Michigan Academy of Family Physicians June 2021

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Stay on Course:

YOUR TICKET TO FAMILY MEDICINE CME Bringing On-demand and Virtual CME to You

Plus Watch for your official invitation from MAFP Vice President Glenn Dregansky, DO, FAAFP to attend the Annual Membership Meeting on July 24

Virtual Advocacy: The New Normal? MDHHS Launches We Treat Hep C Initiative

Navigate Your Practice Through Uncharted Waters As we enter the next stage of the pandemic, ISMIE continues to support and encourage healthcare professionals in their fight against COVID-19. With vaccinations more readily available, our Risk Management team has released COVID-19 vaccines: Guidance for healthcare professionals to aid medical practices steering through these extraordinary times. Read more at visit ismie.com/vaccines.

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TABLE OF CONTENTS Chair Keerthy Krishnamani, MD, MBA President Mustafa “Mark” Hamed, MD, MBA, MPH, FAAFP President-elect Srikar Reddy, MD, FAAFP Vice President Glenn Dregansky, DO, FAAFP Speaker Beena Nagappala, MD, MPH Treasurer Rachel Klamo, DO AAFP Delegates Robert Jackson, MD, MMM, FAAFP Loretta Leja, MD AAFP Alternate Delegates Tina Tanner, MD, FAAFP Mary Marshall, MD, RN, FAAFP Members-at-Large Harshini Jayasuriya, MD, FAAFP Brandon Karmo, DO Amy Keenum, DO, PharmD, FAAFP Holli Neiman-Hart, MD, FAAFP Sadeer Peter, MD Pamela Rockwell, DO, FAAFP Kristi VanDerKolk, MD, FAAFP Bashar Yalldo, MD Resident Member Linda Stanek, MD Student Member Jaclyn Israel Ex Officio, Chief Executive Officer Karlene Ketola, MSA, CAE


Stay on Course: Your Ticket to Family Medicine CME Cover Story



Emerging on the Other Side

In It for the Long Run



President’s Message

CEO Insight

Evidence-based Safer Opioid Prescribing Toolkit

Virtual Advocacy




Advocacy Update

FMFM BOARD OF TRUSTEES President Mary Marshall, MD, RN, FAAFP Vice President Keerthy Krishnamani, MD, MBA Secretary/Treasurer Robert Jackson, MD, MMM, FAAFP Executive Vice President Karlene Ketola, MSA, CAE Trustees-at-Large Jennifer Aloff, MD, FAAFP Christal Clemens David Kazanowski, MD Amy McKenzie, MD, MBA

Improvement to the ABFM Certification Process Professional Development

Elizabeth Pionk, DO, FAAFP Jeanette Wilson, MD Bradford Woelke, MD

Michigan Family Physician is published quarterly by Michigan Academy of Family Physicians and provided to MAFP members. Statements of fact and opinion are the responsibility of the authors and do not imply an opinion on the part of the Board of Directors or members of MAFP. Materials may not be reproduced without written permission. For subscription information, reprints, and back issues, email info@mafp.com. ©2021 MAFP. All rights reserved.

Editor: Dana Lawrence

Michigan Academy of Family Physicians 2164 Commons Parkway, Okemos, MI 48864 517.347.0098 | mafp.com


Senator Rick Outman Meet the Legislators


‘Stay Well’ Program Offers Relief from Pandemicrelated Occupational Stress Personal Wellness


MDHHS Launches We Treat Hep C Initiative Clinical Corner

Focus on Students & Residents p. 22 Members in the News p. 24 Events p. 26

Every American Needs a Primary Care Physician A comprehensive report published in May by the National Academies of Sciences, Engineering and Medicine (NASEM) strengthens the case for primary care as the foundation of the U.S. healthcare system. It also makes policy recommendations that reinforce several of American Academy of Family Physicians’ (AAFP) long-standing advocacy positions. “Primary care is the only healthcare component where an increased supply is associated with better population health and more equitable outcomes,” concludes the 448-page report titled “Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care.” The report reflects some 18 months of research and was co-sponsored by AAFP and 16 other partners. In this country, primary care visits account for 35% of healthcare visits, yet they make up only about 5% of healthcare expenditures. The report echoes and extends a 1996 Institute of Medicine report, starting with an updated definition of high-quality primary care as the “provision of whole-person, integrated, accessible, and equitable healthcare by interprofessional teams who are accountable for addressing the majority of an individual’s health and wellness needs across settings and through sustained relationships with patients, families, and communities.” NASEM’s study calls for a five-pronged implementation plan

