Archive for Advocacy

Physicians Perspective: Dr. Chris Adams Talks Telemedicine

Physicians Perspective: Dr. Chris Adams Talks Telemedicine

Adversity and necessity mandate invention. 

During the COVID-19 pandemic, telemedicine has been transformed almost overnight into a necessary medical tool for remaining connected to our patients.  Without warning, physicians suddenly found themselves in the position of adding communication technologies, learning regulatory requirements, and adapting to an entirely new way of interacting with patients, sometimes reinventing their standard clinic procedures.  Similarly, government and private health care had to modify longstanding obstacles and prohibitions by allowing interstate practice and revising reimbursement policies.

I doubt there is a physician in our state who believes they could have managed their patients through this pandemic without the benefit of telemedicine.  Having said that, telemedicine is not a panacea. 

Practicing in a rural environment, we have discovered that bandwidth challenges are a huge issue.  Older patients also have vision and hearing challenges that make telemedicine less effective than face-to-face visits.  There is still an enormous amount of paperwork involved in conducting a telemedicine visit, it is not simply a matter of “picking up the phone and chatting.”  That is one reason why it is so important to have parity for video and telephone encounters. 

Despite these challenges, most clinicians would like to maintain the availability of this tool as we continue our social and medical confrontation with coronavirus.  At the same time, we also recognize inherent limitations that telemedicine imposes (I just cannot do a good knee exam over the telephone).  The challenge we now face is to define and refine best practices for employing telemedicine.  Part of this effort will require continued advocacy and encouragement of health delivery systems to support telemedicine.  Some of this will also necessitate new legal safe guards for practitioners employing this tool.

As you reflect on how this pandemic has changed your practice, please consider how you can support and contribute to the future of medicine in our state by advocating for your patients and your practice.  It is up to us as clinicians to help mold the future of healthcare delivery.

Posted in: Advocacy, Coronavirus, Members, Technology

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Discussions with Decisionmakers: Senator Dan Roberts

Discussions with Decisionmakers: Senator Dan Roberts

1. Please tell us a little bit about yourself – Primary occupation? Interests? Hobbies?

Growing up, my family moved around a good bit, and we lived as far north as Buffalo, New York, and as far south as Mobile, Alabama. That said, I finished high school in Birmingham and went on to Auburn University where I obtained a degree in Building Science Construction. Following undergrad, I worked in construction for Blount International and worked in South Korea and Saudi Arabia.

I returned to the U.S. to obtain a Masters Degree in Real Estate Development and Urban Affairs from Georgia State. In graduate school, I started our own company doing international trading in South Korea and Pacific Rim countries. I started a real estate sales and development firm based in Birmingham, which I continue to do today.

As far as hobbies go, our seven grandchildren (from our three sons) take up most of our free time my wife and I might have. We enjoy hunting, fishing, and farming, and are blessed to have developed a Treasure Forest and tree farm in central Alabama.

2. What first prompted you to consider running for your Senate District seat and how do you believe your background and experiences help you serve in the legislature?

From an early age I have had an interest in politics and policy. From serving on the Student Government Association in both high school and at Auburn, as well as holding positions in organizations like Fellowship of Christian Athletes and Campus Outreach Brazil, I have a passion for being involved.

In addition to my background in real estate development and international trade, I have also invested in various companies and served on various boards across Alabama. All of these experiences have given me a unique outlook on cultures and markets and, in turn, a unique outlook on legislative policy.

3. During the last legislative session, you were a leading voice in bringing awareness to the need for expanding access and funding for telemedicine in Alabama.  Tell us a little about why this issue is so important to you. 

I’ve been fascinated with the field of medicine nearly my entire life. Not only does healthcare play a major role in my district, I also have many friends and family who work in the healthcare sector.

As far as telemedicine goes, I really was not aware on the impact this type of technology plays (and can play) in healthcare until I was elected to the Alabama Senate. While telemedicine has always been out there, I had never thought of it as a legislative opportunity to help address healthcare needs and disparities.

