Archive for Advocacy

Advocacy in Action: Recapping AAFP’s “Day on the Hill”

Advocacy in Action: Recapping AAFP’s “Day on the Hill”

Why Advocacy Matters

Multiple times each legislative session, the Medical Association’s Government Relations team calls and emails physicians asking them to contact their legislator(s) regarding a specific bill or amendment. As evidenced by the Association’s track record of advocacy successes each year, a number of physicians respond to these “calls to action,” but not near as many as needed.

Unfortunately, there is a belief (not only amongst physicians) that an individual’s voice doesn’t matter; that emails to legislators won’t be read; that phone calls to legislators won’t be passed along; or that legislators won’t listen. Whatever the reason, the underlying premise – that an individual’s voice can’t make a difference – is incorrect.

Not only do legislators desire to hear from constituents, they desperately need to hear from physician-constituents on important health topics. Still, many legislators are surprised when they hear from local physicians at all. This must change.

Heeding the Medical Association’s calls to action could not only have lasting impacts on legislators’ positions on a particular issue, but it could also open the door for physicians to weigh in on other health-related topics.

As the old adage goes, “If you’re not at the table, you’re on the menu.” The Medical Association makes it a priority to ensure physicians are at the table, but medicine can’t get there without individual physicians doing their part; our likelihood of continued success on state health policy issues depends on your advocacy.  

AAFP's Advocacy Efforts

In early March – shortly before the legislature shutdown due to COVID concerns – the Medical Association teamed up with the Alabama Academy of Family Physicians (AAFP) and the UAB Rural Scholars Program for a day of advocacy at the State House. Particular topics spotlighted throughout the day were the need for updates to the Rural Physician Tax Credit and increasing funding for the BMSA.

Of those in attendance were Dr. Bill Coleman, Dr. David Bramm, Dr. Holly McCaleb, Dr. Drake Lavender, Wesley Minor, and Whitney Lee. Every single one of these individuals made their presence known throughout the State House and displayed an energy for advocacy. Whether it was a short introduction in the hallway or a private meeting in a legislator’s office, the conviction and effectiveness with which they spoke made a lasting impression on every individual they met.

And their work paid off.

In fact, just a couple months later, when COVID had shut down most government bodies and future budgets were being slashed, state legislators decided not only fully fund the BMSA, but to increase its appropriation by over half-a-million dollars.

In a follow-up email to one of the participants from that day, said this:

You lay out your proof in detail not only as to why BMSA has been a good investment, but why it deserves increased funding based on sound business principles using ROI comparisons. I have been a supporter in the House since the issue was presented, passed, then enacted as statutory law.  I will be a willing ally in keeping these programs funded and growing. . . Thanks for “making my day” with your excellent communication!

 

We are extremely appreciative these individuals took time out of their day to travel to Montgomery and advocate on issues important to them and their peers. We also appreciate Jeff Arrington, Executive Director of AAFP, for his tireless efforts in helping to coordinate this event. The increased funding for BMSA is, no doubt, a direct result of their hard work.

Wesley Minor meets with his Senator, Majority Leader Greg Reed (R-Jasper)

Whitney Lee and Dr. David Bramm meet with Rep. Mike Holmes (R-Wetumpka)

Wesley Minor and Dr. Bill Coleman meet with Rep. Tim Wadsworth (R-Winston)

From left to right: Dr. Holly McCaleb, Dr. Drake Lavender, Dr. David Bramm, Senator Larry Stutts, M.D. ( R-Tuscumbia), Wesley Minor, Whitney Lee, Dr. Bill Coleman, and Jeff Arrington, who discussed the importance of increasing access to care in rural areas through programs like the Board of Medical Scholarship Awards and the Rural Medical Scholars Program.

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Discussions with Decisionmakers: Rep. Howard Sanderford

Discussions with Decisionmakers: Rep. Howard Sanderford

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

I’m an accountant by education, and received my bachelor’s degree from Mississippi State University. Following college, I served as an officer in the U.S. Marine Corps. From there, I went to work with IBM and eventually left to open my own company, Computer Leasing Company, Inc.