to make high-quality primary care available and accessible nationwide. Specifically, it calls for policies that: • Pay for primary care teams to care for people, not doctors to deliver services • Ensure high-quality primary care is available to every individual and family in every community • Train primary care teams where people live and work • Design information technology that serves the patient, family, and interprofessional care team • Ensure that high-quality primary care is implemented in the U.S. The report’s findings and recommendations support the Academy’s position that the country’s fee-for-service healthcare design promotes misaligned incentives and prizes “sick care” at the expense of population wellness. This dangerous gap was exposed and exacerbated by the COVID-19 pandemic. “We look forward to working with policymakers, payers, and our other partners in primary care to make the study recommendations a reality — the health of our nation depends on it,” said Shawn Martin, executive vice president and chief executive officer of AAFP. Read more at aafp.org/news/practice-professionalissues/20210504nasemreport.html.

Emerging on the Other Side by Mark Hamed, MD, MBA, MPH, FAAFP As we head from spring into summer 2021, we are in a much better place than we were this time last year. While Michigan Academy of Family Physicians (MAFP) members and our patients are preparing for life on the other side of the pandemic, our work is far from done, however. A major challenge remains in eliminating COVID-19 vaccine hesitancy and overcoming misinformation. Each patient we vaccinate will help bring us 6


closer to the confidence we need to achieve that normalcy for which we all yearn. We must put forth every effort to make this happen, or we risk reversing the progress we have made. Over the past year, MAFP has been hard at work helping members and patients get through this pandemic and preparing us for moving beyond COVID-19. This spring, MAFP once again held our

Michigan Family Medicine Advocacy Day in collaboration with the Michigan Association of Osteopathic Physicians, albeit virtually. The event highlighted the importance of the profession, the need for distributing COVID-19 vaccine to family physicians, protecting scope of practice, reforming the prior authorization process, and helping to preserve and enhance the relationships we have with our patients.


Yes, this pandemic has brought challenges to family physicians across Michigan and nationwide; however, it also highlighted the importance of family physicians’ scope of practice and the value we bring to the table, having cared for COVID-19 patients in nearly every clinical setting throughout the crisis.

As I write this article, preparations are underway for our annual MAFP Annual Meeting & Awards Celebration, also taking place virtually, as well as the newly packaged on-demand and virtual CME annual conference. Not only are these events highly educational, they provide important opportunities for Academy members to connect—leadership looks forward to that. While much of our focus has been on the devastation brought about by the pandemic, the spring and summer months remind us that “getting back to normal” is just ahead. That means resuming business “almost” as usual. The cover story of this issue of Michigan Family Physician focuses on our virtual annual conference, “Stay On Course: Your Ticket to Family Medicine CME” and MAFP Annual Meeting & Awards Celebration. All members are invited to learn, govern, and celebrate together. This issue of Michigan Family Physician also touches on important initiatives that remind us of “normalcy,” such as advocating for our profession and our patients (pages 10-11), a successful Match Day, MAFP “Academy” Award winners (page 28), American Board of Family Medicine certification updates (pages 18-19), and the Michigan Department of Health and Human Services’ new Stay Well Program (page 20). As a physician who has routinely practiced primary care, public health, as well as inpatient and emergency care during the pandemic, I understand the importance of staying mentally healthy. We must continue to remember that physician well-being is vital to being able to care for patients, more so now than ever before.

As our patients are eager to escape the quarantine lifestyle and reenter the active world to catch up on missed cancer screenings and chronic care management, as well as address anxiety and COVID-19 weight gain, it is important that family physicians are mentally and physically healthy to meet them where they are in this new normal. Yes, this pandemic has brought challenges to family physicians across Michigan and nationwide; however, it also highlighted the importance of family physicians’ scope of practice and the value we bring to the table, having cared for COVID-19 patients in nearly every clinical setting throughout the crisis. MAFP has been persistent in our messages to lawmakers and policymakers that addressing our patients’ and our members’ needs come first and foremost. We have reinforced the need for both political parties to work together, and to work with us, to ensure that patient safety and the physician-patient relationship are not compromised. Not only must we protect our profession against scope of practice infringement, we have to protect it against an effort to bring in out-of-state telemedicine physicians. This would further fragment care and disrupt the special relationships we have with our patients. If we were ever to allow these dangerous changes, it would be almost impossible to turn back the clock and undo the ramifications. Our family medicine community must continue to be passionate and persistent in defense of our patients and our profession. To that end, Academy leadership has been strategic in working with partners who we believe will bring strength to our lobbying efforts. We will also continue