4. This pandemic has led to the rapid expansion and adoption of telemedicine both statewide and nationally. How do you believe it’s impacted Alabama patients and do you foresee these changes become permanent?

The rapid expansion of telemedicine has given physicians another tool in their tool chest to provide quality care to patients throughout the state. Still, we must ensure that the strides made during this pandemic – both for telemedicine and healthcare in general – do not diminish. To do this, we must ensure that physicians are adequately reimbursed for telemedicine visits if we are going to see this adoption remain and grow. We must also expand our broadband connectivity access to all areas of the state.

We are at the infancy of Telemedicine in our country. I believe that with the right vision and adoption we will see explosive growth in technology, patient adoption, Physician and patient benefits which will result in better patient health, cost savings, a more efficient health care delivery system. We will all be amazed in 2030 with what we have accomplished in Telemedicine.

5. If you could change one thing about our state’s health care system, what would it be?

Overall, we as a state need to be in better physical shape whether it be related to obesity, smoking, exercise, etc. It’s no secret that we’re not the healthiest state in the country. I know it’s a broad answer, but I would change how we think about and address personal health. 

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

A big role the Medical Association can play right now is continuing to push for increased telemedicine access and appropriate provider reimbursement. The Association can help us by ensuring future policy positively impacts physicians in all specialties, in all practice types and sizes, and all areas of the state.

While we’ve made progress, our progress will not become permanent without the input and advocacy from physicians. Physicians’ voices are heard through the Medical Association and that needs to continue.

7. What’s the one thing you would like to say to physicians in your district?

First of all, thank you for the untold hours you have spent in and out of hospitals and your offices. I know there are no scheduled hours for physicians, and those “hey doc” calls come
at all times.

To those on the front lines of this fight – whether it’s battling COVID-19 in the hospital or seeing patients in your office – thank you for your commitment to the profession and your patients. Many of you have put work over family, constantly risking your health so that others may have healthcare. Then leaving work trying to not take COVID 19 home with you.

We will get through this pandemic, and hopefully, we will be better able to address situations in the future. We will be better off for having fought this season, but we still have challenges and we must work together to be successful in the future.

For now, I would simply like to convey a heartfelt ‘Thank You’ to all the physicians and healthcare workers. You are inspirational to us all. Thank you.

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Physicians’ Perspective: Dr. Lindsay Robbins & Funding the MMRC

Physicians’ Perspective: Dr. Lindsay Robbins & Funding the MMRC

The Alabama Maternal Mortality Committee completed its inaugural year, reviewing a full year’s worth of maternal deaths in the state of Alabama. During the review process of each maternal death, the committee ensures that the cause of death is recorded correctly, weighs in on whether or not the death was preventable, and makes recommendations to prevent similar deaths in the future. The Alabama Perinatal Quality Collaborative, a separate entity, will use the MMRC’s recommendations to implement state-wide changes and reforms so that together we can improve reduce maternal mortality and morbidity in the state of Alabama.

The work we have done this year has been incredibly eye-opening. While formal data analyses are not yet available, trends became clear over the course of the year. We need better infrastructure to provide mental health care before, during, and after pregnancy; substance use continues to be a major issue for the women of our state; and we absolutely must keep a laser focus on ensuring that equal care is available to all women regardless of race, ethnicity, geographic location, insurance status, socioeconomic status, disability status, or citizenship.

We are very grateful for the funding recently allocated to this committee so that the work can continue. We need to continue to track these tragic cases so we can find ways to reduce the rates of maternal mortality in the future. Funding and support must continue until preventable maternal deaths no longer exist.

Dr. Lindsay Robbins, MD, MPH

OB/GYN, Maternal-Fetal Medicine Fellow

University of Alabama at Birmingham

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Discussions with Decisionmakers: Rep. Laura Hall

Discussions with Decisionmakers: Rep. Laura Hall

1. Please tell us a little bit about yourself – Primary occupation? Interests? Hobbies?

I am a native of South Carolina, though I’ve been in Alabama for 47 years now. My background is in education, with 25 years having been spent teaching science at J.O. Johnson High School. While I chose to stay in South Carolina and attend Morris College for my undergraduate degree, I received my masters from THE Ohio State University and obtained my certification in administration from Alabama A&M.