In the community, I have served in various roles with various organizations, including past President of the Huntsville Rotary Club, past Chairman of the Madison County Republican Executive Committee, past Co-chairman of the Chamber of Commerce Free Enterprise Committee, past Vice President of the Metropolitan YMCA Board, and I was a member of the Alabama Commission on Aerospace Sciences and the Alabama Management Improvement Program.

Today, I am a board member of the Alabama Space and Rocket Center, Volunteers of America of North Alabama, YMCA, Alabama Men’s Hall of Fame, and Alabama Board of Medical Scholarship Awards (BMSA).

Finally, I would be remiss if I didn’t also mention my wife, Dot, and our three children: Mary Ann, Peggy, and Betty.

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?

Following retirement from IBM, I became more involved in political organizations in the Huntsville area. When then-representative and democrat, Stephen Hettinger, left the seat in 1988 to become mayor of Huntsville, the Madison County GOP was looking for a candidate to run for the seat. As it turned out, nobody wanted to do it; so, the Executive Committee asked me to run for District 20 as a republican.

Frankly, the last thing I wanted to do is run the highway from Huntsville to Montgomery. Now, 32 years (1988 – Present) later, I guess the position was meant for me.

3. Every legislative session, you are a leading voice in bringing awareness to one of the Medical Association’s top priorities – increasing funding for the Board of Medical Scholarship Awards (BMSA) and ensuring there are primary care physicians working in rural, medically underserved areas of the state.  Tell us a little about why this issue is so important to you. 

This is a funny story. I actually had no idea that I was being appointed. In fact, I found out at a legislative reception one evening years ago when Governor Hunt approached me and said, “I appointed to you a board today. I forgot which one but I’ll send you a letter.” It just so happened to be the BMSA.

BMSA is a tremendous program. I’m extremely glad Governor Hunt decided – for whatever reason – to appoint me to this board. The program deserves more money to put more physicians in areas of need because year after year we have more applicants than we do scholarships. And every one of these applicants is the “best of the best.”

4. By increasing funding for the BMSA, if Alabama is able to reverse the trend of having a shortage of primary care physicians, what kind of message does that send for the state’s ability to tackle other troubling health care issues?

This program has a major impact on healthcare in Alabama. Most physicians in these areas struggle to pay of their loans or succeed. Those who are selected for the BMSA are typically the top of their class and have a true desire to give back to communities who lack proper access. These young men and women want to go serve rural Alabama; it’s unfortunate we cannot provide them with the money to help them do it.

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

More physicians. Even I have struggled to find a physician, and I live in Huntsville. Those in areas with one or two – or even zero – physicians face even more burdensome hurdles.

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

Whether it be bills before my Committee – Boards, Agencies, and Commissions – or others being considered by the entire House, the Medical Association has always been there to provide us with much needed information. Continuing to do so is needed and much appreciated.

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

We appreciate you. My wife and I have seen a fair share of physicians over the years – from broken bones of our children to our own personal illnesses – and we are grateful for the care we received. These are unique times, but we will make it through. Keep up the good work.

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2nd Annual President’s Council Meeting Joined by Legislative Leadership

2nd Annual President’s Council Meeting Joined by Legislative Leadership

Nearly two weeks ago (October 17), the Medical Association hosted its 2nd Annual President’s Council Legislative Roundtable to discuss priorities for the upcoming 2021 Session. This year’s event included a Q&A session with legislative leadership, an open forum with physicians and executive directors from each medical specialty, and an update on major developments with ALAPAC.

 

Although the pandemic forced the event to take place virtually, this year’s Legislative Roundtable was once again a resounding success. We are especially grateful to those physicians who took time out of their Saturday morning to join us via Zoom and provide insight as to those issues most impacting their specialty.

 

To that end, we are proud to announce that, as a direct result of the input and discussion from the Roundtable, the Medical Association has finalized its 2021 Legislative Agenda. These priorities were developed by members of the President’s Council on October 17, presented to physicians on the Government Relations Committee of the Medical Association on October 20, and approved by the entire Board of Censors on October 21. 

 

To those Medical Association members who are interested in learning more about the President’s Council and our legislative priorities, we have included a few different items below to keep you up-to-date. Not only are we publishing a link to our 2021 Agenda, we have also put the Roundtable’s Legislative Q&A is on YouTube.

