ADVOCATING EXCELLENCE IN THE PROFESSION OF MEDICINE
PLUS:
PHYSICIAN PRIORITIES SURVEY
NAVIGATING MALPRACTICE STRESS
MEET THE CANDIDATES FOR CMS LEADERSHIP
As your premier medical liability insurance carrier, you can trust us to put our strength, expertise, and agility to work on your behalf. Our claims support includes access to alternative resolution programs designed to help you confidently manage unexpected outcomes and preserve patient relationships. If a claim progresses, we protect and guide you, help you understand your options, and are with you each step of the way. That’s Value Beyond Coverage.
The 2024 Colorado General Assembly, which concluded May 8, was marked by significant victories for physicians and patients alike, showcasing the power of organized advocacy and the importance of legislative engagement. CMS played a crucial role in driving several key legislative outcomes, reflecting the priorities of health care providers and ensuring that the state’s health care system remains responsive to the needs of physicians and patients.
10 2024 PHYSICIAN PRIORITIES SURVEY
The Colorado Medical Society consistently polls physicians to tailor our services to your needs and adapt to the ever-changing health care landscape. View highlights of a survey CMS conducted in the first quarter of 2024 that polled member and non-member physicians on how Colorado physicians perceive CMS and our value.
12 NAVIGATING MALPRACTICE STRESS: FORTITUDE AMIDST THE TRIALS OF MEDICINE
Nothing shatters the altruism that led us to medicine than a malpractice suit. You must seek support if or when you find yourself in this situation.
14 BREAK AWAY TO BRECKENRIDGE FOR THE 2024 CMS ANNUAL MEETING
Join us Sept. 13-14 in Breckenridge for CMS’s signature event of the year where colleagues, thought leaders, students, and supporters come together as a community to champion medicine in Colorado.
28 FINAL WORD: FROM THE EXAM ROOM TO COLORADO LAW
Northern Colorado Medical Society President Sean Pauzauskie, MD, a neurologist in Fort Collins, took a concern from the exam room through CMS’s Central Line policy platform through the Colorado General Assembly, and ultimately saw the creation of a new law that will protect patients while encouraging technological advances.
3 PRESIDENT’S LETTER
CMS President Omar Mubarak, MD, MBA, reflects on the legislative session and the tremendous effort and coordination required to navigate the complex political landscape.
24 2024 CMS LEADERSHIP ELECTION
Get to know the candidates running for CMS leadership positions by reading their candidate statements. Two candidates are running for president-elect and four candidates are running for AMA Delegation.
16 Reflections: Leave your blindfold at the door
17 Reflections: Slow sutures
18 Introspections: This white coat
20 COPIC Comment: COPIC Medical Foundation – 2024 grants
22 Partner in Medicine spotlight: Why the health care staffing labor shortage is so prevalent and what we need to do next
23 Letter to the editor:
Honoring Marilyn Gifford, MD
7351 Lowry Boulevard, Suite 110 • Denver, Colorado 80230-6902
720.859.1001 • www.cms.org
2023-2024
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
Brittany Carver, DO
Elizabeth Cruse, MD, MBA
Kamran Dastoury, MD
Amy Duckro, DO, MPH
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
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Cindy Austin Director of Membership
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Virginia "Ginny" Castleberry
Executive Director
Denver Medical Society
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(ISSN-0199-7343)
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Holzkamp,
and
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Dorcia Dunn Program Manager, Membership Dorcia_Dunn@cms.org
Crystal Goodman Executive Director, Northern Colorado Medical Society
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Mihal Sabar Director of Accounting Mihal_Sabar@cms.org
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
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Chet Seward Chief Strategy Officer Chet_Seward@cms.org
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Physicians often cite advocacy as a top priority for the Colorado Medical Society and this year, I had the opportunity to see firsthand how pivotal this work is to our members and patients. Given our demanding day jobs, we depend on the commitment of dedicated physicians, staff, and allied experts to navigate the complex political landscape and policy reform. This year, as CMS president, I witnessed this tremendous effort and coordination necessary for effective advocacy.
This legislative session brought a fullscale onslaught on the top priorities of medicine in a manner not experienced in a generation. And I hope it will be at least another generation before we see another session that requires even a fraction of the expenditure of time and resources. You can read more about the achievements, skillful defense and opportunities for future sessions in the cover story on page 4. I want to share insight into the behind-the-scenes efforts that drove our successes.
I want to give personal thanks to our outstanding contract lobbyists, Jerry Johnson and Dan Jablan, whose esteemed reputations at the Capitol allow us to be the first to hear if a bill that will affect health care policy is on the horizon and serve as a resource to educate elected officials on potential impacts. I also want to thank John Conklin and Amy Cardone, our outside counsels, who analyzed bills for their legal ramifications and also provided expert testimony. And, of course, thanks to our CMS staff – especially Chet Seward and Dean Holzkamp – for their above-and-beyond work on our behalf.
All the physician leaders on our Council on Legislation gave hours of their lives discussing, providing direction and voting on the bills, and respectfully considering the many sides of each issue. These physician leaders represented the county and specialty medical societies that comprise
the House of Medicine, and CMS convening such a group amplifies our voice. I’ve heard several times that we lose on issues when we don’t stand together to protect our patients and profession. It’s for this reason that building consensus through the House of Medicine is critical.
I especially want to thank the physicians and staff of the Colorado Academy of Family Physicians for their partnership in passing prior authorization reform, which was achieved after a three-year effort that will mean real positive change for patients and practices. And leaders from COPIC, the Colorado Hospital Association and other organizations in Coloradans Protecting Patient Access (CPPA) stood with CMS in safeguarding the stable liability climate and preserving peer review.
It is important for physicians to show up at the Capitol. I watched how individual doctors testifying were what got the votes we needed to advance or kill a bill. I heard Dr. Ricky Dhaliwal testify on a scope of practice issue and safety in the emergency room. Dr. Mark Johnson gave passionate testimony on funding for substance use disorders, drawing from his three decades in public health. Dr. Sean Pauzauskie spoke eloquently on cutting edge technology that held great potential for patients but also has great potential for abuse. I personally sat side by side with my patient to talk about my practice and the care I provide, and how operating in an uncapped liability environment would devastate medicine.
When doctors engage in the political process, it makes a difference. It has been an honor to represent you at the Capitol this session, standing up for patient safety, excellence in care and practice viability. I couldn’t be prouder of us as a profession. ■
Permanente Medicine allows you to practice value-based, patientcentered medicine in a culture that is collaborative, inclusive, and committed to making a di erence in people’s lives.
Permanente Medicine allows you to practice value-based, patientcentered medicine in a culture that is collaborative, inclusive, and committed to making a di erence in people’s lives.
Permanente Medicine allows you to practice value-based, patientcentered medicine in a culture that is collaborative, inclusive, and committed to making a di erence in people’s lives.
Permanente Medicine allows you to practice value-based, patientcentered medicine in a culture that is collaborative, inclusive, and committed to making a di erence in people’s lives.
Permanente Medicine allows you to practice value-based, patientcentered medicine in a culture that is collaborative, inclusive, and committed to making a di erence in people’s lives.
Permanente Medicine allows you to practice value-based, patientcentered medicine in a culture that is collaborative, inclusive, and committed to making a di erence in people’s lives.
A system created with patients at the heart.
A system created with patients at the heart.
A system created with patients at the heart.
A system created with patients at the heart.
A system created with patients at the heart.
A system created with patients at the heart.
Our physician-led, multispecialty group practice has a unique integrated relationship with Kaiser Foundation Health Plan of Colorado. Together, we have provided high-quality, a ordable health care to Coloradans for more than 50 years.
Our physician-led, multispecialty group practice has a unique integrated relationship with Kaiser Foundation Health Plan of Colorado. Together, we have provided high-quality, a ordable health care to Coloradans for more than 50 years.