to strongly and loudly advocate for our patients, profession, and communities throughout this pandemic and beyond. That is an obligation that our patients and our colleagues have entrusted to us, and we will not let them down. As I pass the presidential torch to Dr. Srikar Reddy and transition to the chair position on the MAFP Board of Directors during our Annual Meeting on July 24 (register at mafp.com/events), I have no doubt that the membership will support Dr. Reddy as he guides MAFP past the pandemic and back to “normal” operations. Dr. Reddy’s drive, commitment, and vision will further advance our Academy goals, ensuring family medicine in Michigan is stronger and ready to take on any and all challenges that lie ahead. Thank you for your support this past year and for your devotion to advancing family medicine. It was an honor and a blessing to lead MAFP through this historic and pivotal time.

Mark Hamed, MD, MBA, MPH, FAAFP is the president of Michigan Academy of Family Physicians. He is also medical director of the Departments of Emergency Medicine and Hospital Medicine at McKenzie Health System in Sandusky, medical director at health departments in eight rural Michigan communities, a senior staff physician and faculty at Henry Ford Health System/ Wayne State University’s residency program, and associate clinical instructor at the Michigan State University College of Human Medicine and Central Michigan University College of Medicine. SUMMER 2021 | MAFP.COM



In It for the Long Run Stay on Course by Karlene Ketola, MSA, CAE After more than a year since COVID-19 first shut down our state, many of us have been worn down by the pandemic. The virus and its variants have pushed us to the limit, and the spring surge felt even more punishing for those working in family medicine. At the same time we’re working to encourage patients to get the vaccine, we’re also helping them recognize and manage the threats to their health that still exist. It’s a process, and one we’d hoped would happen more quickly than it is. Along the way, however, we continue to learn important lessons about the value of community. It’s not just about Michiganders working together to keep our communities safe by masking up, social distancing, and handwashing—it’s about family physicians sharing resources, supporting one another, and advocating for the people they serve.


Michigan Academy of Family Physicians (MAFP) and Family Medicine Foundation of Michigan (FMFM) remain grateful to help facilitate and advance your leadership locally and at the state level. We will continue turning up the volume on your voices at the state Capitol. Our legislative and policy leaders need to hear from you as they make important decisions that affect us all. See pages 10-11 for details about MAFP’s 2021 policy and budget priorities, and for a recap of important discussions that took place between members and state legislators during our 2021 Michigan Family Medicine Advocacy Day in March.

Family Medicine Week

In conjunction with Advocacy Day, we celebrated Family Medicine Week in Michigan, March 21-27. This provided a valuable opportunity to remind our communities about the importance of family 8


medicine, even when there is no pandemic to face. We also reminded policy leaders about the need to involve primary care physicians in the distribution of COVID-19 vaccines, which remains an enormous concern for us all. Check out a compilation of the media coverage our Family Medicine Week and call for vaccine distribution received, posted at mafp.com/about-us/media-center.

Annual Conference

We’ll continue these important conversations—and many more—through our virtual annual conference package, Stay On Course: Your Ticket to Family Medicine CME, that kicks off on July 24. A variety of on-demand clinical and practice management webinars, such as contract negotiations, human trafficking, and opioid abuse, to name just a few, will be available for viewing until July 17, 2022. Plus, you can look forward to hearing about healthcare transformation and artificial intelligence from American Academy of Family Physicians (AAFP) President Dr. Ada Stewart and AAFP Vice President and Chief Medical Informatics Officer Dr. Steven Waldren via live CME webinars on July 21 and July 22. Yes, MAFP and FMFM have a lot in store for you over the next 12 months. Our professional development resources are truly second to none, and our actionpacked year-long agenda bringing ondemand and virtual CME directly to you—anywhere and at any time—includes everything you need to remain on the leading edge of your work and to meet some of the most pressing challenges facing you head on. See pages 12-15 and visitmafp.com/events for details and to register for the robust conference package.