 

Lastly, the names of those physicians who are representing their specialty on the President’s Council is published below. We are thankful to have such an awesome group of individuals who are willing to be leaders in medicine and we hope you will join them in advocating on behalf of physicians and patients in 2021.

Watch the Legislative Panel Q&A

2021 President's Council Members

Dr. Allen Meadows
Dr. John Tole
Dr. Suzanne Blaylock
Dr. Bill Curry
Dr. Jo Herzog
Dr. Bryan Balentine
Dr. Hamad Husainy
Dr. Annalise Sorrentino
Dr. Ray Stewart
Dr. Travis Rutland
Dr. Amit Arora
Dr. Bob Robinson

Dr. David Ellington
Dr. Janeen Arbuckle
Dr. Russell Read
Dr. Trey Baird
Dr. Clinton Martin
Dr. Dan Dahl
Dr. Doug Sutherland
Dr. David McLain
Dr. Mark Parker
Dr. Michael Bivins
Dr. Richard Jones

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2021 Legislative Agenda

2021 Legislative Agenda
As the professional association for some 7,000 physicians of all specialties in Alabama, the Medical Association of the State of Alabama exists to serve, lead, and unite physicians in promoting the highest quality of healthcare for the people of Alabama through advocacy, information, and education.

The Medical Association of Alabama is proud to advocate on behalf of physicians and their patients and, despite the challenges to care delivery and daily life brought by the COVID-19 pandemic, is committed to moving medicine forward in 2021.

General Legislative Policies Supported

The Medical Association supports the physician-led health team model and maintaining the highest standards for medical care delivery across all specialties of medicine. The Association supports physician autonomy in patient care and medical practice decisions as well as fair reimbursement for services. The Association also supports reducing the administrative tasks required of physicians by insurers which increase annual health spending and negatively impact patient health. Specifically, the Association supports reforming prior authorization processes and step therapy protocols and ending non-medical switching and co-pay accumulator programs.

Further, the Association supports increasing health insurance options for Alabamians, including expanding Medicaid. The Association supports increasing access to quality mental health care and continued state funding for the Maternal Mortality Review Committee and the Infant Mortality Review Committee. Recognizing the long-term effects of social determinants of health on individuals, families and ultimately communities, the Association supports comprehensive solutions to addressing these challenges.

Finally, by ensuring medical liability environment stability and pursuing further civil justice reforms, the Association believes Alabama can continue to attract highly-qualified physicians.

Specific Legislative Priorities Supported

For the 2021 Legislative Session, the Association specifically supports:

  • Legislation to provide physicians and medical practices “safe harbor” from COVID-related lawsuits.
  • Legislation prohibiting deceptive health care advertising and requiring health professionals identify their license to patients.
  • Reforming the “certificate of need”  process  to increase physician ownership of equipment and facilities and expand access to quality, affordable care.
  • Recommendations of the Rural Health Taskforce, including increased funding for the Board of Medical Scholarship Awards and broadening the rural physician tax credit.
  • Mandated review of the state vaccine registry prior to administration and uploading of patient vaccine information into the database.
  • Continued physician compounding and dispensing of drugs.
  • Same standards and reimbursements for telehealth as for face-to-face visits, and expanding broadband initiatives to facilitate increased use of telemedicine.

General Legislative Policies Opposed

The Medical Association opposes any scope of practice expansion for non-physicians, which could fracture the physician-led health team model and lower quality of care and increase costs for patients. The Association also opposes any interference with the physician-patient relationship and attempts to reduce a physician’s autonomy in patient care or medical practice decisions.

The Association opposes legislation or other initiatives that could increase lawsuit opportunities against physicians, including the establishment of statutory standards of care or any statutory dictums for medical care delivery. The Association also opposes any state- level increase of requirements for Maintenance of Certification. Finally, the Medical Association opposes tax increases disproportionately affecting physicians.

Specific Legislative Polcies Opposed

For the 2021
Legislative Session, the Association specifically opposes:

  • Expanding Prescription Drug Monitoring Program (PDMP) access for law enforcement.
  • Statutory requirements for mandatory Prescription Drug Monitoring Program (PDMP) checks.
  • Changes to workers’ compensation laws negatively affecting treatment of injured workers and medical practices.

