Q1 2024 Colorado Medicine

COLORADO MEDICINE

ADVOCATING EXCELLENCE IN THE PROFESSION OF MEDICINE

FIGHT TO PROTECT MEDICAL LIABILITY CAPS

AND PROFESSIONAL REVIEW

PLUS

REPORT FROM THE 2024 COLORADO LEGISLATIVE SESSION

TIPS FOR PHYSICIANS RETIRING FROM PRACTICE

ENCOURAGE PROPER DISPOSAL OF PRESCRIPTION

MEDICATIONS

AND MORE

INSIGHT

COVERAGE BEYOND

COPIC Financial Service Group’s team of specialists will partner with you to identify your personal goals and navigate your financial path. We’ll help you determine the best option for everything from paying off student loans to retirement planning. We are here for the long haul for each stage of your career, offering insurance and financial solutions at every step. That’s Value Beyond Coverage.

FIGHT TO PROTECT MEDICAL LIABILITY CAPS AND PROFESSIONAL REVIEW

Two proposed ballot measures would destroy long-term policies key to maintaining quality, affordable and accessible care. The Colorado Medical Society and a broad health care coalition are fighting back to protect quality care and the commonsense practice of medicine in Colorado. But we can’t do it alone; we need your help.

FEATURES

6 PRESERVING YOUR LEGACY: NAVIGATING IDENTITY, FINANCES AND FULFILLMENT IN RETIREMENT

Everyone works as long as necessary so they can enjoy post-career retirement, right? Physicians are inherently different from many other professionals and can encounter unanticipated consequences. CPHP Medical Director Scott Humphreys, MD, offers helpful advice on making a smooth transition.

8 A PRESCRIPTION FOR A HEALTHIER, SAFER COLORADO: COLORADO’S MEDICATION TAKEBACK PROGRAM

Physicians play a vital role in patient safety. Encourage your patients to participate in Colorado's Medication Takeback Program for safer homes and communities.

10 CMS ADVOCATES FOR YOU ON BILLS THAT WILL AFFECT THE PRACTICE AND DELIVERY OF MEDICINE

The 2024 Colorado legislative session is in full swing. CMS is your advocate at the Capitol, diligently taking action on bills that could affect the practice and delivery of medicine.

12 NATIONAL ADVOCACY CONFERENCE REPORT

Colorado physicians and medical society staff traveled to Washington, D.C., in February to learn about federal health care issues and meet with elected officials.

24 FINAL WORD: OUR WORDS MATTER

Jill Hilty, MD, a Western Slope physician who also provides global health care, reflects on the evolution of language in interactions with patients and in documentation in health records, and how intentionally choosing patient-first language can help foster a more inclusive and respectful health care environment for all patients.

DEPARTMENTS

14 REFLECTIONS: Preserving life

15 REFLECTIONS: I can see your heart

16 INTROSPECTIONS: Compartmentalization and empathy: An essential dichotomy in health care

18 COPIC COMMENT: Checklist for physicians retiring from a medical practice

20 PARTNER IN MEDICINE SPOTLIGHT: Tebra’s prescription for revenue growth

22 MEDICAL NEWS

• In memoriam: Marilyn J. Gifford, MD

• Colorado physicians can help MHMS fund Blackwood scholarship

COLORADO MEDICAL SOCIETY

7351 Lowry Boulevard, Suite 110 • Denver, Colorado 80230-6902

720.859.1001 • www.cms.org

2023-2024 OFFICERS

Omar Mubarak, MD, MBA President

Kim Warner, MD President-elect

Patrick Pevoto, MD, MBA

Immediate Past President

Hap Young, MD Treasurer

Dean Holzkamp Chief Executive Officer

BOARD OF DIRECTORS

Brittany Carver, DO

Elizabeth Cruse, MD, MBA

Kamran Dastoury, MD

Amy Duckro, DO

Gabriela Heslop, MD

Enno F. Heuscher, MD, FAAFP, FACS

Liz Jones, MSC

Rachelle M. Klammer, MD

Marc Labovich, MD

Chris Linares, MD

Michael Moore, MD

Rhonda Parker, DO

Lynn Parry, MD

Sean Pauzauskie, MD

Leto Quarles, MD

Hap Young, MD

COLORADO MEDICAL SOCIETY STAFF

Dean Holzkamp

Chief Executive Officer

Dean_Holzkamp@cms.org

Kate Alfano

Director of Communications and Marketing

Kate_Alfano@cms.org

Cindy Austin

Director of Membership

Cindy_Austin@cms.org

Virginia "Ginny" Castleberry

Executive Director

Denver Medical Society

Virginia_Castleberry@cms.org

Cecilia Comerford

Executive Director, Colorado Society of Eye Physicians and Surgeons Cecilia_Comerford@cms.org

Dorcia Dunn

Program Manager, Membership Dorcia_Dunn@cms.org

Crystal Goodman

Executive Director, Northern Colorado Medical Society

Crystal_Goodman@cms.org

Mihal Sabar

Director of Accounting Mihal_Sabar@cms.org

of the Colorado Medical Society on a space-available basis.

Dean Holzkamp, Executive Editor, and Kate Alfano, Managing Editor. Design by Scribner Creative.

AMA DELGATION

David Downs, MD, FACP

Carolynn Francavilla, MD

Mark Johnson, MD, MPH

Jan Kief, MD

Rachelle Klammer, MD

A. "Lee" Morgan, MD

Tamaan Osbourne-Roberts, MD

Lynn Parry, MD

Brigitta J. Robinson, MD

Michael Volz, MD

AMA PAST PRESIDENT

Jeremy A. Lazarus, MD

Chet Seward Chief Strategy Officer Chet_Seward@cms.org

Kim Vadas

Director of Continuing Medical Education and Recognized Accreditor Programs Kim_Vadas@cms.org

Debra Will Director of Business Development Debra_Will@cms.org

Remove barriers to timely care between Colorado doctors, patients

Omar Mubarak, MD, MBA

As a physician, my first priority is always the health and safety of my patients and their families. As their doctor, I have direct contact and conversations with my patients, the most updated information on their medical needs and surrounding circumstances, and a vested interest in making sure they receive the care they need.

This is why Colorado doctors and patients are coming together to support the streamlining of our state’s prior authorization process to improve access to care and ensure insurance carriers are not delaying life-changing treatment. Health can’t wait.

The facts are clear. Nine out of 10 patients surveyed nationally believe medical decisions should be made between a patient and their provider — not by an insurance carrier. Unfortunately, however, 94 percent of physicians report delays in patient care due to prior authorization challenges, and 80 percent have stated it can even result in patients abandoning treatment. Even more disturbing, 25 percent of doctors reported a delay in care due to a prior authorization issue leading to patient hospitalization, 19 percent reported a life-threatening event, and 9 percent reported an event leading to disability, permanent damage or death. These are risks we shouldn’t and don’t have to take.