Annual Meeting & Awards

Also being held via virtual livestream on

Saturday, July 24, 12-2 pm ET, is this year’s MAFP Annual Meeting—the state-level forum for members to make governance and business decisions. Whether you are a new or established family physician, retired from practice, or in residency or medical school, MAFP seeks your input on its policies, programs, services, and election of new leadership. There is no cost to participate in the Annual Meeting, but advance registration is required at mafp.com/events. Immediately following the meeting, beginning at approximately 2 pm ET, is our presentation of the 2021 “Academy” Awards. These annual awards recognize exemplary members of our family medicine community and their commitment to their profession and their patients. See page 28 for a preview of this year’s award winners. We, at MAFP and FMFM, are proud to be your professional resource. We do all we can to support your work so you can maximize patient outcomes and serve as a highly trusted voice in your community. Please reach out at any time with your questions, concerns, ideas, and strategies, so your Academy and Foundation can help you stay on course for the long run, leading the way no matter what the future holds.

Karlene Ketola, MSA, CAE is Michigan Academy of Family Physicians’ chief executive officer and Family Medicine Foundation of Michigan’s executive vice president. She joined the MAFP/FMFM team in spring 2019 after serving as executive director of the Lansing-based Michigan Oral Health Coalition for 10 years.


Evidencebased Safer Opioid Prescribing Toolkit for Clinical Care Eve D. Losman, MD, MHSA To address a deficit of easily accessible educational resources and tools for clinicians and their patients on safer opioid prescribing, the Injury Prevention Center at the University of Michigan in partnership with the Michigan Department of Health and Human Services created the Michigan Safer Opioid Prescribing Toolkit—a comprehensive, evidencebased resource funded by the Centers for Disease Control and Prevention. The toolkit (injurycenter.umich.edu/ opioid-overdose/michigan-saferopioid-prescribing-toolkit) is one of the first fully online, comprehensive opioid resources of its kind. Since launching in November 2019, the toolkit has had more than 16,280 unique page views. Creation of the Michigan Safer Opioid Prescribing Toolkit began with a needs assessment of primary care providers across Michigan. Valuable feedback from the leadership of our state’s primary care professional organizations guided this work. Although the toolkit was initially informed by and created for primary care providers, it contains a wealth of material that is applicable to all clinical disciplines. In addition, although the toolkit focuses on Michigan providers and includes material regarding recent opioid legislation passed in Michigan as well as state-specific linkages to services and telehealth resources, a lot of the content is generalizable to any healthcare professional or patient in any state. Respondents to the needs assessment noted multiple challenges regarding the care of patients with pain, including how to raise the topic of tapering and/ or discontinuing opioids, how to taper

opioids appropriately, and how to take care of patients with acute pain and preexisting substance use disorders (SUD). In addition, the challenges of how to treat pain while avoiding opioids, how to assist patients in seeking SUD treatment, and how to manage patients with complex comorbidities—including youth, older adults, and pregnant women with opioid use disorder—were raised. Needs assessment respondents also noted the lack of availability of pain specialists and SUD treatment providers across our state, as well as limited alternatives to treatment of chronic pain and SUD. Lastly, respondents expressed confusion regarding how to interpret Michigan’s new opioid legislation. With this background, we did an extensive literature review and used the Google search engine to find existing providerand patient-focused educational content and resources. The Michigan Safer Opioid Prescribing Toolkit—designed for practicing clinicians and their patients— consists of articles, protocols, videos, and links to the very best pain-related resources from across the country, including those curated from existing sources as well as resources newly developed for the toolkit. To facilitate searching the toolkit, material is organized graphically and by audience (provider versus patient/ family). “Just in time” resources for the busy clinician are highlighted, and a few excellent resources on each topic are included to avoid information overload. Handouts, infographics, and workflows were designed, with specific guidance on caring for different populations

and how to speak to patients when challenging topics arise. Evidencebased recommendations regarding non-opioid and non-pharmacologic pain management are also recommended, and there is a section devoted to health disparities and stigma related to OUD. The resources we curated and created were reviewed by expert researchers and clinicians for accuracy and by practicing primary care clinicians for usability and applicability. The Michigan Safer Opioid Prescribing Toolkit is a living resource that is updated regularly. In March 2021, material for teachers and coaches was added to the adolescent section. In October 2020, protocols and resources for Take Home Naloxone and emergency department initiation of medication for OUD were added within the Post-Overdose Care in the Emergency Department section of the toolkit. This work was informed by two summits held in 2019 and 2020, attended by more than 100 stakeholders from across the state including physicians, nurses, social workers, pharmacists, SUD treatment providers, and public health professionals.