Although I’m no longer teaching, I still have a joy for learning. These days, I spend a lot of time reading anything and everything, from books to research reports and studies. I also enjoy swimming and try to start every morning at the pool.

2. What first prompted you to consider running for your House District seat and how do you believe your background and experiences help you serve in the legislature?

Well, I actually had not even considered running for office prior to the 1993 election. Throughout my life I have always been involved in various organizations and worked on campaigns, but I never intended to be an elected official. In fact, it wasn’t until a group of friends and district leaders approached me with the idea that I even considered this opportunity.

Looking back, it really is incredible just how my life came full circle. Having grown up during the civil rights era and participated in many demonstrations, I was now heading to the birthplace of that movement as a duly elected member of the Alabama House of Representatives.

3. During the last legislative session, you were a leading voice in bringing awareness to one of the Medical Association’s top priorities – reversing the maternal mortality crisis in Alabama and ensuring sufficient funding to combat it through public health research and strategy.  Tell us a little about why this issue is so important to you. 

That’s simple: because the women and families impacted by this issue told me their stories. I distinctly recall a young lady telling me how she did not speak or see a doctor until she was over six months pregnant. Similarly, another lady told me how she never went back to the doctor after having the child.

These women aren’t alone, either. Their stories, coupled with the mortality disparities for black women, is not something I could sit idly by and do nothing about. Fighting for better health care for women in Alabama is now a lifelong passion.

4. By funding the maternal mortality review committee, if Alabama is able to reverse its disturbing trend in maternal deaths like other states with similar programs have done, what kind of message does that send for the state’s ability to tackle other troubling health care disparities?

When you look at the real impact MMRCs have had in states like California – where the MMRC has decreased its maternal mortality rate by over 55% since 2006 – I am optimistic that we will be able to look back and see similar results. When a program is able to show reliable, positive data, it strengthens the argument for funding similar initiatives.

Moving forward, I believe more work needs to be done on policy that expands access for mothers and children and addresses social determinants of health. I intend to continue advocating for things like extending postpartum Medicaid coverage from sixty days to one year, as well as increased childcare services and educational options for those mothers and children.

5. If you could change one thing about our state’s health care system, what would it be?

Sticking with social determinants of health, I’d remove barriers to access to quality healthcare and the transportation to get there.

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

Having led a successful coalition to fund the MMRC, I think it’s critical for the Medical Association to continue being a leading voice for those who do not have the resources to do so. From expanding Medicaid to encouraging mental health funding and promoting rural health care access, the Medical Association can continue to be a leader in shaping Alabama policy.

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Funding the Maternal Mortality Review Committee: An Effort to #SaveALMoms

Funding the Maternal Mortality Review Committee: An Effort to #SaveALMoms

The Statistics

According to the most recent statistics, Alabama’s 2018 maternal death rate of 36.4 maternal deaths per 100,000 live births means women in this state die from pregnancy and childbirth complications at more than double the rate of women nationally (17.4 deaths). The numbers also mask a glaring racial disparity: black women die at a rate of (37.1) more than double the rate of white women (14.7) and Hispanic women (11.8).

Unfortunately, the issue of maternal mortality is not cut and dry, and determining what is (and isn’t) a maternal death can be complicated. In fact, prior to 2018, the Centers for Disease Control and Prevention (CDC) and the National Vital Statistics System had not published data on maternal deaths since 2007.

So, what can we do to obtain better statistics and reverse this unacceptable trend?

To the Medical Association and the Alabama Section of the American College of Obstetricians and Gynecologists, the answer was simple: fund the Maternal Mortality Review Committee (MMRC).

The MMRC

The MMRC is a collaboration of agencies and health professionals working to better understand factors causing maternal deaths and identify the strengths and weaknesses of current programs and services. At its core, the purpose of an MMRC is to conduct reviews of each maternal death, create actionable prevention strategies, and implement positive changes in health systems.