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2020 ALAPAC Voting Guide: Constitutional Amendments

2020 ALAPAC Voting Guide: Constitutional Amendments

OVERVIEW

On Election Day, the people of Alabama will have the chance to cast their votes for a number of federal and state officials. In addition, voters will decide whether several proposed amendments should be added to the Alabama Constitution.

The purpose of this guide is to explain the statewide constitutional amendments in plain language to help Alabama physicians make informed decisions on election day.

STATEWIDE AMENDMENT 1:

Amendment Text:

Proposing an amendment to the Constitution of Alabama of 1901, to amend Article VIII of the Constitution of Alabama of 1901, now appearing as Section 177 of the Official Recompilation of the Constitution of Alabama of 1901, as amended, to provide that only a citizen of the United States has the right to vote.

Basic Summary:

If adopted, Amendment 1 will have little to no impact on voting laws, as Alabama and federal voting requirements already require voters to be citizens of the United States.

Detailed Summary:

Amendment 1 concerns who has the right to vote in Alabama, making a wording change that has no legal effect.

Currently, the Alabama Constitution reads that “every citizen of the United States. . . .” This amendment, if passed, would exchange the word “every” for “only” so that the Alabama Constitution would read, “Only a citizen of the United States. . . .”

This language and the original language of the Alabama Constitution of 1901 mention U.S. citizenship. That has traditionally been interpreted to mean that U.S. citizenship is required to vote. Federal law requires only U.S. citizens vote in federal elections. Amendment 1 proposes to change the language of Article VIII to replace “Every Citizen of the United States” with “Only a Citizen of the United States.”

STATEWIDE AMENDMENT 2:

Amendment Text:

Proposing an amendment to the Constitution of Alabama of 1901, to increase the membership of the Judicial Inquiry Commission and further provide for the appointment of the additional members; further provide for the membership of the Court of the Judiciary and further provide for the appointment of the additional members; further provide for the process of disqualifying an active judge; repeal provisions providing for the impeachment of Supreme Court Justices and appellate judges and the removal for cause of the judges of the district and circuit courts, judges of the probate courts, and judges of certain other courts by the Supreme Court; delete the authority of the Chief Justice of the Supreme Court to appoint an Administrative Director Courts; provide the Supreme Court of Alabama with authority to appoint an Administrative Director of Courts; require the Legislature to establish procedures for the appointment of the Administrative Director of Courts; delete the requirement that a district court hold court in each incorporated municipality with a population of 1,000 or more where there is no municipal court; provide that the procedure for the filling of vacancies in the office of a judge may be changed by local constitutional amendment; delete certain language relating to the position of constable holding more than one state office; delete a provision providing for the temporary maintenance of the prior judicial system; repeal the office of circuit solicitor; and make certain nonsubstantive stylistic changes.

Basic Summary:

If adopted, Amendment 2 would implement changes to how the administration of Alabama’s court system functions and revise the process for appointing and impeaching judges.

Detailed Summary:

This amendment proposes six changes to the state’s judicial system. In summary, this amendment:

1. Provides that county district courts do not have to hold city court in a city with a population of less than 1,000;

  • This is largely a practical change.

2. Allows the Alabama Supreme Court, rather than the Chief Justice, to appoint the Administrative Director of Courts;

  • Currently, the Chief Justice of the Supreme Court chooses the Director of Courts, who oversees the $450 million and 2,500 employee state court system. Since 2010, there have been five different Chief Justices and therefore five different Directors of Courts. If approved, Amendment Two would allow for the entire Supreme Court to make an appointment out of three candidates brought to them by a nominating board of judges, a clerk, and a lawyer. Instead of changing every time the Court’s makeup changes, this appointment would last for ten years.

3. Increases from 9 to 11 the total membership of the Judicial Inquiry Commission and determines who appoints each member (the Judicial Inquiry Commission evaluates ethics complaints filed against judges);

  • Expanding the Commission’s composition from 9 to 11 allows for the inclusion of a probate judge and a municipal judge.