Eve D. Losman, MD, MHSA is an assistant professor in the Department of Emergency Medicine at Michigan Medicine and the University of Michigan. She also serves as core faculty at the University of Michigan Injury Prevention Center and is an emergency physician at Michigan Medicine. Her work in public health focuses on the opioid epidemic and vulnerable patients. SUMMER 2021 | MAFP.COM


Virtual Advocacy The New Normal? by Matt Black

As the COVID-19 pandemic continues, 2021 has brought even more changes within the Michigan Legislature and how advocacy is conducted. Senators and representatives are now meeting on a more regular schedule than they did last year, with hybrid committee meetings and the reintroduction of in-person testimony hearings. Legislators who are in quarantine have joined meetings remotely, although virtual voting is currently not permitted, and Michigan Academy of Family Physicians (MAFP) staff continues its advocacy work through phone, email, and Zoom meetings.

MAFP Budget Priorities

As is customary, MAFP’s advocacy focus at the beginning of the year has been on the state budget. While COVID-19 has created many challenges to the budget process, on a positive note, the state has appropriated additional funding it received through the federal CARES Act, and revenues are higher than initially expected. This has helped in maintaining important programs that initially faced funding cuts in the 2021 state budget. Throughout the budget process, MAFP’s priorities have centered on retaining family physicians in the state. We continue to advocate for investments in the Michigan State Loan Repayment Program and MIDOCs—programs to increase the number of primary care physicians practicing in underserved communities and to shore up the state’s physician shortfall. Studies show that medical 10 SUMMER 2021 | MAFP.COM

residents are more likely to remain in the communities where they do their training. MAFP is also advocating for increased Medicaid reimbursement for certain primary care services, continued state funding for the I Vaccinate campaign, and expansion of the Healthy Moms, Healthy Babies program, which provides postpartum Medicaid coverage for up to one year for new mothers and their children.

State Budget Process

All of MAFP’s budget priorities were included in Gov. Gretchen Whitmer’s 2021-2022 executive budget recommendation, with the exception of a Medicaid reimbursement increase. Her budget is designed to be a “saver’s budget,” where the focus is on expanding education and training to continue economic growth in Michigan, and many programs have shifted to dedicated funding instead of one-time funding. The House and Senate Department of Health and Human Services (MDHHS) Appropriations subcommittees advanced their budget priorities in late April. The House subcommittee took a different approach to the budget than in previous years, recommending quarterly funding for different line items. The panel also made some adjustments to the proposed Healthy Moms, Healthy Babies program. On the other side of the aisle, the Senate subcommittee also did not eliminate any

line items of importance to MAFP, and it recommended an increase of $1.3 million for MIDOCs, bringing the program’s overall funding to $6.7 million. Also notable for the Senate subcommittee this spring was a shift in leadership and membership. Following the resignation of Sen. Peter McGregor, who was elected to a county position, Sen. Rick Outman, took over as chair, and Sen. Curtis Hertel stepped down from the committee, possibly to prevent any potential conflicts of interest that could arise due to his wife, Elizabeth Hertel, being appointed director of Michigan Department of Health and Human Services. Both the House and Senate budget proposals passed their respective committees along party line votes, with some Democrat members abstaining from voting and none voting in favor. Many of the line items important to the committees’ Democrats were funded with a $100 placeholder to maintain them as points of difference for discussion and negotiation during conference committee.

Prior Authorization Reform

Another of MAFP’s priorities, prior authorization reform, is back before the state Legislature. Now numbered Senate Bill 247, this legislation spearheaded by the Health Can’t Wait Coalition , of which MAFP is a founding member, calls for increased transparency, fairness, and clinical validity to the prior authorization


process. Major provisions include “goldcard” language and requiring insurers to post on their websites the number of prior authorization denials and appeals, as well as the top reasons for denial. It is important to note that step therapy language has been removed from SB 247 and will be put forth in a stand-alone bill that is expected to be introduced later this legislative term. SB 247 passed the Senate Health Policy and Human Services Committee after a single day of testimony in April. Last year, testimony on then-numbered SB 612 spanned four weeks and filled committee hearing overflow rooms with high numbers of attendees. The bill ultimately passed the Senate but expired in the House during lame-duck session at the end of 2020.