I have had countless experiences with this, but you don’t have to take my word for it, nearly every person in Colorado has direct experience with a prior-authorization delay for themselves or a loved one. We also know these experiences are more likely for women, people of color, Coloradans with disabilities and low-income Coloradans who reported a higher percentage of delayed or missed care due to administrative tasks such as prior authorizations. In fact, national pharmacy claims data show among asthma, chronic kidney disease and cardiovascular disease patients covered by commercial

insurance, Black and Hispanic patients experience prior-authorization rejections at considerably higher rates than white patients.

There have also been countless national stories about how insurance practices around prior authorization have delayed care, prevented patients from accessing essential treatments, and increased medical costs by the millions. Though insurance carriers are supposed to conduct thorough reviews of medical claims, recent national investigations found one insurance carrier in particular was using an algorithm that denies claims in mere seconds, allowing the insurance company to save money by denying claims and reducing labor costs.

This isn’t a practice used by all insurance carriers, and not all carriers are looking to save money at the expense of patient care. Carriers do a lot of good and serve an important role in our health care system, but this is an example of why we need systematic change.

Health can’t wait, and it’s time for us to remove the bureaucratic and burdensome delays that come between patients and providers, and prevent people from accessing the care they need. There are several reforms that could help streamline access to treatment for families across the state including preventing disruptions in already approved care, like requiring repeated authorizations for patients taking prescription drugs even after they have already been approved for the medication. We can ensure there is continuity of care by extending prior authorizations to last through the course of treatment and protecting patients from disruptions in care by ensuring multiple approvals are not needed as additional treatment is required.

We can also work to make sure there is more transparency in the system and that patients know their rights and likelihood of being approved. This could be done by requiring formularies to be made publicly available to help patients understand their benefits and help patients know what medications are covered and which require prior authorization. Finally, we can incentivize physicians consistently providing quality care and referring patients for medically necessary treatments.

Colorado has looked at improving patient care by streamlining prior authorization requirements in the past, but insurance carriers typically launch a campaign threatening increases in premiums. The reality is these unproven threats don’t tell the whole story. Physicians like myself spend on average two full business days per week dealing with prior-authorization challenges, taking valuable time and resources away from patient care. Eightysix percent of physicians surveyed said prior authorization resulted in higher utilization of health care resources, including needing additional office visits, emergency room visits, ineffective therapies, and hospitalizations. The truth is delayed care results in more expensive care.

It’s clear rather than seeing patients like physicians do — as people, family members and loved ones — current prior-authorization regulations allow insurance companies to see them as faceless dollar signs.

Health can’t wait. We need lawmakers to work to remove barriers between patients and doctors and streamline our prior-authorization process in Colorado. ■

Read more about our efforts to reform prior authorization in the legislative report on page 10.

Fight to protect medical liability caps and professional review

Colorado physicians are watching with growing apprehension as two recently proposed ballot measures are taking shape in the state.

Initiative #150, backed by the Colorado Trial Lawyers Association and personal injury attorneys, would eliminate non-economic damage caps in catastrophic injury and wrongful death cases. If approved by voters, it will lead to astronomical jury awards that will inflate medical malpractice insurance costs and drive physicians and other health care practitioners from our state.

“With the potential for larger damage awards in malpractice cases, obstetricians and gynecologists may face increased malpractice insurance premiums,” said Kim Warner, MD, an obstetrician-gynecologist an obstetrician-gynecologist and CMS president-elect. “Some obstetricians and gynecologists may choose to adjust their practice

patterns or even leave the state in response to increased litigation risks and costs associated with potential malpractice claims.”

“This could result in crucial decreases in access for women in Colorado and force women to travel long distances to seek care, ultimately leading to higher morbidity and mortality rates.”

If passed, Initiative #150 would have a chilling effect on specialty care providers like Dr. Warner, as well as all medical professionals and patients throughout the state.

But we’re not going to let that happen.

As the largest organization representing the interests of physicians in Colorado, the Colorado Medical Society has been a driving force behind a broad health care coalition, Coloradans Protecting Patient Access (CPPA), that has been working for more than a decade to advocate for fair

and equitable laws. Now, we’re asking you to help us protect quality care and the commonsense practice of medicine in our state.

BALLOT INITIATIVES THREATEN OUR CAREFULLY CREATED, COMMONSENSE SYSTEM

Along with Initiative #150, trial lawyers filed another ballot measure with the Colorado Legislative Council requesting to be placed on the November ballot. Initiative #149 imperils our current medical peer review process by requiring patients to have access to any medical record, medical information or medical communication by a health care professional or institution if it relates to an “adverse medical incident,” including a near miss.

This would gut protections provided in the nearly 50-year-old Colorado Professional Review Act, destroying the safe space needed to foster an environment

Staff report

where physicians, physician assistants (PAs) and advanced practice registered nurses (APRNs) can critically review the care of their peers and self-report when there is an adverse health care incident or near miss in the interest of improving care for all patients.

Initiatives #149 and #150 would destroy long-term policies key to maintaining quality, affordable and accessible health care.

Medical liability caps were created in 1988 as part of the Colorado Health Care Availability Act (HCAA) to provide stable liability rates. In the last few years, trial lawyers have pushed to significantly raise or even eliminate caps on non-economic damages nationwide, which are defined as subjective, non-monetary losses such as reduced quality of life, pain and emotional trauma. These efforts have included ballot fights and legislative compromises in states like California, Iowa and Nevada. In states without non-economic damage caps, practices have been forced to file for bankruptcy or close altogether because of astronomical verdicts, ultimately limiting access to care for patients.

“Eliminating the caps will make medical liability coverage for physicians skyrocket. This will limit access to patient care,” said Omar Mubarak, MD, MBA, a vascular surgeon and CMS president. “After years of increasing administrative burden, increasing burnout and a global pandemic that became so divisive, I predict we will see many more physicians in the prime of their career retiring early and fewer young professionals choosing medicine.”

This would impact all Coloradans, particularly those in rural areas and high-risk patients requiring specialty care, by making it more difficult to retain and recruit physicians and other health care professionals.

SWEEPING CHANGES FOR ALL COLORADO BUSINESSES

In addition to personal injury claims for medical liability, Initiative #150 affects general liability for any business in the state. Hospitals, facilities and clinics that are businesses themselves would feel

double the impact, including rising costs of property and casualty insurance, auto insurance and more. While these increased costs fall on businesses, they will likely result in “cost of doing business” expenses being passed down to consumers, impacting the quality and affordability of life for everyone in Colorado.

