Archive for Advocacy

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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COVID-19 State Liability Protection Bill to Be Filed

COVID-19 State Liability Protection Bill to Be Filed

Alabama State Senator Arthur Orr (R-Decatur) is preparing to file a bill today to provide liability protection to physicians, health facilities and businesses from claims arising from COVID-19 and the state’s response to the pandemic. 

“These are unprecedented times and the Legislature must take swift action to protect physicians and businesses from COVID-19 frivolous lawsuits,” Sen. Orr said.  “We cannot wait to pass this legislation, as every day that goes by without these protections in place could mean these entities have unknown liability exposure for situations and dynamics far beyond their control.”

Medical Association President John Meigs, M.D., thanked Sen. Orr for his willingness to bring forward the legislation. 

“Practices of every specialty of medicine have been affected by this pandemic, from both the care-provision aspects but also the economic and business side.  The association appreciates Senator Orr’s leadership and willingness to bring this critical legislation forward,” Dr. Meigs said. 

The bill has widespread support among the health care and business communities.  The Legislature may meet as few as five legislative days this week but has as many as 14 at its disposal.  Most of the focus this week will be on local bills and the two state budgets, but the Medical Association is also encouraging legislators to take up Sen. Orr’s bill as a top priority.  

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Senate Committee Keeps MMRC Funding in Reduced 2021 Budget

Senate Committee Keeps MMRC Funding in Reduced 2021 Budget

The Alabama Senate General Fund Committee met and approved a stripped-down 2021 budget that includes funding for the Maternal Mortality Review Committee.  MMRC has been a Medical Association priority this session, and we applaud the chairman and committee for funding this much-needed program.

Just a few months ago, state leaders were optimistic the general fund budget for FY2021 would contain raises for various state employees and revenue increases for many agencies.  But the coronavirus pandemic changed much of that. 

Many have been trying to ascertain just how big of an impact COVID-19 – and Alabama’s actions to slow the spread of the virus – would have on state revenue. Some have cautioned of coming cuts and “bare bones” funding due to the financial uncertainty. 

Thankfully, when senators approved their version of the 2021 budget Tuesday, the committee appropriated $478,000 for MMRC. 

“I want to thank Chairman Albritton for prioritizing research on maternal mortality in these unprecedented times,” Larry Stutts, M.D., a member of the Senate General Fund Committee, said. “It’s important to move ahead with funding this now in the 2021 budget so we can ultimately craft a strategic plan to reverse the upward trend in Alabama’s increasing maternal deaths.”

Alabama’s maternal mortality rate is one of the highest in the nation (and the developed world). At 36.4 deaths per 100,000 live births, Alabama’s maternal mortality rate is more than double that of the national average. By investing in research, Alabama may be able to realize substantial reductions in its maternal mortality rate.  Some states, because of their MMRC programs, have seen a decrease in maternal deaths of more than fifty percent. 

“We sincerely appreciate senators keeping funding for the MMRC in the 2021 budget,” said Dr. Grace Thomas, assistant state health officer for family services at the Alabama Department of Public Health. “Alabama’s maternal mortality rate is one of the worst in the nation and we need to figure out why. This funding will allow us to more appropriately examine the current crisis and develop recommendations that better protect our mothers.”

Funding the MMRC was a major Medical Association legislative priority this year, and we appreciate the work of the MMRC coalition – including March of Dimes, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and Johnson and Johnson – to keep this issue a topic of discussion. We would also like to thank all the physicians and health professionals who used our advocacy portal to contact their legislator in support of the MMRC.  

The bill now moves to the Senate floor.

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Legislators: Just Apply Heat

Legislators: Just Apply Heat

Through years of medical school, residency and fellowships, physicians earn not only more knowledge and expertise than any other health professional, they also earn the right and responsibility of leading the health team.  It is through physician-led care that we ensure continued quality and safety for patients.  But each year, “scope creep” proposals seek to “replace medical education with legislation” and to blur the lines between medicine and other health disciplines. 

Legislators, when confronted with such proposals, often ask how they can be expected to determine whether a particular piece of health legislation is in their constituents’ best interest.  After all, the extent of most legislators’ experience with health care is only on the patient side.  While muscle soreness can be alleviated by applying heat, legislators reviewing scope legislation would be well served by, as explained below, just applying H.E.A.T.  

What is HEAT?

Could the proposal harm patients and will its effects adhere to the Hippocratic Oath’s directive to “first, do no harm?”

Do the proponents of the proposal have the requisite education today to safely perform the tasks or functions they are seeking to amend the law to allow; and, have all members of the profession to whom the proposal would apply received the same levels of specified education to cover the subject of the proposal? 

Would the proposal expand access to additional quality care for patients or just additional care, perhaps of a lower standard? 

Do proponents of the proposal possess the requisite training at present to perform the tasks they are seeking to amend the law to allow?

What does it mean?

If the answers to any of the above questions is no, then the answer to the legislative proposal in question should likewise be a resounding “no.”   Medical education, residency and fellowships prepare physicians for the challenges of delivering quality care in today’s ever-changing health landscape.  While proponents of “scope creep” pitch their proposals as cure-alls for the state’s health delivery system, there are no shortcuts to addressing Alabama’s health challenges. 