Family Medicine Advocacy Day

The 2021 Michigan Family Medicine Advocacy Day, once again hosted by Michigan Academy of Family Physicians in collaboration with Michigan Association of Osteopathic Family Physicians (MAOFP), saw a lot of changes this year with the transition to a virtual event. Last year, our Advocacy Day was one of the final in-person events held at the state Capitol, and it was the last in-person event hosted by MAFP. Nearly 70 student, resident, and active members convened for this year’s half-day event, meeting virtually with legislators and their staff to discuss funding for MIDOCs and the Michigan State Loan Repayment Program, prior authorization reform, telehealth payment parity, and scope of practice.

As in prior years, advocates attended a morning seminar to learn about these priorities in detail, as well as the status of the state’s budget and policy updates. The House MDHHS Subcommittee chair, Rep. Mary Whiteford, delivered a keynote presentation highlighting her budget and policy priorities, several of which address the lack of behavioral healthcare resources in our state. “While the virtual Advocacy Day was not as intimate as in-person, MAFP and MAOFP members were still able to make an impact and educate legislators and staff on issues important to the advancement of family medicine in Michigan, preservation of the patient-physician relationship, and protection of the scope of family medicine practice,” said MAFP Director of Government Relations Matt Black. “We all look forward to being back in person, where a large number of advocates are on-site to meet with legislators in downtown Lansing.”

Family Medicine Week

Family Medicine Week 2021, proclaimed by Gov. Whitmer as March 21-27, was held in conjunction with Advocacy Day. This annual week-long campaign highlights the role family physicians play in individual, family, and community health and well-being. To kick off the week, MAFP President Mark Hamed, MD, MBA, FAAFP, and Pamela Rockwell, DO, FAAFP, medical director at Domino’s Farms, associate professor in the Department of Family Medicine at the University of

MAFP President, Dr. Mark Hamed, interviewed by WOOD-TV8 in Grand Rapids.

Michigan, and American Academy of Family Physicians’ liaison to the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, participated in a COVID-19 vaccine roundtable discussion. The roundtable garnered significant media coverage and put the spotlight on the importance of the state distributing COVID-19 vaccine to family physicians to help reach the goal of 70% of Michiganders being vaccinated.

Family Medicine Advocacy Summit

After a one-year hiatus due to the pandemic, AAFP held this year’s Family Medicine Advocacy Summit in the spring via Zoom. State chapters organized meetings with key congressional members serving on committees impacting AAFP priorities. With the goal of increasing access to primary and preventive care, discussions focused on telemedicine, Medicaid payment parity, and highdeductible health plan primary care visits.

Advocacy Moving Forward

Since the Michigan Legislature is a fulltime legislative body, meaning it meets throughout the entire year, there will be plenty of opportunities yet this legislative session for Academy members to actively engage in advocating for their patients, profession, and practice of medicine. In addition, all members are encouraged to attend the MAFP Annual Meeting to discuss and vote on resolutions—formal written proposals/recommendations for the Academy to establish policy, address an issue of concern, eliminate a non-essential activity, or explore or implement a new program. Annual Meeting information is found on page 15 and no-cost registration is available at mafp.com/events.

Matt Black serves as Michigan Academy of Family Physicians’ director of government relations. He is responsible for directing the organization’s state public policy agenda, analyzing legislation and regulatory changes for potential impact on patients and the practice of medicine in Michigan, and bridging the gap between members and elected officials. SUMMER 2021 | MAFP.COM


Stay on Course: Your Ticket to Family Medicine CME Bringing On-demand and Virtual CME to You 12 SUMMER 2021 | MAFP.COM


It is our pleasure as presidents of Michigan Academy of Family Physicians (MAFP) and Family Medicine Foundation of Michigan (FMFM) to invite you to our redesigned Michigan Family Medicine Conference & Expo. Included are ondemand webinars, live webinars, virtual annual membership meeting, and virtual expert-guided tour of Detroit. Due to COVID-19, this year’s virtual conference experience is being offered in lieu of our annual inperson family medicine gathering. We are eager to reconvene in person at the historic Grand Hotel on Mackinac Island for the 2022 conference and look forward to seeing you then! Watch MAFP’s Family Medicine Update e-newsletter for details as they become available. ~ Mark Hamed, MD, MBA, MPH, FAAFP and Mary Marshall, MD, RN, FAAFP

The following on-demand clinical and practice management webinars are available to watch at your leisure, anytime and anywhere, beginning July 24, 2021, through July 17, 2022. The cost is just $350 for MAFP physician and resident members and $50 for student members. Register at mafp.com/events.