“Colorado’s legal climate has been deteriorating, making it more and more difficult to do business here. We’ve dropped from ninth to 21st in our national legal climate ranking,” said Loren Furman, president and CEO of the Colorado Chamber. “ We are already one of the most expensive places to live and do business – the consequences of encouraging even more costly lawsuits across the state will be felt by everyone.”

OUR RESPONSE: COUNTERMEASURES AND A BALANCED LEGISLATIVE SOLUTION

A broad-based coalition of small and large businesses, patient advocacy groups and health care organizations, including CPPA, has filed two countermeasures with the Colorado Legislative Council. The issue committee, called Coloradans for Attorney Accountability (CAA), wants its ballot measures to ensure Colorado maintains transparent legal reforms, with a focus on impacted parties’ rights to recover fair compensation for damages.

The first initiative, Initiative #170, caps attorney fees in cases of personal injury and wrongful death at no more than 25 percent of their client’s total damages award. The second initiative, Initiative #171, also known as a “sunshine law,” requires lawyers in personal injury and wrongful death cases to disclose litigation costs to be borne by clients in civil cases proactively and transparently. These measures would ensure attorneys don’t benefit from high fees or a failure to disclose expected costs at the expense of their client’s ability to receive fair compensation.

At the legislative level, since Colorado’s non-economic damages cap (as included in the HCAA) is one of the lowest in the country and has been unchanged for 20 years, we support a reasonable increase to the medical liability cap that provides

fair compensation in medical liability cases, while ensuring health care accessibility, affordability and stability.

Senate Bill 24-130 , with bipartisan sponsorship including licensed emergency room nurse Sen. Kyle Mullica (D-Thornton), would increase Colorado’s non-economic damages cap in the HCAA from $300,000 to $500,000 over a fiveyear period. In the past two years, California and Nevada raised non-economic damage caps to avoid ballot initiatives eliminating non-economic damage caps altogether. We strive for a similar outcome. Over 30 health care organizations in the state support this legislation, and that list continues to grow.

A second legislative measure, Senate Bill 24-062, would have prohibited a plaintiff's attorney from collecting attorney contingency fees based on the portion of the ultimate damages award attributable to 9 percent compounding interest. Sponsored by Sen. Bob Gardner (R-Colorado Springs), this bill failed in committee following trial lawyer testimony – demonstrating the substantial resources of our opponents and the need for those supporting health care access to come together.

How you can help

We must immediately raise critical funds to fuel a robust statewide ballot campaign to defeat both ballot initiatives and to pass those introduced by Coloradans for Attorney Accountability. Please reach out to your colleagues, employers, business associates, friends and family to invest in the fight to maintain high-quality, affordable health care in Colorado.

DONATE NOW:

• Donate online at givebutter.com/ QPZnJ3

• Send a check made out to the Colorado Medical Society with Liability Defense Fund written in the memo section, to 7351 E. Lowry Blvd, Suite 110, Denver, CO 80230.

• Call the CMS offices at 720-859-1001 Monday-Friday 8:30 a.m.-5 p.m. to make a secure contribution using your credit card. ■

Preserving your legacy: Navigating identity, finances and fulfillment in retirement

Scott Humphreys, MD, CPHP medical director

Most of us look forward to retirement as a reward for a successful career. But as physicians, we have considerations that may not be obvious.

Physicians tend to retire later than other professionals. The average physician retires at 69 years old. This may be because we start working and earning later than our non-physician peers. It could also be that we find our work more fulfilling or the need for our work more pressing.

The most common unanticipated consequence of retirement I see at Colorado Physician Health Program (CPHP) is a doctor’s loss of identity. Being a physician is who we are! I often say we have one of the few careers we change our name for. I am married to a pediatrician, and I have come to accept that she is a minor celebrity – recognized when we go shopping, out to eat, and during graduation season, of course. Our position and responsibilities to our communities solidify how we think of ourselves.

Finances are another uncertainty. Not starting our careers until our early thirties puts us behind in savings. We miss out on at least one “doubling time.” Also, many physicians planned to use the equity in their practice as a retirement account. For many, this was a devastating blow. I have seen many terrific doctors singularly focused on giving great care that they ignore their own financial needs.

So, what can we do to minimize the negative effects of this transition? We need to anticipate. We need to think about what gives meaning to our lives and how this will look in the next chapter. We won’t miss the EHRs and the bureaucratic red tape that has become ubiquitous in medicine. But most miss the collegiality, the mental stimulation and the respect. It is time for these to take on a new shape.

• Think about the meaning of your years of retirement. What do you want to achieve, contribute, and what do you want your legacy to be?

• You’re likely to be spending much more time with your significant other. It might be a great time to see a couple’s therapist for a tune up. There is probably no greater correlation to one’s happiness in these years than the health of your primary relationship.

• Maintain multi-generational relationships, especially with your colleagues who are still practicing.

• Access activities that are mentally stimulating. For most of us “Wordle” is not going to be enough. Get involved with some charity organizations, take a class in something that has always interested you, travel, or learn a new hobby.

These can and should be wonderful years that you have earned. But you must take control and do some planning in order to navigate this next chapter. Enjoy!

CPHP PRESENTS CMS WITH A SPIRIT OF MEDICINE AWARD

The Colorado Physician Health Program (CPHP) provides peer assistance and wellbeing support at no cost to physicians. To support their work, the nonprofit organization accepts contributions through their Spirit of Medicine campaign. In turn, CPHP recognizes donors for contributions to their work with Spirit of Medicine awards. CPHP Executive Director Sarah Early, PsyD, and CPHP Immediate Past Chair Lawrence G. Wood, MD presented the 2023 Spirit of Medicine award to CMS President Omar Mubarak, MD, MBA during the Dec. 8, 2023 CMS Board of Directors meeting, in recognition of CMS’s $5,000 contribution. ■

A prescription for a healthier, safer Colorado: Colorado’s Medication Takeback Program

HELP EMPOWER YOUR PATIENTS TO BETTER PROTECT THEIR FAMILIES AND ENVIRONMENT!

COLORADO MEDICATION TAKEBACK PROGRAM

TakeMedsSeriously.org/safe-disposal

As dedicated health care professionals, you understand the importance of safe medication storage. However, did you know that your guidance can make a significant impact on your patients’ families and the environment? Encourage them to participate in Colorado’s Medication Takeback Program – a vital step towards a safer and healthier Colorado.

WHY ENCOURAGE MEDICATION DISPOSAL?

By recommending the Colorado Medication Takeback Program to your patients, you help:

• Ensure patient safety: Prevent accidental poisoning, misuse, or theft of unused medications, ultimately protecting your patients and their families.

• Safeguard the environment: Discourage improper disposal methods such as flushing or tossing meds in the trash. Safe disposal of old and expired meds reduces contamination of our water supply and ecosystems.

