact the Association’s Legal Department at 334-954-2540. They can also find all of the requirements of the new rules here: https://www.albme.gov/resources/licensees/medical-records/

¹Ala. Admin. Code 540-x-9-.10; Ala. Admin. Code 545-x-4-.08.

Posted in: Uncategorized