Bipolar Disorder: A Complex Diagnostic Challenge for Primary Care

Bipolar disorder is common in family physician offices, yet it is one of the most difficult diagnostic and treatment problems family physicians face, leaving it often undiagnosed. This session will provide practical pointers in the diagnosis and treatment of bipolar disorder. Loretta Leja, MD (Cheboygan)

Chronic Kidney Disease: Managing Your Patient Across Specialties Chronic Kidney Disease (CKD) is permanent kidney damage or decreased kidney function that continues for three months or more. When left untreated, CKD can lead to complete kidney failure. Attend this session to learn how

to screen patients for CKD, when to make nephrologist referrals, and how to have a collaborative relationship in the management of CKD patients across specialties. Ben Collins-Hamel, DO, internist, Motor City Internists; faculty physician, Ascension Macomb Hospital; assistant professor of medicine, Michigan State University College of Osteopathic Medicine (Warren) and Kal Ismail, MD, program director, Nephrology Fellowship, St. John Macomb/Oakland Hospital; clinical assistant professor of medicine, Michigan State University College of Osteopathic Medicine; medical director, Fresnius Medical Services Warren and Madison Heights, Apheresis Hypertension Nephrology Associates (Warren)

Clinical Ethics—A Pragmatic Approach

Available until May 1, 2022. | Fulfills the State of Michigan’s medical ethics professional development requirement for medical licensure. As a patient nears the end of life, conflicts commonly arise when the family’s expectations exceed what is medically possible. Physicians may also experience moral distress when they SUMMER 2021 | MAFP.COM


FREE VIRTUAL CME KEYNOTE PRESENTATIONS Staying the Course to Transform Healthcare Wednesday, July 21, 7-8 pm ET During this one-hour, FREE interactive webinar, AAFP President Ada Stewart, MD, FAAFP, will share how AAFP is working to continue transforming healthcare to achieve optimal health for everyone. Learn about the Academy’s strategic priorities and efforts around COVID-19, payment reform, practice transformation, administrative burden, and physician well-being.

Will Artificial Intelligence Expand Family Medicine Comprehensiveness? Thursday, July 22 | 7-8 pm ET There is significant hype and investment in artificial intelligence (AI) for healthcare. AI that does not optimize the character of family medicine impedes the physician and degrades the patient experience. During this session, AAFP Vice President and Chief Medical Informatics Officer Steven Waldren, MD, MS, will explore the potential perils and promise of AI for family medicine, as well as our potential role to help steer its future. There is no cost to participate, but advance registration is required.

recognize that aggressive treatment is no longer beneficial. Utilizing recognized ethical tenants, this session explores a structured framework for analyzing ethical dilemmas and provides suggested techniques for managing conflict and aligning end-of-life goals through effective communication. Fred VanAlstine, MD, MBA, palliative and supportive care, Mercy Health Physician Partners (Traverse City).

Care Teams: Coding for Success

Providing high quality care is a top priority for family physicians. Doing so can be difficult when facing significant administrative burdens. This session will discuss how you can benefit from implementing a team-based care model, funded by using current procedural terminology codes to enhance financial well-being. Ewa Matuszewski, BA, chief executive officer, Medical Network One (Rochester)

Contract Negotiations

Entering into an employment contract can be a complicated time of life. This session will discuss the dynamics of contract agreements, how noncompetition agreements work and are enforced, and how to assess whether to accept and enter into an agreement. Cliff Hammond, attorney, Foster Swift Collins & Smith PC (Southfield, Lansing) 14 SUMMER 2021 | MAFP.COM

Human Trafficking: How Family Physicians Can Recognize and Assist Victims

Fulfills the State of Michigan’s human trafficking professional development requirement for medical licensure. Family physicians may see victims of human trafficking more often than they realize. One U.S. study found that more than 85% of survivors had contact with a healthcare professional while being trafficked. Identifying a human trafficking victim can be complicated, requiring an understanding of the law as well as the warning signs. This session will give you tips on how, as a family physician, to identify human trafficking, what you can to do help victims of human trafficking, and how strategies used by the Genesee Human Oppression Strike Team can be useful to you. Chris Swanson, sheriff, Genesee County (Flint) and Rachel Klamo, DO, chief of family medicine, Ascension Providence Rochester Hospital (Rochester)

Opioids: How We Got Here, How to Prescribe by the Rules, and How to Compassionately Address Patients’ Beliefs on Opioids and Pain

Fulfills the State of Michigan’s pain and symptom management professional development requirement for medical licensure.