Guiding your patients on how to participate is straightforward. Share these three simple steps:

1. Education: Explain the importance of proper medication disposal and the benefits of using the Medication Takeback Program. It’s a simple yet effective way to enhance their safety and protect the environment.

2. Collection process : Encourage them to collect all their unused or expired medications, reminding them to remove personal information from prescription bottles or packaging. They can then place medications in a sealable bag or container to prevent leakage or spills.

3. Locate a drop-off point : Direct them to find the nearest drop box at TakeMedsSeriously.org/safe-disposal. When they arrive, they can place their sealed bag or container with medications inside. Some drop boxes may have specific instructions or signage, so they should follow any guidelines provided.

As health care providers, you are instrumental in ensuring your patients’ health and wellbeing. By promoting Colorado’s Medication Takeback Program, you can empower your patients to make safer and more responsible choices, leading to a healthier and greener Colorado. Let’s work together to protect our communities and the environment.

FREQUENTLY ASKED QUESTIONS What can be dropped off?

PATIENTS CAN UTILIZE COLORADO’S MEDICATION TAKEBACK PROGRAM TO DISPOSE OF:

• Over-the-counter medications

• Prescription medications (Including opioids and other controlled substances)

• Prescription patches

• Prescription creams and ointments

• Unused medication inhalers (if empty)

WHAT SHOULDN’T BE DISPOSED OF?

• Trash

• Sharps or syringes

• Thermometers

• Chemotherapy medication

• Illicit substances (including marijuana) ■

CMS advocates for you on bills that will affect the practice and delivery of medicine

Staff report

Health care policy has been a major focus of the General Assembly and the governor in recent years, and the Second Regular Session of the 74th Colorado General Assembly – which convened Jan. 10 and is expected to run through May 8, 2024 – is no exception. As of Feb. 28, 520 bills have been introduced, and CMS is analyzing all bills that could affect the practice and delivery of medicine.

We have already seen action in tort reform, prior authorization reform, violence against health care workers, substance use disorder and mental health, CME requirements, required health benefit coverage, and network adequacy/primary care payment reform – just to name a few.

A top priority for CMS in 2024 is prior authorization reform, and Council on Legislation strongly supports HB24-1149 Prior Authorization Requirements Alternatives, sponsored by Rep. Shannon Bird (D), Representative Lisa Frizell (R), Sen. Dylan Roberts (D) and Sen. Barbara Kirkmeyer (R).

CMS President Omar Mubarak, MD, MBA, testifies in support of HB24-1149 before the House Health & Human Services Committee on Feb. 21.

Physicians know that to best ensure equitable, timely access to critical medical care for Colorado patients, medical decisions should be made between a patient and their provider; carriers should not be practicing medicine nor are they qualified to do so. Reforms are needed in Colorado to streamline and improve our prior authorization system to empower patients and providers to make important medical decisions and reduce the financial costs, trauma, and wasted valuable provider hours caused by delayed care. Health can’t wait for Colorado patients.

CMS and the Colorado Academy of Family Physicians, with other supporting organizations, coordinated a press conference at the Capitol on Feb. 21, the day HB24-1149 was heard in the House Health & Human Services Committee.

Northern Colorado Medical Society President Sean Pauzauskie, MD, right, and Neurorights Foundation Co-founder Rafael Yuste, MD, left, testify in support of HB24-1058 before the House Judiciary Committee on Jan. 30.

Physicians then stayed to testify at the hearing, clearly making the case that unnecessary prior authorization harms patients. The bill ultimately passed out of committee on a 10-2 vote and, as of press time, was awaiting scheduling for a floor hearing.

See the opposite page for additional bills we're working.

We will keep you informed on the latest legislative and ballot developments and provide you ways to make your voice heard. Watch for Code Blue legislative alerts, strategically sent to physicians in key legislators’ districts with analysis on how proposed policies will impact the practice of medicine and the delivery of safe, quality care.

Physicians and patients gather at the Capitol on Feb. 21 in support of prior authorization reform. Pictured with bill sponsors for HB24-1149, Rep. Shannon Bird (D) and Rep. Lisa Frizell (R).

A FEW OTHER BILLS WE’RE WORKING:

SB24-163 Arbitration of Health Insurance Claims (COL supports)

Colorado has passed legislation to protect patients from out-of-network claims and align with federal (no surprises act) law. Yet, important alignments were not made and this bill aims to stop health plan gaming of the system by allowing batching of arbitration claims.

HB24-1066 Prevent Workplace Violence in Health Care Settings (COL amend position)

This bill aims to enhance safety measures across the system, and CMS is focused on reducing administrative complexity and ensuring front-line workers can do their jobs.

SB24-130 Noneconomic Damages Cap Medical Malpractice Actions (COL supports)

With bipartisan sponsorship, this bill would modernize the medical non-economic damage cap, with a modest increase over a five-year period. In the past two years, California and Nevada raised non-economic damage caps to avoid ballot initiatives eliminating non-economic damage caps altogether. We face a similar attack on caps.

HB24-1171 Naturopathic Doctor Formulary (COL strongly opposes)

This bill would enable naturopathic doctors to prescribe all legend drugs and Schedule III-V drugs.

HB24-1037 Substance Use Disorders Harm Reduction (COL supports)

One of four bills drafted by the Opioid and Other Substance Use Disorders

Study Committee, an interim committee that met this summer, it aims to reduce the harm caused by substance use disorders by making important clarifications and exclusions to current law and regulations.

HB24-1058 Protect Privacy of Biological Data (COL supports)

This first-in-the-nation bill puts in place important protections for individuals’ biological data collected by consumer devices now and in the future. It is championed by Sean Pauzauskie, MD, a neurologist who brought the bill to his state representative, Rep. Cathy Kipp (D-Fort Collins), following patient questions about a wearable neurological device.

HB24-1153 Physician Continuing Education (COL seeks to amend)

This bill would create a new maintenance of licensure framework for Colorado physicians, including a CME requirement. ■

CSEPS President Michael Puente, MD, right, and Ryan Frisbie, MD, wait to testify in support of SB24-87 on Feb. 7.

National Advocacy Conference report:

Colorado

physicians advocate

for federal reform in nation’s capital

PLUS: SEN. KYLE MULLICA IS SOLE STATE LEGISLATOR TO RECEIVE NATIONAL SERVICE AWARD

Kate Alfano, CMS Director of Communications and Marketing

Colorado physicians and medical society staff traveled to Washington, D.C., for the American Medical Association’s National Advocacy Conference (NAC) Feb. 12-14. Attendees had the opportunity to connect with industry experts, members of Congress, the administration, and others about federal efforts to improve health care, and advocate on crucial health care issues affecting physicians and patients.