Our physician-led, multispecialty group practice has a unique integrated relationship with Kaiser Foundation Health Plan of Colorado. Together, we have provided high-quality, a ordable health care to Coloradans for more than 50 years.
Our physician-led, multispecialty group practice has a unique integrated relationship with Kaiser Foundation Health Plan of Colorado. Together, we have provided high-quality, a ordable health care to Coloradans for more than 50 years.
Our physician-led, multispecialty group practice has a unique integrated relationship with Kaiser Foundation Health Plan of Colorado. Together, we have provided high-quality, a ordable health care to Coloradans for more than 50 years.
Our physician-led, multispecialty group practice has a unique integrated relationship with Kaiser Foundation Health Plan of Colorado. Together, we have provided high-quality, a ordable health care to Coloradans for more than 50 years.
As a Permanente physician, you have access to our quality resources and technology, state-of-the-art facilities, an Epic-based electronic medical record system, Abridge AI and true experts who collaborate. We empower you to focus on caring for your patients.
As a Permanente physician, you have access to our quality resources and technology, state-of-the-art facilities, an Epic-based electronic medical record system, Abridge AI and true experts who collaborate. We empower you to focus on caring for your patients.
As a Permanente physician, you have access to our quality resources and technology, state-of-the-art facilities, an Epic-based electronic medical record system, Abridge AI and true experts who collaborate. We empower you to focus on caring for your patients.
As a Permanente physician, you have access to our quality resources and technology, state-of-the-art facilities, an Epic-based electronic medical record system, Abridge AI and true experts who collaborate. We empower you to focus on caring for your patients.
As a Permanente physician, you have access to our quality resources and technology, state-of-the-art facilities, an Epic-based electronic medical record system, Abridge AI and true experts who collaborate. We empower you to focus on caring for your patients.
Why work here?
As a Permanente physician, you have access to our quality resources and technology, state-of-the-art facilities, an Epic-based electronic medical record system, Abridge AI and true experts who collaborate. We empower you to focus on caring for your patients.
Why work here?
Why work here?
Why work here?
Why work here?
Why work here?
You will find opportunities to explore other interests, such as developing new best practices, and taking on leadership responsibilities. You’ll receive excellent compensation, a broad range of benefits, and a generous retirement package. Fulfill the promise of medicine in a professional environment as concerned with your health and wellness as we are about our patients.
You will find opportunities to explore other interests, such as developing new best practices, and taking on leadership responsibilities. You’ll receive excellent compensation, a broad range of benefits, and a generous retirement package. Fulfill the promise of medicine in a professional environment as concerned with your health and wellness as we are about our patients.
You will find opportunities to explore other interests, such as developing new best practices, and taking on leadership responsibilities. You’ll receive excellent compensation, a broad range of benefits, and a generous retirement package. Fulfill the promise of medicine in a professional environment as concerned with your health and wellness as we are about our patients.
You will find opportunities to explore other interests, such as developing new best practices, and taking on leadership responsibilities. You’ll receive excellent compensation, a broad range of benefits, and a generous retirement package. Fulfill the promise of medicine in a professional environment as concerned with your health and wellness as we are about our patients.
You will find opportunities to explore other interests, such as developing new best practices, and taking on leadership responsibilities. You’ll receive excellent compensation, a broad range of benefits, and a generous retirement package. Fulfill the promise of medicine in a professional environment as concerned with your health and wellness as we are about our patients.
Apply today
You will find opportunities to explore other interests, such as developing new best practices, and taking on leadership responsibilities. You’ll receive excellent compensation, a broad range of benefits, and a generous retirement package. Fulfill the promise of medicine in a professional environment as concerned with your health and wellness as we are about our patients.
Apply today
https://colorado.permanente.org
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https://colorado.permanente.org
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Contact a recruiter: Andrea Hughes-Proxmire Physician Recruiter
Contact a recruiter: Andrea Hughes-Proxmire Physician Recruiter
Contact a recruiter: Andrea Hughes-Proxmire Physician Recruiter
Contact a recruiter: Andrea Hughes-Proxmire Physician Recruiter
Contact a recruiter: Andrea Hughes-Proxmire Physician Recruiter
Andrea.C.Hughes-Proxmire@kp.org 303-565-6104
Andrea.C.Hughes-Proxmire@kp.org 303-565-6104
Contact a recruiter: Andrea Hughes-Proxmire Physician Recruiter Andrea.C.Hughes-Proxmire@kp.org 303-565-6104
Andrea.C.Hughes-Proxmire@kp.org 303-565-6104
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Andrea.C.Hughes-Proxmire@kp.org 303-565-6104
We are an EOE/AA/M/F/D/V Employer.
Andrea.C.Hughes-Proxmire@kp.org 303-565-6104
We are an EOE/AA/M/F/D/V Employer.
We are an EOE/AA/M/F/D/V Employer.
We are an EOE/AA/M/F/D/V Employer.
We are an EOE/AA/M/F/D/V Employer.
Colorado Permanente Medical Group
Colorado Permanente Medical Group
Colorado Permanente Medical Group
Colorado Permanente Medical Group
Colorado Permanente Medical Group
Colorado Permanente Medical Group
Cecilia Comerford-Ames
The Colorado General Assembly concluded its 2024 legislative session on May 8, adjourning sine die . This session was marked by significant victories for physicians and patients alike, showcasing the power of organized advocacy and the importance of legislative engagement. The Colorado Medical Society (CMS) played a crucial role in driving several key legislative outcomes, reflecting the priorities of physicians and ensuring that the state's health care system remains responsive to the needs of patients.
• 1,822 advocacy messages were sent to legislators by physicians and practice staff, demonstrating a robust and active engagement.
• 38 positions on bills were taken by the CMS Council on Legislation, with 62 bills closely monitored by staff.
• 14 meetings were held by the Council on Legislation in the month before and during the session, ensuring thorough advocacy.
Several critical bills were passed, and significant progress was made in areas that directly impact physicians and their
ability to provide crucial and quality care.
Actions: The epic attack on Colorado’s stable tort environment is over and the prospect of catastrophic November ballot initiatives has been averted. With just days left in the legislative session, a deal was brokered by Alec Garnett, Gov. Polis’s chief of staff, with Coloradans Protecting Patient Access (CPPA) and Colorado Trial Lawyers Association (CTLA) to increase non-economic damage caps. CMS partnered with COPIC, the Colorado Hospital Association and many others through CPPA over the past year to protect patient access to care, safeguard the stable liability climate, preserve peer review, and avoid a costly ballot fight. Hours of final negotiations led to the introduction of HB24-1472, which passed the day before sine die. The bill will increase the medical non-economic damages cap over a fiveyear period from the current $300,000 cap to $875,000 and establish a new wrongful death cap at $1.575 million. Starting in 2030, the medical caps will be adjusted for inflation every two years. Separately, the bill will also increase general liability non-economic damage and wrongful death caps over time.
“The most immediate win of this compromise is the withdrawal of ballot measures that would have potentially eliminated non-economic damage caps altogether and obliterated peer review
protections that promote patient safety in medical care. This would have risked access to care and caused health care costs to skyrocket for all Coloradans, particularly those in underserved and rural communities,” said CMS President Omar Mubarak, MD, MBA. “Instead, the medical community did the right thing by our patients and compromised on the numbers to preserve the cap, protect confidentiality and stabilize our health care system as a whole. We are grateful to Gov. Polis and our legislative sponsors for getting this done at the state Capitol instead of punting it to the ballot, which would have resulted in a divisive, expensive and potentially detrimental fight.”