4. Allows the Governor, rather than the Lieutenant Governor, to appoint a member of the Court of the Judiciary (the Court of the Judiciary hears complaints filed by the Judicial Inquiry Commission);

  • Language elsewhere has already caused this shift to happen in practice. The amendment would simply clarify it in the Alabama Constitution.

5. Prevents a judge from being automatically disqualified from holding office simply because a complaint was filed with the Judiciary Inquiry Commission; and

  • Currently, judges are suspended from service, with pay, when a complaint is filed with the Judicial Inquiry Commission. Alabama, alone, suspends judges based simply on a complaint. Amendment 2 removes this provision.

6. Provides that a judge can be removed from office only by the Court of the Judiciary.

  • Currently, Supreme Court justices and appellate judges are the only judges suspect to impeachment. This change would place them under the same disciplinary procedures as other judges.

STATEWIDE AMENDMENT 3:

Amendment Text:

Proposing an amendment to the Constitution of Alabama of 1901, to provide that a judge, other than a judge of probate, appointed to fill a vacancy would serve an initial term until the first Monday after the second Tuesday in January following the next general election after the judge has completed two years in office.

Basic Summary:

This amendment changes the initial term of a judge that is appointed to fill a vacancy due to death, resignation, retirement, or removal. The current law and this proposed amendment do not apply to probate judges.

Detailed Summary:

Judicial vacancies, which are created by the death, resignation, retirement, or removal from office of a sitting judge, are filled by gubernatorial appointment. Judicial terms are six years. Per the Constitution, probate judges appointed by the Governor serve out the balance of the unexpired term. Also, per the Constitution, all other appointed judges serve until the general election after serving one year in office.

In practice, however, appointed judges routinely serve two, and sometimes almost three years, due to how the dates of general elections fall. Amendment 3 extends the time of service for an appointed judge from the general election after one year of service to the general election after two years of service.

STATEWIDE AMENDMENT 4

Amendment Text:

Proposing an amendment to the Constitution of Alabama of 1901, to authorize the Legislature to recompile the Alabama Constitution and submit it during the 2022 Regular Session, and provide a process for its ratification by the voters of this state.

Basic Summary:

Alabama’s constitution contains segregationist and racist language and has sections that are repeated or do not currently apply. If approved, Amendment 4 would allow the state legislature to rearrange the constitution and remove racist or repeated language.

Detailed Summary:

Alabama’s constitution can be changed only during a constitutional convention or when a majority of voters approve a constitutional amendment.

Amendment 4 does not change the requirement that a majority of voters must approve a constitutional amendment. Amendment 4, if approved, simply allows the Alabama Legislature, when it meets in 2022, to draft a rearranged version of the state constitution.

This draft could only:

(1) remove racist language;

(2) remove language that is repeated or no longer applies;

(3) combine language related to economic development; and

(4) combine language that relates to the same county.

No other changes could be made.

STATEWIDE AMENDMENTS 5 & 6

Amendment 5 Text:

Relating to Franklin County, proposing an amendment to the Constitution of Alabama of 1901, to provide that a person is not liable for using deadly physical force in self-defense or in the defense of another person on the premises of a church under certain conditions.

Amendment 6 Text:

Relating to Lauderdale County, proposing an amendment to the Constitution of Alabama of 1901, to provide that a person is not liable for using deadly physical force in self-defense or in the defense of another person on the premises of a church under certain conditions.

Basic Summary:

The amendments are identical other than the county to which they apply. Both would put into the Alabama Constitution a version of the state’s already-existing “stand your ground” law that applies to the use of deadly force in churches.

Unless the statewide “stand your ground” law changes, these amendments will have little practical effect.

Detailed Summary:

Alabama is among 27 states with stand your ground laws, which protect individuals from criminal prosecution if they use physical or deadly force in defending themselves or someone else from serious threat of harm. The law does not require the person to retreat before using physical force.

Even without specific language related to churches or the proposed amendment, lawful participants in a church have the right to defend themselves when under attack. But the stand your ground law and the proposed amendments would not prohibit churches from developing policies banning handguns and other weapons from church property.

If passed by the majority of voters in Alabama and by voters in Franklin and Lauderdale County, the state constitution would be amended to contain a special “Stand Your Ground” law that applies to churches in Franklin and Lauderdale Counties.

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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.

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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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