Take, for instance, a 2018 report from MMRC’s in 9 states which found more than half of maternal deaths were ultimately preventable, and Tennessee found that number to be as high as 85 percent.

Or consider how California’s MMRC, which was established in 2006, created a set of best practices which resulted in a 55 percent reduction in maternal deaths.

Unfortunately, Alabama is behind the curve, having only recently launched a zero-budget, all-volunteer committee in early 2019 under the Alabama Department of Public Health (ADPH). Knowing the impact a funded MMRC can have, the Medical Association led a coalition of partners to obtain just that during the past legislative session.

The Campaign

Initially comprised of only the Medical Association, ACOG, and ADPH, our coalition grew to attract an array of other partners in short order. From physician groups like AAP to the nonprofit, March of Dimes, and even Johnson & Johnson, the call for legislators to fund the MMRC grew rapidly.

Ultimately, Governor Ivey included a $478,000 request specifically for the MMRC in her budget and, even amidst budgetary uncertainty due to COVID-19, the legislature chose to keep the funding in the final budget.

With the MMRC funded, now begins the work to #savealmoms.

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Discussions with Decisionmakers: Rep. Paul Lee

Discussions with Decisionmakers: Rep. Paul Lee

Get to Know Representative Paul Lee

Please tell us a little bit about yourself – Primary occupation? Interests? Hobbies?

I am the currently Executive Director of the Wiregrass Rehabilitation Center, which is located on a 26-acre campus in Dothan and hosts over 200 employees. At Wiregrass Rehab, we work to assist individuals in securing employment, overcoming vocational barriers and achieving personal independence. I am extremely proud to say that our operations have grown tremendously, and we now serve over thirty counties across three states.

When I have time away from my two jobs (State Representative and Wiregrass Rehab), I enjoy fishing, golfing, and bird hunting.

What first prompted you to consider running for your House District seat?

Prior to being elected into the House of Representatives in 2010, I served as a City Commissioner in Dothan. It was during my second term that I realized how important our legislative delegation was and the impact that the state legislature can have on our district. So, I decided to give up my seat as City Commissioner and run for the House of Representatives in hopes of making a greater impact to my community. 

How do you believe your background and experiences help you serve in the legislature?

My background has tremendously helped me in my capacity as a state representative. Before my position with Wiregrass Rehab, I worked for 31 years in manufacturing with Sony. That experience is more relevant now than ever, as it furthers my belief that we need to invest in the production of goods and services here at home and not be so heavily reliant on other countries – whether it be related to healthcare or virtually anything. Additionally, the experience I gained while serving on the board of one of our local hospitals (along with my wife working in medical management) has vastly helped me in my position as Chairman of the House Health Committee.

As chairman of the House Health Committee, what will some of your priorities be in the next legislative session?

Mental health will be a major priority in the coming years. There are far too many caregivers who cannot care for and maintain the needs of those they serve.

We must find a way to save our local hospitals, pharmacies and physician practices. The closures of local healthcare facilities have a negative impact on the entire community and drives up the costs of services and drugs.

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

Expanding broadband access to rural Alabama so that those individuals can take advantage of telehealth services. The pandemic has shown how useful this resource can be, and we need to do everything we can to ensure all Alabamians are able to reap its benefits and received needed care.

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

Of course, there are many issues that need attention and must be addressed. However, I believe it is vital to look at ways to expand access to affordable care. Also, we need to maintain appropriate reimbursement rates for physicians and hospitals. Too many Alabamians are left without healthcare services, and too many providers are not compensated fairly for those services. 

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

We need new ideas to reform and expand primary care. Access to primary care is critical in preventing more serious disease complications; which, in turn, saves the entire healthcare system money.

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

I am grateful for the physicians in our district and have the highest degree of admiration and respect for them.  We are fortunate in Houston County to have access to many specialties. Over 500K people from 3 states come to our area for healthcare.