HB24-1149 Prior Authorization Requirements Alternatives: After a three-year effort with Colorado Academy of Family Physicians and other state specialty societies, commercial health plan prior authorization requirements will get some much-needed changes. This bill places more health care decisions in the hands of patients and physicians. Rhonda Parker, DO, testified, “Nothing is more frustrating than when these painstakingly thought-out decisions regarding a procedure or medication are taken out of the hands of me and my patient because of outdated, overly bureaucratic prior authorization processes.”
This bill extends prior authorization approvals from 180 days to a full calendar year and increases approval timeframes for chronic medications to three years under certain circumstances. The bill also prohibits denials for additional care during surgery if it was previously approved and requires the development of alternative programs for prior authorization. These changes will take effect in January 2026. This success was greatly aided by CMS's "Health Can't Wait" campaign, which collected compelling stories from patients and physicians.
HB24-1058 Protect Privacy of Biological Data: This groundbreaking legislation protects individuals' personal biological data, including neural data collected by devices. Read more about this bill in the Final Word on page 28, written by bill champion Sean Pauzauskie, MD.
Three bills were passed addressing the opioid crisis.
• HB24-1003 : This bill works to get Naloxone into schools.
• HB24-1037: This bill creates more harm reduction policies.
• HB24-1045: This bill expands treatment for substance use disorders.
Speaking specifically about HB24-1003, CMS President Mubarak said, “The Colorado Medical Society prioritizes child safety. Supporting legislation to distribute opiate antagonists on school buses and to students who receive training reinforces our commitment to protecting every member of our community. Now, with the proper training and legal protections in place, we stand ready to act decisively in opioid emergencies, ensuring the wellbeing of all Coloradans. We thank the American Medical Association for their leadership on combatting the opioid epidemic, and their support on this and other solutions to this multifaceted issue."
This bill, passed on the last day of the session, aims to increase the number of health care professionals in rural counties, addressing a critical workforce capacity issue. It builds on the work of another bill passed in 2022, SB22-172. Sen. Dylan Roberts (D) was co-prime sponsor of SB24-221 and as a representative in 2022 was a co-prime sponsor of SB22-172. He said of the first bill’s passage: “This program is exactly what my part of the state and all of rural Colorado needs and deserves: dedicated resources to recruit, train and place doctors, nurses and other health care professionals into rural communities, and to allow the state’s higher education institutions the opportunity to be a part of this exciting initiative.”
While many bills were championed by CMS, we kept an eye on all bills impacting medicine, reflecting CMS's commitment to patient safety, appropriate scope of practice and practice viability.
Formulary: This bill, which would have allowed naturopaths to prescribe most schedule III-V drugs, was defeated. CMS remains vigilant in opposing inappropriate scope of practice expansions that could compromise patient safety. CMS President-elect Kim Warner, MD, gave impactful testimony: “Contrary to some misconceptions, this isn't a turf battle; it's about safeguarding patients. With only 55 licensed, in-state naturopaths, mostly in well-resourced areas, the issue at hand is ensuring equitable patient safety standards statewide.”
Significant Impact Standard: This bill was a regurgitation of a bill CMS similarly defeated last year. Had it passed, the bill would have increased liability exposure for physicians by finding automatically that there has been a “public impact” based solely on evidence of an unfair trade practice. Physicians would be liable for treble damages and attorney fees.
HB24-1153 Physician Continuing Education: CMS secured crucial amendments to this bill, reducing the mandated CME hours and allowing for national board certification to meet the requirements. CMS will engage with the Colorado Medical Board in their consideration of whether to require specific topics for CME.
Several bills that did not pass this session remain priorities for the CMS, ensuring continued advocacy in the years to come.
SB24-163 Arbitration of Health Insurance Claims: Although this bill, supported by CMS, was postponed indefinitely, it highlighted ongoing issues with the current arbitration process for out-of-network claims. The drive to level the playing
field against unfair health plan practices and ensure fair arbitration processes for physicians continues.
SB24-082 Patient's Right to Provider Identification: This bill aimed to improve transparency by helping patients understand the qualifications and training of their health care providers. Despite its postponement, CMS remains committed to ensuring patients can make informed decisions about their care.
SB24-062 Prohibit Attorney Fees on Personal Injury Interest: This bill was killed in committee. Patients should get the timely awards they are owed from a lawsuit. CMS strongly supported this bill that aimed to put an end to the longstanding trial lawyer practice of delaying action on cases because they make more money by claiming 9 percent interest per annum on damages from the date the
cause of an action accrued to the date the judgment is satisfied.
The 2024 legislative session was a monumental year for advancing health care priorities in Colorado. The collaborative efforts of CMS, House of Medicine specialty society partners, CPPA, COPIC, CHA and dedicated health care advocates resulted in significant legislative victories that will benefit physicians and patients across the state. As we look ahead, continued advocacy and engagement will be essential to maintaining and building on these successes, ensuring that Colorado's health care system remains a model of excellence. ■
Top: Physicians, supporters and bill sponsors after the press conference for prior athorization reform. Bottom left: Sean Pauzauskie, MD, right, testifies in support of HB24-1058 with Rafael Yuste, MD, PhD, co-founder fo the Neurorights Foundation, left Bottom right: Sen. Kyle Mullica, right, speaks at the bill signing of SB24-087 Topical Medication Continued Care.HOUSE BILL 24-1472 RAISE DAMAGE LIMIT TORT ACTIONS
• The damages limitations for noneconomic damages in medical liability increase to $415,000 effective Jan. 1, 2025 for actions filed on or after that date that accrued on or after Jan. 1, 2024.
• The damages limitation will rise over the next five years to $875,000. That limitation will be adjusted for inflation every two years beginning Jan. 1, 2030.
• A new, separate claim for wrongful death will increase to $1.575 million over five years.
• Starting in 2030, both will be automatically adjusted for inflation every two years.
HOUSE BILL 24-1149 PRIOR AUTHORIZATION REQUIREMENTS
Starting Jan. 1, 2026:
• For denial of a prior authorization request, a carrier must identify relevant alternative services or treatment that may be a covered benefit or are required before approval.
• For denial of a prior authorization request for a prescription drug, a carrier must specify which dosages or alternative drugs in the same class of medication are a covered benefit.
• The duration of prior authorization approvals is extended from the current 180 days to a new duration of one year or the length of treatment.
• The duration of prior authorizations for chronic medications will generally be three years. Drugs that cost more than $30,000 annually may be subject to a one-year approval.
• A carrier is prohibited from denying coverage for surgical care that was approved but then during surgery requires a medically necessary additional or related covered procedure that would likely harm the patient to delay.
• Each carrier must post on a publicly facing website prior authorization requirements and restrictions, formulary requirements, and outcomes data in a searchable format.
2024 PHYSICIAN
Staff report
The Colorado Medical Society consistently polls members to tailor our services to your needs. Your input guides how we adapt to the ever-changing health care landscape. CMS conducted a survey in the first quarter of 2024, polling member and non-member physicians to gauge how Colorado physicians perceive CMS and our value.
CMS members value the education/CME they get from their memberships most, folowed by information and advocacy.
CHALLENGES
SOCIAL OPPORTUNITIES/NETWORKING
VENDOR DISCOUNTS
COMMUNITY INVOLVEMENT
SUPPORT WITH PRACTICE MANAGEMENT
OTHER/SPECIFY NONE OF THE ABOVE
NON-MEMBERS: VALUE MOST?
9 out of 10 non-member physicians value the education/CME they get from memberships in other organizations, followed by information and advocacy.
OTHER/SPECIFY NONE OF THE ABOVE
Just 1 in 5 say they have heard a lot about CMS, while a plurality have heard only a little and 32% have not heard much; a few have heard nothing at all. Overall, 43% have a positive impression of CMS, 31% have a neutral impression and 10% have a negative impression.
CMS MEMBERS: RECOMMEND CAREER AS A PHYSICIAN
Among CMS members, 43% are certain or very likely to recommend someone pursue a career as a physician, while 37% are somewhat likely and 20% are not likely.