To the contrary, removing physician supervision and reducing safety standards and protocols will only endanger patients and reduce quality.  By investing in and supporting programs, proposals and initiatives that recruit and retain physicians to this state, legislators can grow the physician workforce, maintain quality of care and boost Alabama’s economy. 

In the meantime, lawmakers utilizing the four-step HEAT process to analyze legislative proposals should find it helps them separate appropriate changes to Alabama’s health laws from the many dangerous “scope creep” bills that are on the increase. 

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New Maternal Mortality Statistics Highlight the Need for Alabama to Take Action

New Maternal Mortality Statistics Highlight the Need for Alabama to Take Action

Largely due to the slow implementation of a standardized death certificate by states, data on maternal deaths has not been reported on the National Vital Statistics System since 2007. Meaning that, for over a decade, the United States has not recorded an official count of pregnancy-related fatalities, nor an official maternal mortality rate. 

This year, however, we finally got a look at the numbers and, to the surprise of no one, they aren’t good.

The biggest takeaway is that the way we record deaths still isn’t very reliable and, for the second time in less than twenty years, the government is reformatting the death certificate.

Still, the government’s findings (separated by three separate formulas and spanning over sixty pages) help to shed light on the current maternal mortality crisis. Whatever statistical issues there might be, the data conclusively shows that the rate of pregnancy-related deaths has increased substantially over the past decade.

In total, 658 women were identified as having died from pregnancy-related causes (during pregnancy, at birth, or within 42 days after birth) in 2018 – resulting in a maternal mortality rate of 17.4 deaths per 100,000 live births. These numbers place the U.S. in dead last among similar, developed countries.

Even more appalling are the stark disparities in maternal deaths of black women. Specifically, the maternal mortality rate for black women (37.1 deaths per 100,000 live births) was 2.5 times that of white women (14.7 deaths per 100,000 live births) and 3.1 times that of Hispanic women (11.8 deaths per 100,000 live births).

Significant disparities also exist among different age groups, with the maternal mortality rate of women 40 and older nearly 8 times (81.9 deaths per 100,000 live births) that of women under 25 (10.6 deaths per 100,000 live births).

Unfortunately, the numbers for Alabama are much worse. In fact, with 36.4 deaths per 100,000 live births, Alabama’s maternal mortality rate is more than double that of the national average. And since the state figures are merely a top-line summary, there’s no telling what the numbers are if you were to separate by race and age.

In our state, “becoming a mother can turn into a life-or-death situation,” said Dr. Grace Thomas, assistant state health officer for family services at the Alabama Department of Public Health. “It’s a failure of our healthcare system when that happens. We’ve got to do better.”

The good news? Alabama is working to do better.

Just last year, a coalition of Alabama doctors, nurses, public health leaders and others began forming a Maternal Mortality Review Committee (MMRC) under the umbrella of the Alabama Department of Public Health (ADPH) to get a deeper look at why mothers are dying and what we can do about it.

But volunteers can only do so much, and the MMRC lacks the funding for staff and supplies in order to properly review each death. We’re trying to change that.

Right now, the Medical Association of the State of Alabama – along with other stakeholders like March of Dimes, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and Johnson and Johnson – is spearheading an advocacy effort to bring attention to the issue of maternal mortality and see to it that the legislature provides ADPH with the resources it needs for the MMRC to be successful.

Dr. John Meigs, President of the Medical Association of Alabama, believes the MMRC, if properly funded, can reduce maternal mortality in a way similar to that of the initiatives ADPH has had in place on infant mortality – Alabama’s infant mortality rate was the lowest ever recorded in 2019.

“Ultimately, until we have a thorough review of the maternal death data, we can’t answer the all- important question of ‘why?’ when a mother dies and take steps to stop maternal death,” said Dr. Meigs. “But Alabama currently doesn’t fund maternal mortality review, and until we appropriately do so we can’t expect to be able to make informed health policy decisions as a state to move forward in eradicating maternal deaths.”

In other states, a funded MMRC has helped decrease the maternal mortality rate by over fifty percent. For only $478,000 (the amount ADPH requested for the MMRC in its budget), Alabama might be able to do the same.

Find out more about Alabama’s maternal mortality crisis and how you can join our campaign to Save Alabama Moms at alabamamedicine.org/savealmoms

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Medical Association Convenes “Treatment Hurdles” Work Group

Medical Association Convenes “Treatment Hurdles” Work Group

Earlier this week, the Medical Association convened a work group of stakeholders to discuss hurdles and or delays that patients and their physicians face in accessing the tests, treatments and medications the treating physician believes are appropriate.

Patient advocacy groups, many of them disease-specific, joined the Association and others in discussing the hurdles patients face in accessing what their doctors have ordered or prescribed. In addition to delays or denials of care patients and their caregivers face in these situations, the administrative tasks required of physicians by insurers increase annual health spending nationwide by more than $250 billion and occupy millions of uncompensated hours of American physicians and their staff’s time.

The coalition that’s been formed to work collaboratively on these issues is gathering information from other states. If you are interested in participating in this effort, contact cflack@alamedical.org

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