Also during the conference, the AMA presented Awards for Outstanding Government Service. Colorado State Senator Kyle Mullica was this year’s recipient in his category, member of a state legislature. He is serving his first term in the Colorado Senate after two terms in the Colorado House of Representatives and has been a staunch champion of medicine throughout his time in office. Last year he was awarded the Colorado Medical Society’s 2023 Defender of Medicine award.

“It’s an honor to be recognized by the American Medical Association for my commitment to improving public health in Colorado,” Mullica said in a release from the Senate Democrats on Feb. 13. “As an ER nurse, I know firsthand the challenges that patients face when seeking care, as well as the challenges providers face in delivering care. Throughout my time in elected office, I have fought for policies that ease the burdens for patients and providers alike and improve health outcomes for all Coloradans.” ■

Sen. Kyle Mullica, center, received the American Medical Association’s Award for Outstanding Government Service. With the Senator are Geoff Bennett, left, co-anchor of PBS Newshour, who emceed the awards ceremony, and AMA Board Chair Willie Underwood III, MD, MSc, MPH, right, who presented the award.

Colorado physicians and medical society staff traveled to Washington, D.C., to learn about federal issues and advocate on behalf of physicians and patients.

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Preserving life

Addie Netsanet

Addie Netsanet is a fourth-year medical student at the University of Colorado School of Medicine in the Research Track. Addie is applying into orthopaedic surgery and hopes to continue to integrate research, mentorship, and serving vulnerable patient populations into her future career. In her free time, Addie enjoys volunteering, playing acoustic guitar, spending quality time with her dog, baking and traveling.

It was 9 a.m. when my heart rate started to accelerate. I repeatedly, and inconspicuously, glanced at my watch as I walked out of interdisciplinary rounds during my Internal Medicine clinical rotation. We were taking care of a patient who I will call “Ms. Sara,” and I had assured her that I would do everything in my power to return to her room after morning rounds so we could watch her grandson’s virtual graduation together. Ms. Sara’s family became well known to everyone on our team over the course of several weeks. They were exactly the type of supportive family members you would want to surround you if you were dying. And Ms. Sara was dying. She suffered from hepatorenal syndrome secondary to nonalcoholic fatty liver disease, which had progressed to a point that was refractory to medical treatment. Every day was a constant battle against the effects of the compensatory mechanisms that her body initially developed to preserve her life in the setting of advanced liver disease. I felt a sense of pride as I learned not only about Ms. Sara’s condition, management options, and prognosis, but also about her personal values, which largely centered around her family. I was able to form a

close bond with Ms. Sara and her family while gaining an intimate understanding of their collective medical fluency, interpersonal dynamics, and goals of care.

In caring for Ms. Sara, I learned that listening attentively, building trust, and providing unbiased counseling are not skills that we can easily master. It is probably never easy to help someone realize that they are dying, nor to usher their family towards the realization that their seemingly invincible matriarch would likely succumb to her disease soon, regardless of any medical interventions. For Ms. Sara, although there were options to escalate her care that could improve her vital signs, these options had low efficacy and could be detrimental to her remaining quality of life. In our conversations, we commonly touched on the topic of how important it was for Ms. Sara to be at home with her family before she passed, and that this outcome would be statistically unlikely if we escalated her care. After many interdisciplinary meetings, it was clear to me that she would choose her family and remaining quality of life over escalating care. When the day came to discharge Ms. Sara home with hospice care, my

entire team came to say our farewells and stand with her family one last time in a room that had become familiar and meaningful to many because of Ms. Sara’s presence. My heart raced again as we approached her room. My eyes welled while her family expressed their sorrow. They were mourning their family’s matriarch as they once knew her.

Throughout medical training, we develop the inherent skills of humanism, compassion, and patient-centered care that help us care more completely for our patients. In caring for Ms. Sara, I saw the importance of empowering people to make autonomous choices while providing compassionate care and education that allows them to live fulfilled, dignified lives. I saw that taking care of a whole person can also mean taking care of their loved ones, who often play integral roles both during life and the process of death. Ms. Sara’s case is not entirely unique, but it poses the quintessential dilemma of what it means to preserve life. Reflecting on this experience, I am honored to have been a part of this team that preserved Ms. Sara’s quality of life while caring for her as a whole person. ■

I can see your heart

Rita Molem

Rita Molem is a fourth-year medical student at the University of Colorado School of Medicine. Born and raised in Los Angeles, she earned her bachelor’s in human biology at the University of Southern California prior to moving to Colorado and contributing to Denver’s traffic. An avid non-skier, she enjoys park hopping with her friends and exploring Denver cafes and restaurants. She is currently applying to anesthesiology residency programs this cycle and is excited (and a bit nervous) for the next phase of her medical journey.

As a medical student, I have had the great privilege of witnessing and experiencing humanism in medicine, and I have experienced firsthand just how healing it can be. I was on the gyn-oncology service, my last clinical rotation. I was feeling burned out, frustrated, and helpless. I went to check in on my patient who had advanced ovarian cancer; she had been made aware of her poor prognosis the day prior. She was Spanish-speaking only, and even with the use of the interpreter, I had felt a connection with her throughout my time on service.

At the end of our final conversation she said, “I know I’m going to die, but I am so grateful to have met you and that you were on my team. I can see your heart. Thank you for seeing mine.” She handed me a two-dollar bill that was folded and crafted into the shape of a heart. I keep that heart in my badge as a reminder of the importance and power of human connections. Even when this woman was at her sickest and at her most vulnerable, she extended gratitude when I thought I least deserved it. When all the surgical

interventions, medications and medical technology were exhausted, genuine, meaningful human connection prevailed. Caring for our patients as fellow human beings transcends language barriers, medical knowledge and clinical grades. This experience serves as my reminder that heart and compassion will always carry me through burnout and take precedence in my interactions with patients.

Humanism also includes the compassion we show each other when we are at our most vulnerable. I experienced this as a second-year student during my medicine rotation early in our clinical year. A patient had asked for water, something I knew how to do very well as a medical student. I gave the patient water and as I am walking out of the room, an “NPO” (nothing by mouth) poster stares me straight in the face. Panic runs down my spine. What did I just do? Am I going to be the reason this patient doesn’t have the surgery he has long waited for? I felt horrible. After removing the palm from my forehead, I flagged down a third-year student I recognized and asked for advice. She

was effortlessly consoling, encouraged me to tell my resident, and reassured me that everything was going to be okay. I had made an error, and when I couldn’t find the grace to give myself, a colleague had. A year later, I found myself offering that same grace to an MS2 I found in the hallway crying about a “botched presentation.” I was transparent and candid about my own prior mistakes and offered my contact for any time she needed an ear or felt self-doubt surface.