Among non-members, 28% would recommend, 43% are somewhat likely and 23% are not likely.
Physicians — both members and non-members, across diverse practice settings — reveal struggles in openended survey responses. Just 28 percent of non-members are likely to recommend a career in medicine, compared to 43 percent of CMS members – perhaps suggesting possible lower burnout and greater satisfaction.
Numerous respondents describe frustration with continuing challenges on physician autonomy, burnout, administrative burdens and other issues. The image of medicine and science has declined in some communities, and trust in science/ doctors has dropped.
CMS continues to be a reliable source for advocacy, information and education among members. We take this responsibility at the highest level.
Physicians are busy and high engagement is not possible for everyone. Whatever the level of your engagement, CMS continues to fight and support you and promote the care you provide to patients. However, we need non-members to invest in membership to boost our strength in numbers; our opponents have significant resources, and we can only match them at the Capitol, in board rooms and in courtrooms with a large force in numbers.
Non-members
• 114 non-members in active practice gave results to the survey
• CMS outreach/partnerships allowed us to distribute a link to an open survey
CMS members
• 530 members gave a full response to the survey, of a total of 6,098 members emailed (with 29 partial surveys), giving a 9% response rate
• For the sample of 530 members, the margin of error is +4.3% at the 95% confidence level ■
When we embarked on our journey into medicine, we were prepared for challenges: the weight of high expectations, the relentless hours, the ongoing pursuit of knowledge, and the delicate dance with life, death and illness. Yet, amidst these anticipated trials, few events hit with the force of a malpractice suit or regulatory complaint.
Driven by altruism, we chose medicine, forsaking potential wealth from other career paths for the profound satisfaction of aiding our fellow beings. It became our calling, our very essence.
With the ear of a fellow healer, we find reassurance, perspective and a lifeline in the tempest.
But nothing shatters this identity quite like facing a malpractice suit. Suddenly, the compassionate healer stands accused of breaching the sacred bond between patient and practitioner – a betrayal that cuts deep. And as the accusations are skillfully woven by seasoned attorneys, the accused find themselves engulfed in a vortex of doubt and despair.
The initial response is often sheer panic – a cascade of catastrophic thoughts envisioning ruin in every aspect of life. Isolation follows, as shame cloaks the afflicted, convincing them they stand alone in their anguish. I have witnessed this descent into darkness, where the burden becomes unbearable. Sometimes, the unthinkable, taking one’s own life, becomes a desperate consideration.
Similar anguish accompanies regulatory complaints, each word a legal dagger aimed at the heart of our noble intentions. The threat of losing one’s license looms large, casting a shadow over all else.
So, what can be done? We must speak about it. Through initiatives like CPHP’s Doc2Doc Wellbeing Consulting (D2D) line or COPIC’s Care for the Caregiver, physicians in Colorado have found solace and support. You may call D2D 24/7 at 720-810-9131 and speak with someone who has helped thousands of similar doctors with similar fears. With the ear of a fellow healer, we find reassurance, perspective and a lifeline in the tempest. We stand ready to listen, to guide, and to remind you that you are not alone. ■
Colorado Medical Society
Sept. 13-14, 2024
535 S. Park Ave, Breckenridge, Colo.
BREAK AWAY TO BRECKENRIDGE: BRING THE FAMILY AND CONNECT WITH FRIENDS WHILE WE EDUCATE AND UPDATE YOU ON THE LATEST MEDICAL TRENDS
Welcome to the 154th Colorado Medical Society Annual Meeting in beautiful Breckenridge September 13 and 14, 2024.
Join us at CMS’s signature event of the year where colleagues, thought leaders, students, and supporters come together as a community to champion medicine in Colorado.
• Great food, drinks, entertainment and opportunities to meet new faces and renew friendships
• CME and presentations on the hottest topics in Colorado medicine
• Ample free time around conference events for you and your family to enjoy the gorgeous fall landscape in Breckenridge
• Optional small group activities to hike, sightsee, wine and dine
• Childcare for kids 12 and under (register in advance)
• A celebration of our new leadership: incoming CMS President Kim Warner, MD, an ob-gyn with Colorado Permanente Medical Group, and outgoing CMS President Omar Mubarak, MD, MBA, a vascular surgeon and practice owner of Vascular Institute of the Rockies
Most important, this special event is an opportunity for CMS to get to know you better and hear your thoughts on how we can best support you and physicians in Colorado.
We welcome your ideas for making this event truly memorable, so reach out to membership@cms.org and let us know if you would like to be involved or have suggestions for interactive experiences. ■
• Diagnostic imaging at up to 60% less than hospital imaging
• In-network with 99% of health insurance plans in Colorado
• Fast prior authorizations assistance for easy scheduling
• same day/next day appointments with extended and weekend hours
• subspecialized radiologists available for consultation
• Prompt standard reports delivered within hours
• Obtain reports quickly through easy-to-access physician portal
• 97% patient satisfaction rate
Refer your patients to our 11 convenient locations throughout metro Denver
Sonaali Pandiri is a rising fourth-year medical student at the University of Colorado School of Medicine. Her passions include health care for the unhoused and the intersection of medicine and the humanities. Originally a native of Los Angeles, she has loved living in Colorado and getting to explore all it has to offer in its cities and mountains. In her spare time, she enjoys visiting the local movie theater, trying new foods, reading, and enjoying the outdoors.
Tents.
A spark of joy runs through me when I see them studded in the mountains. I think of the curvature of the milky way I may see later that night, I hear the crackling of a campfire, sparks and smoke dancing for me as I laugh in good company. But to see these same tents on sidewalks or tucked away in alleyways, I feel heavy.
How could something so transient to me be a whole home for someone else?
I knew a lady in Baltimore, she sat on the corner outside of Eddies. I never caught her name, but her face is etched in my memory forever. A soft smile that beckoned a smile back even from the most unforgiving faces. Her eyes were piercing, intimidating, with immense depth into some unknown.
I first noticed her belly bump as she sat on the lumpy, unforgiving concrete. I wondered what pregnancy would be like with the added challenge of homelessness. She greeted everyone that passed with such patience while we rushed on to our busy lives,
as if she knew that one day when we had a moment to catch our breaths, we would say Hi back.
She went in and out of being unhoused, she explained to me one day.
Cruel landlord, baby on the way, unpredictable boyfriend, maybe the simplest part of her day was sitting right here. Come winter, I’d gather warm clothes to bring her eager to listen to how her day went.
I always wanted to do more, but what could one person do to change the trajectory of a whole life?
Life always pulled me back, and I knew I’d have to keep walking.
How did we get here?
An expectant mother on a street corner as commonplace as the cracks in the sidewalk. Homelessness is a reality of most cities, yet it dissipates from our awareness like brilliant stars lost in black holes, suddenly, violently, silently.
When did we lose our curiosity about those at the edge of our perceptions? What is the story some eyes will tell if we care to explore?
I have more questions than answers. Perhaps the answer starts with empathy and curiosity. Is a dollar really enough, or a passing smile? When we reach out a hand or lend an ear, can that really make a difference in someone’s day?
Perhaps not, but I’d like to believe it’s better than looking the other way. ■
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.
Anima Shrestha is a rising fourth-year medical student at the University of Colorado School of Medicine. She will be applying to child neurology residency this fall and is excited to provide care and advocate for children, wherever it may take her. She was born in Fort Collins, but spent most of her childhood in Atlanta, Ga., before moving to California to earn her bachelor’s in human biology at Stanford University. She finds it poetic that her journey has brought her full circle back to Colorado to begin her career in medicine.