I am not sure they could ever adequately train and prepare for the current situation with COVID-19. Our physicians have stepped up and done more with less. In my district, we have many great physicians who are also effective leaders and fulfill their role effectively. I have the utmost confidence in our physicians.

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ALAPAC Announces Support for Carl, Coleman in Congressional Races

ALAPAC Announces Support for Carl, Coleman in Congressional Races

The all-physician board of the Alabama Medical PAC, ALAPAC, voted recently to support several candidates in their bids for federal office:

  • In Alabama’s First Congressional District, the ALAPAC Board voted to support Jerry Carl.
  • In Alabama’s Second Congressional District, the ALAPAC Board voted to support Jeff Coleman.

The ALAPAC Board considers many factors in making campaign support decisions, including candidate-vetting meetings with ALAPAC staff and board members, electronic surveys of ALAPAC contributors, third-party polling data and outreach from local physician ALAPAC contributors voicing support. Regarding ALAPAC support for Carl and Coleman, ALAPAC Board Chairman David Herrick, M.D. noted a significant factor in both races was outreach from local physicians.

“These candidates have built relationships with physicians in their local communities and a number of those physicians reached out to ALAPAC and asked for support for both Jerry Carl and Jeff Coleman,” Dr. Herrick said. “That’s a key element in ALAPAC’s decision making process in races where there is no incumbent with a voting record that we can look at and examine to see how they voted on the issues medicine believes are important.”

The runoffs for both Congressional District 1 and 2 are Tuesday, July 14. At this point, election officials indicate polling places will be open as usual, from 7 a.m. to 7 p.m. Be on the lookout for emails from ALAPAC as that date nears with additional information on voting resources.

Board also suspends 2020 summer fundraising efforts amid COVID-19

Due to the ongoing COVID-19 pandemic and its negative financial effects on physicians and medical practices of all specialties statewide, ALAPAC is suspending its usual “summer shortfall” fundraising drive and instead focusing board and staff energies in the coming months to revamping ALAPAC into a more specialty-focused and locally-driven political action committee.

“At the same time we are spending money to support candidates in Congressional Districts 1 and 2, we have also had to make the tough decision to suspend our traditional summer fundraising drive, which will ultimately result in fewer funds raised in the short term. Given the current status of COVID and practices’ financial challenges, it seems like the right decision. However, the Board and I are convinced the new approach and restructuring efforts we are planning will serve as a better long-term investment for ALAPAC,” Dr. Herrick said.

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Advocacy Efforts During COVID-19

Advocacy Efforts During COVID-19

The spread of COVID-19 has affected nearly all aspects of our daily lives. For the Medical Association’s efforts in protecting physicians and patients, this was also true. Nonetheless, between March 13 (when Gov. Ivey issued the COVID-19 state of emergency) and mid-May, our advocacy work continued in full-force.

Executive Actions & Proposals

  • Worked with various stakeholders and Governor Ivey to secure liability protections via an Executive Order for physicians, their staff and their practices against frivolous COVID-19 lawsuits (summary available here);
  • Successfully advocated against multiple dangerous scope of practice expansions proposed by both state and national organizations. Among other things, these proposals would have (1) eliminated physician supervision and destroyed the team-based care model; (2) granted CRNAs the ability to prescribe controlled substances; and (3) allowed pharmacists to switch a patient’s drugs without prescriber authorization and without any requirement to notify to the prescriber or the patient; and
  • Successfully advocated against a proposal to give out-of-state telehealth corporations special treatment that physicians currently living, working, and paying taxes in Alabama do not enjoy.

Telehealth Payment Parity

  • As one of our longstanding priorities (payment parity between in-person visits and telehealth services), we were proud to see reimbursement rates addressed and the policy of parity come to fruition.

Miss our 2020 Legislative Recap, What if No One was on Call? Click here for the annual rundown.

Posted in: Advocacy, Coronavirus, Liability, Members

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What if No One was On Call?

What if No One was On Call?