As a medical student approaching graduation and the start of internship, I know there will be long days, steep learning curves and struggles in the days ahead. Yet, I can see more clearly than ever the power of compassionate, humanistic patient care. I am wholeheartedly committed to nurturing humanism and reminding our community that it’s a value that unites us all. I am committed to paying humanism forward every single day. I am committed to seeing each patient’s, and each peer’s, heart. ■

Reflective writing is an important component of the University of Colorado School of Medicine curriculum. Beginning in the first semester, medical students write essays, stories or poetry that reflect what they have seen, heard and felt. The Reflections column was co-founded by Steven Lowenstein, MD, MPH, and Tess Jones, PhD. It is now co-edited by Dr. Lowenstein and Kathryn Rhine, PhD. It is dedicated to the memory of Henry Claman, MD, Distinguished Immunologist and Professor at the University of Colorado, and founder of the Arts and Humanities in Healthcare Program.

Compartmentalization and empathy: An essential dichotomy in health care

Meredith A. Ware

Critical reflective writing holds a prominent place in the Medical Humanities curriculum at Rocky Vista University College of Osteopathic Medicine. Beginning in the first semester of Medical Ethics, students engage in critical reflection to explore their own assumptions and biases and how their values impact their practice. This submission is selected and edited by

Nicole Michels,

PhD,

chair of the Department of Medical Humanities, and Alexis Horst, MA, writing center instructor.

In March 2020, my world shattered. Surprisingly, I'm not referring to the world-halting, life-changing COVID-19 pandemic. Two weeks into quarantine, my mom called me from Los Angeles and gestured to a lump on her neck that was visible over Facetime. She had seen her PCP earlier that day for abdominal pain and was found to have diffuse lymphadenopathy, a sign of cancer. I could see her attempting to stay strong for me as she told me about her upcoming oncology appointment, so I gathered my emotions and tried to do the same for her. As her daughter and a future medical student, I took on the responsibility of supporting my mom however I could from 1,500 miles away.

What we hoped was a false alarm was, in fact, lymphoma. Over the next six

months, my mom completed six rounds of chemotherapy. I kept hearing doctors and family members say that she was “lucky” to have this kind of cancer because her prognosis was good, so I forced myself to focus on gratitude. When she entered remission during my first semester of medical school, I was thrilled to leave this nightmare in the past; however, I soon discovered that this experience was not something I could leave behind.

During my first two years of medical school, I encountered several moments when our lecture content triggered memories of my mom’s journey. I found myself struggling to pay attention to lectures on the mechanisms of aging and death and the various types of lymphoma without thinking of my mom. I asked several classmates if they had

experienced anything similar while studying our medical school curriculum, but I ultimately felt alone in this experience. Our lectures continued to fly by, and I recognized I didn’t have time to dwell on my emotions, so I chose to lean on my peers and the school counselor. Thanks to their support, I could compartmentalize, pass my exams, and focus on the next course, leaving these triggers safely behind me, like all neatly stored away traumatic experiences.

Upon entering my core clinical rotations, I reflected on a piece of advice that someone I respected had given me: “Don’t get too close to your patients because it can occasionally cause more harm than good.” I took this warning at face value, even though I knew it contradicted why I chose to become a doctor – to build

Meredith Ware is a fourth-year medical student at Rocky Vista University in Colorado and is applying for residency in pediatrics. She is passionate about caring for medically complex children and their families, and is currently considering subspecialties in critical care or hospital medicine.

strong relationships with people and support them through their most difficult moments. Nevertheless, I committed to providing excellent care while maintaining emotional walls between me and my patients. However, this all changed when “Jennifer,” one of my internal medicine patients, was diagnosed with the same type of cancer my mom had. Jennifer was from a rural town and had been transported to Colorado because her heart was in critical condition, leaving her hundreds of miles away from her family. Many of the discussions among her care team revolved around whether her heart could withstand chemotherapy, and I realized Jennifer’s time on this earth was likely limited. I felt my emotions creeping up and initially tried to suppress them, but seeing her need for company, I cautiously let down my walls. I spent the remaining time on this rotation finding ways to support Jennifer, including suggesting changes to her treatment plan to make her more comfortable, providing her son with daily updates over the phone, refilling her cup with ice water every time I went in the room, and performing gentle osteopathic manipulative treatments to help ease her pain. We also spent many afternoons chatting about her son and

her hometown. Eventually, I shared with her about my mom’s journey to give her hope for her future, and I saw her glow when she proclaimed she was ready to fight her cancer. On the last day of my rotation, we teared up as we said our goodbyes, silently acknowledging that it would be the last time we would see each other.

Months later, I typed Jennifer’s name into Google and found her obituary, which was published less than a month after I left the hospital. My heart broke for her family, who did not get to spend her final days with her. However, I was surprised when I did not regret opening my heart to her. Instead, I felt honored to have been part of her journey. I finally recognized that the traumatic experience of being the daughter of a mother with cancer provided me with a deep sense of empathy – something that would enable me to connect with my patients and their families throughout my career.

After meeting Jennifer and processing her death, I finally allowed myself to reflect on my experience with my mom. As a result, I became better informed about how to approach “parent care.” While on pediat-

Medical Transcription Services

Busy vs. Kinda Sorta Maybe Busy

ric wards, I met with a patient’s parents daily, providing detailed updates on their son’s condition and discussing at length the various options they were facing, just as my mom’s oncologist had done for my family. While on heme-onc, I hugged my patient’s mother as she cried over her child’s critical condition, just as my friends and family had done for me. While on a PICU rotation, I disclosed to my patient’s mother that her child had cancer, and I implemented a similar compassionate and direct approach that once empowered my mom to face her cancer head-on. Time after time, I have confirmed that utilizing empathy within health care is a gift, not something to fear. While compartmentalization is vital to getting through a workday in health care, I now understand that sometimes, a professional display of personally gained empathy can result in the human touch that makes good physicians genuinely excellent. ■

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Checklist for physicians retiring from a medical practice

Gerald Zarlengo, MD Chairman & CEO, COPIC Insurance Company

COPIC prides itself on establishing lifelong relationships with physicians. From our involvement with medical resident programs to helping navigate challenges throughout your career, we stand ready to offer trusted support. This includes helping physicians plan for retirement.

Retirement takes considerable thought, and once the decision is made, you must address business and regulatory aspects. To that end, we’ve created a Retirement Checklist that will help guide you through the process of taking the next step on your life’s journey.

PATIENTS

Patients seen within two years of the provider’s retirement should receive notice a minimum of 30 days and ideally, 60-90 days prior to discontinuing practice. The notice letter should inform patients of the specific date of retirement and the closure of the practice, if applicable. It should also notify the patient to immediately seek a new health care provider. Direct them to their health insurer. For patients who will need continuing care, you may want to refer them to a specific provider. In addition to sending the notice by mail, post the notice at your practice location, perhaps near where patients check in. Provide notice on your website and on your practice’s social media accounts.