“Patient arriving to trauma bay 1.” It is my first ever Emergency Department (ED) trauma call, and my preceptor and I rush into a room bustling with nurses and techs. It takes me a second to find the patient, a young woman lying on the table, eyes closed, arms hanging off the sides. Dark red blood sprays onto the floor from a gaping wound on her left arm. I feel woozy as I fumble to pull on my gloves. My preceptor grabs some suture, and as he tries to find the bleeding artery, he instructs me to apply as much pressure as I can above the gash. He digs around inside her arm muscles, and I turn away. I look down at her face instead, which is ashen. Her eyes are still closed. I am unsure how much time has passed before my preceptor ties off the bleeding artery, but our shoes are now sticky with blood. He asks me if I have sutured before, and at my nervous yes, he hands me the needle driver, tells me to close up the skin, and leaves.
I start, shakily piercing the skin of her forearm, reminding myself to breathe and alternate hands as I tie. After a few minutes of tense silence, the room begins to empty. Suddenly, it is just me alone in the trauma bay with this patient. I am concentrating so hard that I don’t notice she has woken up, so when she says, “I think it looks great,” I startle.
I ask her what happened. She tells me her name, and that she’s 24 – my age. She had gotten into a fight with her boyfriend, grabbed a knife, and locked herself in the bathroom. She tells me they fight often. She has bipolar disorder and ran out of medication, and she “pulls stuff like this,” she gestures to her arm, “often.” She’s
almost surprised he called 911 this time. I see some pale scars along her wrist. I ask about her family and friends, and she says she left them all behind on the East Coast, uprooting her entire life to follow her boyfriend to Colorado. Things were going well, but once they arrived here, he changed. I ask if she feels safe at home, and if she wants any resources for mental health or to talk to a social worker. She cuts me off with a firm no. Throughout the rest of our conversation, she keeps apologizing for being an inconvenience, for coming in bleeding and needing help. I tell her not to apologize, of course we want to help her. I try to convince her that she deserves better than a tumultuous relationship, that she deserves our medical care. That she is deserving. As I tie off my last suture, she looks down at her arm and says they look beautiful. I am struck by how she can be minutes out from a near-death experience, but still take the time to reassure a shaky medical student that they did a good job. A nurse comes over to help her to the bathroom, and I start stripping the blood-soaked sheets. As I ball them up in my hands, I look around the room and notice that no one came with her, not even her boyfriend.
I rejoin the chaos of the ED, but when I stop by the trauma bay an hour later, her pile of clothes on the chair are gone, the sheets have been replaced, and the floor is squeaky clean.
Looking back, I am thankful that my slow suturing allowed me to connect with this patient in a vulnerable moment. Though I could not provide her with resources or a referral, I hope our interaction was positive enough that she will seek out
health care again. This experience is a reminder for me that while we cannot fix everything for our patients, we can create small changes, like reminding someone that they deserve more, or making a scary ED feel safer. It also reminds me that humanism is a two-way street. Giving kindness to patients allows them to return it to us, even in situations so terrible we would never have dreamed of receiving kindness. Our patients are worthy, and I am in awe of their capacities for resilience and compassion. I practice humanism to honor them.
The further I venture into medicine, the more I see the clinical space testing the limits of our empathy. My classmates and I have often wondered if we lost our humanism somewhere along this journey. But moments like this remind me that humanism is not some object that can be lost or found. I believe that humanism in medicine is a summation of all the small actions we take to show others that they are not alone in what may be the scariest moment of their lives. Humanism is holding a patient’s hand while she falls asleep before a procedure. It is hugging a daughter when she confesses to you that she’s worried her father will die if he goes to the hospital again. It is smiling over a new mom’s knee at her pale-but-stillstanding husband as he holds their new baby tight. It is congratulating your resident after she performs her first successful circumcision. Humanism is not one big action that shows that we care, but rather the small moments that connect us and allow us to remain compassionate and curious about our patients’ lives, beyond just their “chief concern.” ■
Critical reflective writing holds a prominent place in the Medical Humanities curriculum at Rocky Vista University. Students engage in critical reflection to explore their own assumptions and biases and to understand how their values impact their practice and professional identity. This submission is selected and edited by Nicole Michels, PhD, Chair of the Department of Medical Humanities, Alexis Horst, MA, Writing Center Manager, and Hope Ruskaup, MFA, Writing Center Coordinator.
Mia Panlilio originally grew up in California, where she obtained her bachelor’s in biology at San Diego State University and subsequently completed a year-long post-baccalaureate program at the University of California San Diego prior to starting medical school at Rocky Vista University. In her future medical career, Mia aspires to be a physician who travels to other countries to provide care for patients in resource-limited areas, regardless of what specialty she ends up pursuing. Outside of school, Mia loves to ski, go on hikes with her dog Harley, and write in her free time.
Walking across the stage, I take my place in line as I prepare to put on the article of clothing I’ve waited the past several years to wear. As it comes on, so does the heavy weight of what the next four years may bring: the unexpected challenges, victories and lessons that lie ahead. My emotions are a confusing blend of excitement and fear as feelings of imposter syndrome creep in. Have I worked hard enough to wear this? Are my past accomplishments deserving of me being here? Am I qualified enough to be in medical school? These intruding questions rush into my head as I slip my arms through the sleeves of this white coat.
Time passes and soon we have our first practice patient encounter. Nerves sink in as I am expected to act like a doctor. “Remember your OLDCAAARTS. Take as many notes as you can. Keep eye contact with your patient.” These mental notes run through my head in a constant loop as I interact with my patient. As I go through my exam, again the intruding thoughts begin to invade my mind: How am I in this position? Was this all due to luck? Everyone in my class is so smart and I feel so behind compared to my peers; why am I here? Time flies by as I battle my internal dialogue, and after the end of my patient encounter, I take off this white coat.
Prior to medical school I was a fairly average student. Throughout college I worked as a server in a restaurant in addition to school, and as a result, my GPA was not considered competitive for medical school. I constantly felt less intelligent compared to my peers, which made me feel like I was not meant to pursue becoming a doctor. I knew throughout college I likely had to pursue a post-baccalaureate program to boost my grades, so I continued to do my best to save money and do well in school. Getting accepted into the program not only strengthened my GPA, but also helped me gain much more confidence in myself academically. This gave me a
sense of belonging within the pre-med community and motivated me to continue my path to becoming a physician.
Third year comes around and core rotations are about to begin. This time I am expected to interact with real patients. As I step foot inside the hospital, patients and their family members look at me as if I am a doctor. Patients begin to ask me questions while I interview them, and more questions run through my mind. How have I made it this far? Have I really learned anything from didactics? I take a few deep breaths before I enter the next patient’s room with my preceptor and nervously adjust this white coat.
Once I began medical school, it was hard not to compare myself to others in my class. Many of my classmates had prior careers in medicine or multiple degrees that prepared them for the rigors of medical school, which gave me the perception that everyone was much more qualified than me to be here. As we got deeper into the school year, I began to struggle with certain subjects and was constantly beating myself up if I didn’t get close to the exam average or failed an exam. I was intimidated of talking to my peers at first,
but once I began to open up to others around me about my failures, many admitted they had been struggling too. Hearing this made me realize we have much more of a shared experience of imposter syndrome than I thought, and we all have our own weaknesses that we must work to overcome. It gives me a greater sense of belonging to know that my peers and I are all in this together.
Fourth year has finally arrived and graduation is a few months away. Countless hours studying and working with patients have led me here, but was it all enough for me to move forward into residency? Can I really be trusted to care for a patient? Even as a fourth year, these feelings of imposter syndrome still have not fully shaken, but I brave myself for the next step and hope for the best as Match Day approaches. Hanging in my closet is the coat that has been worn and battered over the last four years, and soon residency will replace this white coat with a longer one.
We receive our first white coat in pristine condition during a ceremony where we promise to dedicate our lives to medicine. As time passes, our white coats become
worn with experience and longer as we progress through medical school, residency, and into our careers. No matter how much experience we gain, there may be moments where we start to feel unworthy of wearing our white coat, especially in instances of error or failure. We begin to feel like imposters, and this feeling becomes an inner demon that we must battle on a daily basis as we wear this white coat.