2020 Legislative Recap

Over the past few months, “unprecedented” has become an oft-used term. Though the outbreak of infectious disease has been seen throughout history, the COVID-19 pandemic halted nearly all aspects of normal life, sparing not even the 2020 Regular Session of the Alabama Legislature.

When it was all said and done, only a handful of bills were passed by each Chamber, with most left hanging in the balance. However, that’s not to say the 2020 Session was without action on important health-related items; in fact; negotiations persisted well through the shutdown.

Had the Medical Association not been “on call” during these times, the health and welfare of physicians, patients and practices could have been in jeopardy. 

*Click the button below to download a pdf version*

COVID-19 Related Items

If no one was on call . . . physicians, their staff, and their practices could have no protection from COVID-19 frivolous lawsuits. The Association worked with both Sen. Arthur Orr (R-Decatur) on legislation (SB330) as well as the Ivey Administration on an executive order along with other health and business organizations. While time ran out on the legislation during the 2020 Session, the efforts with the Governor’s office were successful and on May 8, Gov. Ivey issued an executive order providing liability protection to physicians for care whose provision to patients was negatively affected or impacted by COVID-19 and/or the state’s response to the pandemic.  A summary of the executive order is available here.  Despite the issuance of this order, however, the Association will continue advocating for passage of Sen. Orr’s legislation, whether in a subsequent special session in 2020 or later.

If no one was on call . . . executive orders could have been issued giving out-of-state telehealth corporations unfair business advantages over Alabama medical practices.  Instead, out-of-state physicians providing telehealth to Alabama patients didn’t get special treatment and had to follow the same rules as physicians living, working, and paying taxes in Alabama.

If no one was on call . . . executive orders could have been issued allowing the far-reaching, unnecessary, and dangerous scope of practice expansions.  When the pandemic hit, a countrywide effort ensued from national non-physician associations seeking to advance their own specific scope-expansion agendas.  These groups urged their state-level counterpart organizations to push governors to broadly expand scopes of practice in response to COVID-19, but despite this, the Ivey Administration wisely maintained physician-led, team-based care as the standard for Alabama.

If no one was on call . . . parity in payments for telehealth services may not have occurred.  Parity in reimbursements for the same care provided in-person and via telehealth (especially telephonically) has long been an advocacy priority for the Association.  The Association applauded the Blue Cross Blue Shield of Alabama decision to temporarily cover telephonic services by physicians beginning mid-March.  Alabama Medicaid followed suit, and finally, after weeks of the Association and other allied groups petitioning Congress and Medicare regarding coverage for telephonic-only visits for seniors, CMS also agreed to cover telephonic-only telehealth. Moving forward, the Association supports making permanent these improvements in coverage of telehealth services  If insurers do so voluntarily, legislation may not be ultimately necessary.

Moving Medicine Forward in 2020

For many organizations, major policy proposals and legislative initiatives fell by the wayside during the 2020 Session. However, the Medical Association saw the achievement of two top-priority funding requests (MMRC and BMSA) that were put into place in this session.

If no one was on call . . . the Maternal Mortality Review Committee (MMRC) could not have received vital funding. The Association spearheaded a coalition of stakeholders – which included March of Dimes, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and Johnson & Johnson – to bring awareness to the issue of increasing maternal mortality rates in Alabama and spotlight the impact this committee could have to reverse that trend if properly staffed and resourced. Gov. Ivey included funding for the MMRC in her initial budget request, and legislators maintained the funding in the final budget.

If no one was on call . . . the Board of Medical Scholarship Awards could not have received a significant funding increase. The Association worked with BMSA and the Alabama Academy of Family Physicians (AAFP) to explain how additional funding would expand the impact of this already highly successful program which awards scholarships to physicians and in turn they agree to practice in an underserved area. Gov. Ivey agreed, and the final budget included a $500,000 increase for the BMSA.

If no one was on call . . .  support could not have grown for improving the existing rural physician tax credit. SB195, supported by the Association, would have amended the out-of-date definition of “rural” and strengthened the current residency requirement. The bill was passed by the Senate Committee, but died as a result of the session being cut short. This tax credit is a significant tool for attracting and retaining physicians for rural Alabama communities.