INSURANCE CARRIERS

Advise your professional liability carrier of the practice’s closing date or the date you will stop practicing. If you have a claimsmade policy, arrange for tail coverage for any claims that are brought after the date you cease practicing. If you are fully retiring, you may qualify for tail coverage at no charge (contact your COPIC underwriter for more details). Business interruption, general liability, employment practices liability, and any other insurance carriers for your business will also need to be notified. If you offer insurance to your employees, notify any health, disability, life, and long-term care insurers and terminate those policies.

STATE MEDICAL BOARD OR LICENSING AGENCY

Some states have retired or inactive license categories that may save you money should you wish to renew your license after retirement. You may also need to update your contact information if the board has your business address and phone number on file.

HEALTH INSURANCE CARRIERS AND OTHER PAYERS

Review the provider contract termination provisions. Often 90 days’ advance notice

is required to terminate agreements with private payers. Medicare, Medicaid, TRICARE, and workers’ compensation payers must also be notified of your practice closure.

DRUG ENFORCEMENT AGENCY (DEA)

A DEA number may be kept active after retirement and be needed if you plan to do volunteer medical services. Caveat: Prescribing or treating friends and family is a bad idea when actively practicing; it is more perilous after retirement. When the DEA number is no longer needed, the DEA must be notified in writing and informed that you do not have any schedule II or controlled substances in your possession. The letter must be signed by the retiring physician and the DEA certificate returned with the letter.

You will also need to properly dispose of, transfer, or donate prescription drugs or drug samples that may be on hand in accordance with DEA requirements. Shred any prescription pads upon the closure of the practice. Check www.dea. gov for more details on requirements.

FACILITIES

Advise any hospitals, ambulatory surgery centers, or other facilities that have granted privileges.

MEDICAL RECORDS CHECKLIST

ARRANGE FOR SECURE MEDICAL RECORD STORAGE AND ACCESS.

Many states have medical record retention requirements that do not cease when a physician retires. Medicare and Medicaid also have requirements. HIPAA privacy and security rules continue to apply after you close your practice. COPIC recommends you retain the medical records for 10 years after the date of last treatment or 10 years after a minor patient reaches the age of majority. If the practice is sold to another physician, physician group, or hospital system, medical records can be included in the purchase as an asset. However, the retiring physician will need to include in the contract the buyer’s obligation to secure the records, ensure patients have access, and that the retiring physician will have access in the event of a lawsuit or audit. If the practice is not sold,

consider arranging for another physician or organization to securely store your records and provide timely access for patient requests. Record management companies can provide these services for a cost. Remember that you may need to execute a HIPAA business associate agreement with the party storing your records (unless transferred as part of a sale of the practice).

PLAN FOR THE (EVENTUAL) DESTRUCTION OF RECORDS.

ARRANGE FOR STORAGE OF OTHER RECORDS.

HIPAA requires that you retain a variety of records (other than medical records) for six years. This includes authorization forms, business associate agreements, notice of privacy practices, responses to requests to amend a record, any patient statements of disagreement, and complaint information.

Any records that do not have to be retained under the law that have passed the recommended retention period may be destroyed. Plan to periodically (yearly or biannually) destroy additional records which have passed the required retention periods. If the records contain medical or financial information, the records should be securely shredded. A HIPAA business associate agreement with the file destruction company is required.

The information in this article is for general educational purposes and is not intended to establish practice guidelines or provide legal advice. ■

Embracing digital transformation: A prescription for health care revenue growth

Amanda Zeosky, Director, Tebra Partner Marketing

The health care landscape has experienced a profound transformation in recent years, and it's become increasingly evident that patients are now seeking digital experiences regarding their health care journeys. Adapting to this demand by offering virtual care options eliminates hurdles to quality health care and alleviates the strain on the health care system.

However, how can health care providers integrate digital care solutions, and, more importantly, how can this shift lead to revenue growth?

EMPOWER PATIENTS WITH ONLINE SCHEDULING

If you've ever been frustrated spending hours on hold, you can empathize with patients in a similar situation. Patients left on hold for extended periods are likely to disconnect before securing an appointment, leading to missed opportunities for health care providers. To address this issue, health care providers must implement online scheduling solutions.

Patients expect the flexibility to schedule medical appointments at their convenience without the hassle of waiting on hold. Investing in digital phone systems incorporating virtual waiting rooms can be a game-changer. These virtual waiting

rooms ensure that patients remain in the queue and can even receive callbacks, simplifying the appointment booking process. Additionally, offering online booking options outside regular business hours caters to patients' needs.

Selecting booking software that seamlessly syncs with your office scheduling system can significantly reduce the workload on your front office staff, improving efficiency and patient satisfaction.

PRIORITIZE DIGITAL COMMUNICATION

Recent findings from Tebra’s Patient Perspectives report reveal that 55 percent of patients prefer quick access to their medical providers to seek answers to their questions, even without

a scheduled appointment. Incorporating two-way messaging software can streamline communication between patients and health care providers, potentially reducing the need for unnecessary appointments.

Patients can utilize this platform to request prescription refills, consult their medical providers on specific health concerns, and obtain prompt responses to questions about their symptoms. This enhances patient satisfaction and optimizes providers’ schedules by reducing the influx of unnecessary appointments.

HARNESS THE POTENTIAL OF TELEHEALTH

Before the COVID-19 pandemic, telehealth services were underutilized. Fast

Tebra is a CMS Partner in Medicine. They are the leader in practice growth with the only all-in-one solution that empowers health care providers to improve every digital touchpoint of the patient journey. As experts in the health care technology space, Tebra makes it easy for providers to promote their practice online, attract patients, and retain them for life. To instantly see how you compare to other practices in your local area and specialty: https://compare.patientpop.com/cms

forward to today, and approximately 25 percent of all patients have embraced telehealth options, with many expressing a preference for this mode of care delivery.

Telehealth can eliminate barriers that often deter patients from seeking health care, such as taking time off work, arranging childcare, or dealing with long commutes to medical facilities. While it may not entirely replace in-person visits, telehealth shines in addressing issues like cold and flu symptoms, mental health concerns, and routine check-ins. Integrating telehealth into your health care offerings can significantly enhance patient access to care.

MODERNIZE REVENUE CHANNELS WITH DIGITAL HEALTH CARE

The pace of change in the medical field is relentless, and digital health care solutions are here to stay. To meet the evolving needs of patients and sustain a thriving practice, health care providers should fully embrace the digital strategies outlined in this article. Doing so can diversify revenue streams without compromising patient satisfaction or overburdening your staff.