Reflecting on my own journey thus far, I have already experienced many moments of imposter syndrome throughout my educational career. Whenever I feel it creep up, I try to remind myself of the accomplishments I have achieved that have brought me to this point and also the many failures I have overcome. Although I have been able to better cope with imposter syndrome in recent months, these feelings still linger. Looking back, the biggest piece of advice I would give myself in regards to dealing with imposter syndrome would be that it will be a daily battle. However, there are so many things that make our path worth this daily battle and at the end of the day, I am proud to wear this white coat. ■
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The COPIC Medical Foundation was established in 1991 with the goal of creating a nonprofit that could support our mission of improving medicine in the communities we serve. Today, the Foundation’s efforts extend across multiple states, have impacted the lives of many, and provided more than $11 million in funding to improve patient care and medical outcomes.
The grant funding at the heart of our Foundation continues to focus on initiatives designed to reduce fragmentation across care settings. Breakdowns in care from a fragmented health care system can lead to readmissions, missed diagnoses, medication errors, delayed treatment, duplicative testing and procedures, and reduction in quality of care.
“There are a lot of deserving initiatives backed by compassionate people who are making a difference. The Foundation’s efforts help elevate initiatives that have the potential to improve fragmentation in ways that benefit medical providers, their patients, and systematic changes. We are very excited to announce this year’s recipients and highlight the different ways they are addressing challenges with viable solutions,” said Meredith Hintze, Executive Director of the COPIC Medical Foundation.
The grant funding at the heart of our Foundation continues to focus on initiatives designed to reduce fragmentation across care settings.
For 2024, the Foundation has awarded more than $450,000 in grants to three organizations focused on reducing fragmentation in the healthcare system. Congratulations to the following organizations:
• Visiting Nurse Association – Collaborative multicomponent care for elderly postoperative recovery and fall prevention (Nebraska): A five-organization collaboration addressing post-op care for elderly people with a focus on reduction of fall risks at home, improved circumstances related to social determinants of health, improved physical status, and enhanced well-being.
• St. Elizabeth Healthcare – Community paramedicine pilot program (Kentucky): A program that uses paramedics to address inappropriate use of emergency medical services with a goal to reduce health care costs.
The project will focus on meeting patients in their home environment and addressing social determinants of health care gaps and engagement in care.
• DaneMAC – Expansion of the DaneMAC multi-agency portal (Wisconsin): A new web-based platform through which survivors of sexual violence and post-assault care providers can connect with each other. It provides survivors with immediate, post-assault mental health care and secure, intra-agency communication and coordination among post-assault care providers.
We anticipate that information about the next round of funding along with Request for Proposals (RFP) will be posted in November 2024 with applications due mid-January 2025. For more details on the COPIC Medical Foundation, please visit www.copicfoundation.org
We are excited to welcome Kelly Joines, a dynamic leader with a passion for driving change, to the Foundation’s Board of Directors. Currently serving as the chief strategy officer for Contexture, the leading health information exchange (HIE) for Arizona and Colorado, Joines brings not only extensive experience in health information and technology, but also an unwavering commitment to health equity.
Joines’ first introduction to the Foundation occurred during our inaugural round of grantees in 2021 when Contexture (then Corhio) partnered with the Mile
High Health Alliance on its ER Utilization alert project. However, it was her participation in the 2022 CMF Grantee Summit as a panelist representing HIEs that truly illuminated the impact the Foundation was making, aligning perfectly with her values and expertise.
With a background spanning 17 years in health information exchange, Joines brings a unique perspective to the board. Her expertise in navigating the challenges and opportunities within the HIE space using innovation, strategy, and partnerships equips her with invaluable insights to support the Foundation’s goal of catalyzing improvements in health care delivery and reducing adverse outcomes.
Within Normal Limits: Navigating Medical Risks – hosted by Eric Zacharias, MD, COPIC’s Director of Medical Education –now has more than 35 episodes available. Each episode is around 20-30 minutes and features a discussion with physician
leaders and/or medical experts that offers insights to improve care and avoid medical liability issues. Recent episode topics include:
• Just Culture—A Framework that Promotes Patient Safety
• Documentation—Telling the Story of Patient Care
• Ensuring Patients Make Informed Decisions Through Informed Consent
• Preventing Falls in the Healthcare Setting
Within Normal Limits is available on popular platforms such as Apple Podcasts, Google Podcasts, Spotify, and Amazon. You can also go to www.callcopic.com/wnlpodcast for more information. ■
is so prevalent and what we need to do next
The health care labor shortage is a staffing crisis we can no longer ignore. While most people attribute the staffing shortage to COVID-19, the truth is that it was an issue long before the pandemic and will continue to be an issue long after.
As technology has progressed, several medical advancements have prolonged the average person’s life span. While this is advantageous, it also means that people today require care for longer periods of time. About 10,000 individuals aged 59-77 have joined Medicare plans, which has increased the demand for more health care workers in recent years (Barrueta, 2023).
The pandemic caused unsafe nurseto-patient ratios, further contributing to feelings of burnout. A survey found that 34 percent of nurses wished to quit their
health care jobs by the end of 2022, and 44 percent said this was due to burnout (Keck School of Medicine of USC, 2023).
Training opportunities are severely limited due to the lack of nursing faculty available to train the next generation of health care workers. Universities turn away tens of thousands of applicants for nursing and health care programs each year (Duquesne University School of Nursing, N.D.).
The Great Resignation is a term that refers to a record number of workers who quit their jobs, including health care profes -
sionals (Admin Health care Workforce Trends, 2023). Many factors have influenced The Great Resignation, such as lack of job satisfaction, health care decisions being politicized, and more (Admin Health care Workforce Trends, 2023).
When health care workers get sent to remote or underserved areas, they tend to be unsatisfied with their jobs for several reasons. These reasons include being relocated from their families, remote areas not paying as well, and underserved areas not having as many resources to properly treat patients. This is unfortunate because millions of Americans live in these remote and underserved areas where trained professionals are lacking (Keck School of Medicine of USC, 2023).
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One study found that 55.4 percent of care providers had greater work satisfaction when given the opportunity to have a flexible schedule (Frasier, 2022). The survey also found that 50 percent of respondents with flexible schedules experienced a better quality of life, feeling less stressed and more in control of their workload (Frasier, 2022).
If health care professionals were relieved of some of the burden that student loans place on them, then more people would consider entering the field. Health care employers could incorporate tuition assistance or student loan repayment programs into their benefits packages to entice potential future employees.
Favorite Health care Staffing provides a wide range of staffing services for nursing, allied health, and non-clinical personnel. We offer short-term and longterm staffing solutions, including per diem, local and travel contract, temp-toperm, and permanent hire options. Learn more at www.favoritestaffing.com
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If universities provide the option of obtaining a health degree and other certificates online, this could lead to an increase in people entering the medical field. Although clinicals would still need to take place in person, students could commute less and complete some of their course work in the comfort of their home (Duquesne University, 2023).
As the demand for quality care continues to rise, we need more health care workers than ever before. The health care industry will not see an improvement involving the staffing shortage until these necessary changes have been made.