If no one was on call . . .  support for strengthening Alabama’s athletic trainer statute as it relates to physician supervision and care continuity could not have grown. Prior to the session, the Association worked closely with the Athletic Trainers Association in drafting SB93 to better define the practice of athletic training, ensure appropriate physician supervision and allow joint-promulgation of athletic trainer rules. The bill passed the Senate but stalled in the House due to the shortened session.

Scope Creep – Replacing Education with Legislation

Many people would like to be a physician, but few are willing to endure medical school, residency, and all the other various education and training requirements to become an M.D. or D.O. Instead of pursuing higher education, non-physicians are pursuing legislative changes as an end-around-means to practice medicine. The Association opposes any scope of practice expansions that could endanger quality care for patients.

If no one was on call . . . the physician referral requirement for physical therapy could have been abolished. As introduced, SB104 & HB145 would have abolished the need for a medical diagnosis before a physical therapist could begin providing therapy to a patient.  After consultation with many of our specialties most-involved with issuing PT referrals, the Association led negotiations to firmly maintain the importance of medical diagnosis but to also: (1) extend the current timeframe for which a referral is good from 90 to 120 days; (2) allow therapy without a referral for patients with a diagnosed chronic condition for which therapy is appropriate and who is under physician management for the condition; and, (3) allow therapy for without referral for restorative exercises so long as the patient does not initially present with new on-set pain, illness, or injury.  The bill did not pass but will return.

If no one was on call . . . standards for true collaboration within practice agreements could have been abolished. While SB114 originally would have allowed an “unlimited” number of nurse practitioners a physician could supervise, the Association, understanding that one-size-doesn’t fit all when it comes to practicing medicine,  negotiated a more prudent ratio of 9-to-1 of nurse practitioners. physician assistants or nurse-midwives for each collaborating or supervising physician while also preserving that physician’s autonomy and authority regarding patient care decisions within each collaborative or supervisory arrangement.  The bill did not pass, but will return.

If no one was on call . . . optometrists could have begun performing eye surgeries using scalpels and lasers as well as eye injections.  SB66 would have allowed optometrists, who do not undergo any surgical residencies anywhere in the U.S., to perform surgeries and injections on the eye and would also have given the Alabama Board of Optometry the sole power to define and regulate what is considered to be the practice of optometry, taking all authority away from the Legislature to define it. The bill was unfortunately rammed through the Senate Health Committee by its chairman, Jim McClendon, an optometrist himself (watch this video). The bill did not pass, but will return.

If no one was on call . . . a newly-created state board could have unilaterally set the scope of practice for imaging technologists and potentially increased costs to medical practices utilizing medical imaging.  Among other things, SB171 provided for the licensing and regulation y of health care personnel performing radiologic imaging or radiation therapy for diagnostic or therapeutic purposes. While this is not problematic on its face, the bill could have increased costs for medical practices and dangerously expanded the scope of practice for non-physicians. While the bill did not receive a vote in committee, it is expected to return.

If no one was on call . . . podiatrists could have been granted the ability to perform surgery on the ankle and lower leg. HB198 would have allowed podiatrists who have completed as few as 2-years of podiatry residency (significantly less than either a general orthopaedist or an orthopaedic surgeon specializing in the ankle) to perform ankle surgery. The legislation failed to receive a vote in committee but will return.

Beating Back the Lawsuit Industry

Plaintiff trial lawyers are constantly seeking new opportunities to sue doctors. Alabama’s medical liability laws have long been recognized for ensuring a stable legal climate and fostering fairness in the courtroom. Yet, year after year, personal injury lawyers seek to undo those laws and allow more frivolous lawsuits to be filed against physicians.

If no one was on call . . . physicians could have been held liable for emergency medical treatment decisions of individuals believed to be a threat to themselves or others.  Instead, physicians were protected in a revised version of the legislation, which aimed to create a process for immediate treatment of individuals believed to need mental health care.  The bill did not pass but will return.