In today's dynamic landscape, digital innovation is the prescription for health care revenue growth. Health care

providers can forge a path toward a more prosperous and patient-centric future by leveraging online scheduling, enhancing digital communication, and embracing telehealth. ■

Marilyn

J. Gifford, MD, 1943-2024

Marilyn Gifford, MD, FACEP, an emergency room physician, veteran and leader in the El Paso County Medical Society and Colorado Medical Society, passed away on Jan. 16. She was an influential figure within the Colorado Springs community, creating positive influence through leadership and protocol development for ambulance and fire services to assist first responders. Among her leadership roles, she served in the CMS House of Delegates from 1984-1996 and 2001-2015; on the CMS Board of Directors 1996-1998;

as EPCMS board president from 19931994; and on the EPCMS Pre-Hospital Care Physician Advisory Committee from 1982-1993.

She attended Medical School at Mount Sinai in New York, and continued her medical training while serving in the Navy. Dr. Gifford lived in Boulder and Aurora before moving to Colorado Springs, and she worked in the emergency department at Memorial Hospital from 1980-2013. According to her obituary,

DEPARTMENTS  MEDICAL NEWS

Colorado physicians can help MHMS fund Blackwood

scholarship

The Mile High Medical Society (MHMS), with support from the Colorado Medical Society, asks physicians to donate to the Charles J. Blackwood, MD, Endowed Memorial Scholarship Fund at the University of Colorado School of Medicine (CUSOM).

MHMS established the scholarship in 2016 and started an endowed fund, recognizing the need to create new opportunities in medical education; help develop a more diverse, inclusive health care workforce for Colorado’s

underserved communities; and support students historically underrepresented in health care. It is named for the late Charles J. Blackwood, MD, who in 1947 became the first African American graduate of CUSOM.

The Blackwood Endowed Memorial Scholarship Fund provides full scholarships to one or more students each year pursuing a medical degree at CUSOM. But there is still work to do. CUSOM Dean John J. Reilly Jr. pledged to support the endowment dollar for dollar up to $2

she became medical director of emergency services, despite so few women in emergency medicine at the time, and was instrumental in overseeing the hospital’s renovation. During her directorship, Memorial Hospital Central was the busiest emergency department in the state of Colorado.

She is survived by her sons, Eric Caplan, MD, and Brian Caplan, and many more family members. ■

million. The first $1 million milestone was reached in February 2021. The second $1 million milestone must be reached by June 30, 2024, to earn the match. MHMS has made progress and needs your help.

Donations may be made online with a credit card, ACH transfer, or by written check. Find more information or donate online at https://giving.cu.edu/fund/ charles-j-blackwood-md-endowedmemorial-scholarship-fund ■

MTC’s

MTC

The

for sessions

exhibits,

topics in

and

events like the

Gala. CMS will again host a poster competition for medical students, residents and physicians, and child care will be provided (advance registration required). Find more information and the link to register at cms.org/events

Don’t miss this opportunity to enhance your wellbeing and enjoy the mountains in the fall.

Our words matter

Jill Hilty, MD

Embracing patient-centered care is universally acknowledged as crucial for providing the best service to our patients. However, it’s essential to acknowledge the evolution of patient-first language in recent years. Many of us, particularly in the mid-to-late stages of our careers, may have been trained in a manner that inadvertently perpetuates harm to patients. Implicit biases influence not only our interactions with patients but also our documentation practices in health records, potentially passing on biases and judgments to subsequent clinicians. Recognizing this potential harm

is paramount, and we must actively work to change ingrained habits.

My awareness of the impact of pejorative language heightened during my involvement in global health, supporting local clinicians delivering health care in East African refugee camps. In this role, I provide continuing medical education and work alongside clinicians as they treat patients from diverse backgrounds. Unfortunately, biases and prejudices are prevalent, with clinicians often referring to patients from specific countries or tribes using derogatory terms and stereotypes.

I advocate for treating all patients with equal respect and providing quality care regardless of where individuals were raised or the language they speak.

Native clinicians often find themselves entangled in inter-tribal conflicts that have persisted for centuries, complicating care delivery in the diverse environment of refugee camps. Overcoming negative perceptions about certain groups is essential to ensure each patient receives the care they deserve. Modern medical training emphasizes patient-first language, refraining from using medical conditions as labels and instead focusing on patients as individuals experiencing specific health challenges.

Older training practices, which encouraged describing patient encounters in vivid detail including direct quotations from patients, may inadvertently convey disbelief or mockery. Negative descriptors like “aggressive” or “non-compliant” further perpetuate non-patient-centered practices and can stigmatize patients, particularly those who are already marginalized. Careful consideration of language is crucial, as it directly impacts the patient’s experience and the quality of care they receive.

For instance, encountering stigmatizing language in a patient’s previous medical records can influence subsequent interactions, leading to defensive attitudes and compromised care. It’s imperative that we avoid language that stigmatizes or marginalizes patients, recognizing our responsibility to promote positive change, starting with our choice of words in the electronic health records. By adopting patient-first language and refraining from judgmental descriptors, we can foster a more inclusive and respectful health care environment for all patients. ■

PEACE OF MIND COVERAGE BEYOND

As a premier medical liability insurance carrier, we are committed to being there when you need us. Our physicians and other staff serve as extended members of your team to help answer questions or navigate difficult situations. And when it’s urgent, you have 24/7 access to a physician via our Risk Management hotline. Plus, our legal and HR experts help you tackle other issues as they arise. That’s Value Beyond Coverage.

COPIC is proud to be the endorsed carrier of the Colorado Medical Society. CMS members may be eligible for a 10% premium discount.

STEP 1 STEP STEP

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COLORADO PHYSICIAN OR MEDICAL STUDENT CALLS 720-810-9131.

24/7 line answered by a Masters-Level Licensed Clinician (LCSW, LPC) to assess the clinical need of the caller, including life-threatening situations.

CONFIDENTIALITY IS REVIEWED AND PEER SUPPORT SERVICES ARE INITIATED.

Only in circumstances where an individual is a threat to self or others or as outlined in the Medical Practice Act would confidentiality be breached. Doc2Doc Wellbeing Consulting has the same reporting obligation as all licensed Colorado physicians.

PHYSICIAN CALLER RECEIVES WELLBEING SUPPORT FROM A PEER PHYSICIAN.

If Doc2Doc Wellbeing Consulting is the best fit based upon the caller’s presentation, a physician will return the physician’s call for the first of three free peer consultations.

If CPHP traditional comprehensive evaluation services are a best fit based upon caller’s presentation OR if more help is needed at the end of three free Doc2Doc Wellbeing Consulting sessions, CPHP’s process will commence to ensure client has appropriate treatment supports in place.