Sources:
A Public Health Crisis: Staffing Shortages in Health Care: USC MPH. Online Master’s in Public Health - Keck School of Medicine of USC. (2023, March 13). https://mphdegree.usc.edu/blog/ staffing-shortages-in-health-care/
Barrueta, A. A. (2023, March 7). Hiring alone won’t solve the health care worker shortage. Kaiser Permanente. https:// about.kaiserpermanente.org/news/ hiring-alone-wont-solve-health-careworker-shortage
Frasier, B. (2022, November 8). Critical Condition: A Four-Part Plan to Solve the Dire Shortage of Health Care Workers. SHRM. https://www.shrm.org/executive/ resources/articles/pages/health-careworker-shortage-frasier.aspx
Health care Workforce Trends, A. at. (2023, June 2). Overcoming Health care Staffing Shortages: Why a Managed Service Provider Is Necessary. Trusted Managed Services. https://tmsmsp.com/resources/ health care-staffing-shortages/
The Shortage of Health care Workers in the U.S. Duquesne University School of Nursing. (2020, June 26). https:// onlinenursing.duq.edu/post-master-certificates/shortage-of-health care-workers/. ■
I read the brief memorial piece on Dr. Gifford in the Fall 2023 Colorado Medicine. She was a driving force in the field of Emergency Medicine, and the description of her work did not do justice to the impact of her contributions.
In an era when women in leadership were nearly unheard of, Dr. Gifford owned and operated the company that provided
staffing with boarded EMPs to one of the largest Emergency Departments in the state. She maintained that standing for decades, as well as changing the way pre-hospital care was provided in not only El Paso County but the state of Colorado and even the nation. If you or anyone you know or care about has ever had an emergency in our area and received good care in the field or hospital,
Dr. Gifford had a significant hand in the foundation that made this possible. I want others who did not know her to understand how groundbreaking her work was in both emergency medicine and pre-hospital care, and how missed she is by her colleagues, and by the members of our community. ■
Dr. Anna Olson, MD, FACEP, FAAEM
CMS
Get to know the candidates running for CMS president-elect by reading their candidate statements in this magazine. Visit the CMS election webpage, cms.org/articles/2024-cms-election , to view their CVs and the candidate packets for the candidates for AMA Delegation.
The following physicians are running for a CMS leadership position.
(two candidates running for one position)
Brigitta Robinson, MD, FACS
Darlene Tad-y, MD, MBA
(four candidates running for four positions)
Dave Downs, MD, FACP, incumbent
Mark Johnson, MD, MPH, incumbent
Rachelle Klammer, MD, incumbent
Lee Morgan, MD, incumbent
CANDIDATE FOR PRESIDENT-ELECT
Organized medicine has been a part of my life since my first year in medical school. Alongside other physicians, I have worked to improve the delivery of health care, which is deeply fulfilling. I led the Indiana Medical Student Section and represented Ohio during my surgical residency. I joined the Colorado Medical Society to become involved in Colorado and a part of the Colorado Delegation. Dr. Lazarus guided me towards the Young Physician Section of the AMA. I became Chair of the YPS, and eventually part the Colorado Delegation. I was President of the Clear Creek Medical Society and on the CMS board wearing many different hats over the years. I was the Vice Chair to the CMS HOD, with Dr. Yakely as Chair, when our CMS HOD dissolved. I’ve served on several AMA Committees and am currently part of the Colorado Delegation.
Over the years, many of our CMS delegates have been president of the CMS. In
2006 I became a single mother by choice and had my second child in 2007. Raising them has been a full time job. Now, the timing seems right. When I serve as CMS President, I want to be present, and not feel like my time is being divided as much as it has been in the past 17 years. CMS deserves me being able to give as much to CMS as it has given to me.
There are three things on which I would like to focus as president of CMS: Increasing AMA membership, decreasing the barriers for practicing medicine and improving mental health access. While these are certainly national issues, I would like to focus on Colorado, and find solutions to lead the rest of the country by example.
AMA membership has been around 20 percent for too many years. The AMA has become more progressive and inclusive, and I have enjoyed watching the evolution. I know with more membership, the AMA would be more effective in moving medicine. I will convince those who are
The election will be held in August and all ballots will be cast electronically. Do you receive CMS e-newsletters and email blasts? If not, you may need to update your contact information to receive a ballot. Email membership@ cms.org with any updated contact information.
All CMS members are encouraged to use this opportunity to vote. We also ask you to consider seeking a leadership position next year. More details on the 2025 nomination period will be available in September. Taking the opportunity to vote affirms the commitment of our organization to engage all members in the governance process. Do you have questions about voting, nominations or leadership opportunities? Don’t hesitate to reach out to membership@cms.org
not members why they should be.
Practices are struggling to survive. My practice has seen a 40 percent decrease in payments in the last year, due to how plans are paying for the same services. To stay in practice, this has to improve. The AMA continues to fight for us on this front and has strengthened their stance. We should get paid for what we do, not just a fraction of it.
Mental health has never had enough access for those who need it. I suspected that with my trauma patients. It was confirmed when my family experienced this last spring when there was no option for therapy for my son. I had to call and find treatment for him myself and had to wait because it was not immediately available. Our system is broken and needs an overhaul.
With your vote, I am hopeful that I will be elected to serve as the next President of the Colorado Medical Society. Thank you for your support.
CANDIDATE FOR PRESIDENT-ELECT
With a career deeply rooted in improving systems of care, coupled with my unwavering commitment to improving health care delivery and advocating for the welfare of health care professionals across Colorado, I am motivated by the opportunity to contribute to our society's mission on a broader scale. Throughout my years of practice as an internist and hospitalist, I have not only been a passionate physician but also an advocate for health care reform and the continuous improvement of health care quality and safety. My journey has been marked by dedicated training in systems improvement and progressive leadership and teaching roles to change and improve health care delivery, underscoring my dedication to advancing the standards of health care in our community.
The role of president and president-elect within CMS, to me, is about fostering unity, encouraging innovation, and facilitating meaningful changes that resonate with the needs of our members and the populations we serve. I aim to harness our collective expertise to address the pressing challenges of health care accessibility, the evolution of the scope of the practice of medicine, and the mental health of our health care workforce. Through our advocacy efforts, we can enhance our society's impact on health care policies and ensure effective standards for the practice of medicine in Colorado.
One of my primary goals is to advocate for policies that support physicians in their pursuit of providing exceptional, high-value care. This includes pushing for increasing access to care for our most vulnerable populations while ensuring that Colorado health policies support
CANDIDATE FOR CMS DELEGATION TO THE AMERICAN MEDICAL ASSOCIATION
I have had the honor and privilege to serve the physicians of Colorado in multiple capacities over the past 30 years. I have served as President of the Pueblo County Medical Society, the Colorado Gynecology and Obstetrics Society and the Colorado Medical Society (CMS). I currently chair the Colorado Section of the American College of Obstetrics and Gynecology. I have participated on every major council of the CMS. I have served as chair of the Council on Legislation for nine years and currently still serve on the committee. I am a past chair of the COMPAC Board of Directors as well. I have served on the Physicians Congress and the ad hoc Committee on Patient Safety and Physician Accountability, to mention a few. I have been a member of the AMA since 1978 and an active member of our AMA delegation for 19 years. I served as co-chair of the Colorado delegation to the AMA for two years and now have, for eight years, served as chair of the delegation. At the AMA I have been active within the prior Western Mountain States
Conference having served as treasurer and chair. I played an active role in the merger of the PacRim Conference with the WMSC into the PacWest Conference, currently serve on the Nomination Committee and am the councilor representing District 4 (Colorado, Wyoming, Idaho, and Montana) on the PacWest Governing Council.
My practice experience includes a large multispecialty group as well as a smaller single specialty group. I have practiced in both a large urban environment and a more rural environment. As an Obstetrician/ Gynecologist I am at times considered primary care and at times a specialist. This varied background gives me the ability to look at all sides of an issue. Though I no longer practice full time, I do volunteer work at Doctors Care periodically. My full-time position is as a physician risk manager, doing patient safety and risk management at COPIC. I travel the state regularly and can visit with physicians in a variety of practice situations and locations, thus able to stay up to date with the concerns of physicians of Colorado.
physician practices in a way that aligns with the evolving health care landscape. Additionally, I am committed to enhancing the visibility and influence of the Colorado Medical Society on both state and national levels, ensuring our members' voices are heard and valued in critical health care discussions.