If no one was on call . . . physicians participating in a pilot project “needle exchange” program could have been held liable for helping program enrollees.  Instead, revisions allowed physicians referring patients to the program and being referred patients from the program to be protected if following certain rules.

If no one was on call . . . athletic trainers and possibly other health professionals could have lost existing legal protections they currently enjoy under one proposed change to the athletic training legislation.  Instead, an amendment to the legislation allows athletic trainers and other health professionals to maintain the same level of liability protection they have at present. 

If no one was on call . . . physicians could have been held liable for the health of patients under their care who chose to use cannabis for medicinal use in the proposed medical cannabis bill.  Instead, an amendment was adopted removing this language. The bill did not pass but will return.

If no one was on call . . . physicians could have been held liable for school system employees’ decisions regarding following portable DNR orders for minor students.  Instead, an agreement was reached to ensure physicians cannot be held liable for the actions of those not under their supervision or authority in carrying out DNR orders.  The bill did not pass but will return.

If no one was on call . . . physicians could have been held liable for the actions of school system employees if the physician helped create a “seizure action plan” for a minor child with a seizure disorder.  Instead, physicians were protected for helping create such plans of action for school employees to follow for children with seizure disorders.  The bill did not pass but will return.

Other Legislation of Interest

Medical Cannabis. . . This much-discussed legislation, (SB165) sponsored by Sen. Tim Melson (R-Florence), an anesthesiologist, would provide for the regulation by the state, from “seed to sale”, of cannabis for medicinal use. After surveying its members, the Association found Alabama physicians believe if cannabis for medicinal use is legalized, then the growth, cultivation and sale of cannabis should be highly regulated by the state, and any physician involvement should be regulated not by some new state agency, but by the Board of Medical Examiners. As a direct result of Alabama physicians’ survey responses, the Association worked to bring the legislation in line with the areas of broad medical agreement on the topic. The bill passed the Senate but stalled when it reached the House.  It will return.

If no one was on call . . . various bills establishing standards of care in the law for physicians to follow or be penalized could have become law.  Instead, no such legislation passed, but the Association works on bills of this type every time the legislature comes into session.

If no one was on call . . . physicians could have been charged with manslaughter or murder if a patient experiences a deadly overdose that involved a drug the physician prescribed.  The legislation, intended to target drug dealers, was revised to protect physicians.

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Gov. Ivey Provides Physicians Liability Protections from COVID-19

Gov. Ivey Provides Physicians Liability Protections from COVID-19

Today, Gov. Ivey issued an executive order protecting physicians, their staff, and their practices from lawsuits related to COVID-19. The governor’s order, the eighth such supplemental emergency order issued by her administration since the pandemic began, provides a “safe harbor” for services affected by COVID-19 or Alabama’s response to the pandemic and from other COVID-19 related claims.

“As one of many Alabamians on the front lines of this pandemic, I thank Gov. Ivey for working with the Medical Association to provide this much-needed liability protection for these unprecedented circumstances affecting care provisions that are far beyond any of our control,” Medical Association President John Meigs, Jr., M.D., said.

The order provides immunity for treatment that resulted from, was negatively affected by or was done in response to the COVID-19 pandemic or the State’s response to the pandemic unless proven by clear and convincing evidence that a health professional acted with wanton, reckless, willful, or intentional misconduct – a standard significantly higher than simple negligence. Importantly, the liability protections in today’s order apply retroactively to March 13, 2020, and will remain in place until the COVID-19 public health emergency is terminated.

Protecting physicians, their staff, and medical practices from COVID-19 lawsuits has been a priority of the Medical Association since Alabama entered a state of emergency in mid-March. In addition to the governor’s office, the Association has worked with multiple other organizations on today’s order and appreciates the expertise of the Birmingham law firm of Starnes, Davis and Florie during those negotiations. Click the button below to view a summary of the proclamation.

Posted in: Advocacy, Coronavirus, Legal Watch

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