I am eager to bring my experience, energy, and ideas to the role of president-elect of the Colorado Medical Society. I look forward to the opportunity to discuss how we can collectively work towards a future where our society not only adapts to the challenges ahead but thrives, setting new benchmarks for the House of Medicine.
I have the leadership experience, the experience of listening to multiple points of view and helping forge consensus, as well as strong interest and concern about the issues that affect the practice of medicine today. These last decades have been a time of many changes and challenges for physicians. It is more important now than ever that we work together as a cohesive force in organized medicine on a local, state, and national level.
I have a long interest in legislation affecting the physicians of Colorado and the nation. One of my aspirations at the AMA is to become a member of the AMA Council on Legislation.
I believe that, with your support I can continue to contribute significantly to organized medicine on a local, state, and national level. It is for this reason that I ask for your vote to return me to the AMA as one of your delegates so that I can continue to represent you as we move forward in these interesting and difficult times.
MARK JOHNSON, MD, MPH
CANDIDATE FOR CMS DELEGATION TO THE AMERICAN MEDICAL ASSOCIATION
Medicine is a noble profession, with infinite opportunities to serve our patients and myriad obligations to serve our society. While direct service is best accomplished at the bedside and in the office, surgery center or hospital, organized medicine presents unique avenues to address those opportunities and fulfill those obligations on a broader, societal level. The Colorado Medical Society’s (CMS) delegation to the American Medical Association (AMA) works for each of our members to advance that level of service.
In placing my name on the ballot to join our AMA delegation, I am asking you to allow me to serve you in that endeavor. I do not do so with the expectation that I deserve such an office, simply as a past-president of CMS. I do so because I believe my education and work experience provide skills and knowledge that are highly valuable and necessary in today’s medical environment.
After the 1918 influenza pandemic, organized medicine faced challenges and opportunities that changed the very way medicine was provided in this country. Demands were placed on the policies, processes, procedures, and practices of medicine. New technology was needed. Advances in pharmacology were necessary. Habits and lifestyles were examined. And a new approach to data and evidence-based medicine was required. As these demands were addressed, the average length of life in this country almost doubled over the next century.
Today we are facing questions and challenges raised by the COVID-19 pandemic. The speed with which infectious diseases circle the globe is frightening. The global dependence we have for medications and technical equipment is a potential threat to our health and security. In the past two years, the average length of life has dropped for the first time in over a century.
CANDIDATE FOR CMS DELEGATION TO THE AMERICAN MEDICAL
I have practiced primary care internal medicine in Colorado for 35 years. I understand the challenges we face from payers and the support needed for us to practice high-quality, evidence-based medicine. Perhaps most important, I understand the need to sustain the intimate relationships we have with our patients. I have seen the benefits and pain caused by well-meaning policymakers who make decisions without understanding the complex world we work in.
I have now served on the Colorado Delegation to the American Medical Association for several years. I began as
somewhat of a skeptic, having disagreed with AMA policy over the years. I found the organization to have arcane, sometimes byzantine, processes and politics. At the same time, it is one of the most democratic institutions I’ve worked in and offers a venue in which ideas, presented properly, are given a full vetting.
As the country continues to evaluate massive changes in how health care is structured and financed, the voice of the AMA is important and influential in the evolution of the health care environment. Our delegation is your avenue to express your concerns, aspirations and doubts into the process of policy development within the single largest physician organization in our country.
Physicians are also facing policy questions and problems that are unprecedented. The hold that insurance providers have on the practice of medicine is alarming. Medicare and Medicaid reimbursements are stagnant or dropping. Scope of practice issues are raised by multiple groups every year, to the detriment of physicians and possibly the health of patients. All of these have magnified the challenges of medicine to such a degree that many physicians feel great anxiety and face existential questions about continuing to practice.
This climate calls for bold leadership from the organized House of Medicine. If elected to serve CMS on the AMA delegation, I pledge to do all in my power to represent the needs and wishes of our members at the national level. I would ask for your support in this undertaking.
Thank you very much!
While physicians see different paths to a better practice environment and alternative strategies to make safe, affordable, high-quality care available to everyone, I feel strongly that a consensus that respects differing points of view can be developed and that the AMA is a great place to begin the process of achieving that. Given our current political environment, consensus building in health care policy is sorely needed.
I ask that you support me in bringing the voice of Colorado physicians to the AMA to promote the best policy options and to move them forward in national health policy development.
CANDIDATE FOR CMS DELEGATION TO THE AMERICAN MEDICAL ASSOCIATION
The Colorado Medical Society (CMS) and the American Medical Association (AMA) have been an important part of my medical career. Except for my four years outside of Colorado for residency, I have been a part of our delegation since my first year of medical school. I have had the opportunity to hold many leadership positions within the different sections of the AMA and spent two years on the Council on Medical Service as a medical student. These experiences advanced my knowledge of health affairs and how government policies affect physician practices.
My clinical practice is mainly at the Medical Center of Aurora and Centennial Hospital where I direct the Emergency Medicine rotation for the HealthOne Family Medicine residency. I also coordinate our student rotations within our department.
I currently serve on the board of the CMS where I represent the Aurora Adams County Medical Society (AACMS); I am also the current president of AACMS. Outside of CMS, I also am a board member for the Colorado Chapter of the American College of Emergency Physicians (ACEP). My involvement with both of these boards and on CMS’s Council on Legislation has given me increased knowledge of the issues affecting physicians and patients in Colorado and nationally. These are challenging times and it has never been more important that physicians have a strong voice in health policy decisions.
I would be honored to continue to represent Colorado physicians as a part of our small but mighty delegation. ■
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In the recent legislative session, House Bill 24-1058 Protect Privacy of Biological Data made history by passing both chambers with near unanimity. On April 17, it became the first law of its kind in the nation, signed by Governor Polis, and made national headlines.
By way of this legislation, I have come to realize that our influence as physicians extends far beyond the walls of the exam room, reaching into the realm of policy and legislation.
Action is critical and through collective partnership, we can make a tangible difference. This bill started as an idea from speaking with my patient in the exam
room; then became a CMS Central Line Proposal; and then with the help of CMS, the NeuroRights Foundation, Representatives Cathy Kipp and Matt Soper and Senators Mark Baisley and Kevin Priola, became a bill that made its way through the legislative process.
As physicians, we witness firsthand the changes that can enhance medicine in Colorado. By taking concerted action, we can actualize these improvements into law.
For a long time, I have seen the promise of neurotechnologies, and wanted to promote their innovation, while at the same time ensuring safety and privacy
for patients. Neurotechnologies have the ability to collect vital brain data that we can learn from and use to treat patients. I want to protect the patients of Colorado so that they feel their personal biological data is secure when using this technology to heal.
I feared that without guard rails, patients could be exploited – identified, or biased against – in unprecedented ways based on the data our brains share, especially considering the emerging market of easy-to-obtain consumer products that fall outside of the realm of HIPAA.
HB24-1058 provides a simple, reasonable, balanced approach towards the protection of patients, and clear standards to promote and incentivize innovation in the coming age of neurotechnology for Colorado. Colorado takes care of its own and as a member of the Colorado physician community, I felt that I needed to help protect the data that makes us us.
Physicians in Colorado are responsible for initiating the first law in the nation for the protection of privately collected biological and neural data, a real win for patients and trust in the era of medical-grade consumer neurotechnology. I feel a deep sense of honor knowing I worked to create this change for my patients.
Thank you for your continued support of such efforts, which promise to improve the lives of patients and change the practice of medicine for the better! It is resounding proof that the unified physicians’ voice still matters.
When you see something that could improve, or needs to improve, to better medicine – speak up. Reach out to CMS to learn how to amplify your voice. I am glad I did. ■
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