This three-hour webinar will discuss the history of opioids in America and the opioid epidemic, the legal requirements when prescribing opioids in Michigan, and how family physicians can manage opioids in clinical practice. Suggestions will be offered for screening substance use disorder, tapering methods, and changing the pain narrative. Participants will also gain a better understanding of the physiology of chronic and acute pain and how to help their patients better manage their symptoms. Glenn Dregansky, DO, FAAFP, assistant professor, Western Michigan University Homer Stryker M.S. School of Medicine (Kalamazoo)

Out of Bounds: Previous Claims Under Further Review

Fulfills the State of Michigan’s medical ethics professional development requirement for medical licensure. Whether you are competing for a championship sports title or practicing medicine, there are consequences for crossing the line. Learn about professional liability considerations associated with personally and professionally stepping out of bounds. The information and examples presented will help you stay in the game. Laurette Salzman, MBA, CPHRM, senior risk resource adviser, ProAssurance Companies (Middleton, WI)



MAFP President-elect Srikar Reddy, MD, FAAFP

VIRTUAL MAFP ANNUAL MEETING & AWARDS CELEBRATION Livestreamed Saturday, July 24 | 12-2 pm ET Whether you are a new or established family physician, retired from practice, or in residency or medical school, MAFP seeks the input from all members on its policies, programs, and services. One way members may share their input and help shape their Academy is by attending the MAFP Annual Meeting—the statelevel forum for members to make governance and business decisions. Resolutions will be considered and voted on, the AAFP Degree of Fellow will be conferred to Michigan’s newest AAFP Fellows, officers will be elected, the Board of Directors will be installed, and outgoing and incoming board presidents will address the membership. The 2021 “Academy” Awards will be presented immediately following the Annual Meeting, beginning at approximately 2 pm ET. There is no cost to participate, but advance registration is required.

Join us for a virtual tour of the people, places, and projects that make up Detroit’s past and present. Using immersive storytelling, Detroit Experience Factory will treat you to an experiential journey of the city’s history, highlighting how it has evolved throughout the decades and what’s happening today. This tour is generously sponsored by Southeastern Michigan Academy of Family Physicians. There is no cost to participate, but advance registration is required.

Managing Depression in Primary Care

This session will review current depression screening procedures in primary care (PHQ-9), offer suggestions on how to pick a Selective Serotonin Reuptake Inhibitor (SSRI), review augmentation strategies when prescribing SSRIs, and the discuss the importance of wellness/behavioral change. Perry Westerman, MD, residency program director and associate professor, Department of Psychiatry, Western Michigan University Homer Stryker, M.D. School of Medicine (Kalamazoo)

Simultaneous Knee Joint and Anserine Bursa Injection

Learn how to recognize an often-missed medial knee pathology, anserine bursitis, and how to use a novel technique for simultaneous injections of the medial knee and anserine bursa. Barry Scofield, MD, faculty, Ascension St. John Family Medicine Residency (Detroit, St. Clair Shores)

The Growing Direct Primary Care Movement in Michigan

Direct Primary Care (DPC) is growing in Michigan, with approximately 12 doctors currently practicing this model across the state. Hear from a panel of family physicians about why they feel the DPC model offers a reasonable alternative to the fee-for-service system, and how it has enabled them to regain their

autonomy and create a fulfilling practice environment. Phil Hellman, MD, physician and founder, Paradox Health (Rochester Hills); Raquel Orlich, DO, physician, Plum Health DEP (Detroit); and Paul Thomas, MD, physician and founder, Plum Health DPC (Detroit)

The Role of Primary Care in Expanding MAT for Opioid Use Disorders

Contributes toward fulfilling the State of Michigan’s pain and symptom management professional development requirement for medical licensure. Medication assisted treatment (MAT) is an important evidence-based treatment option for individuals with opioid use disorders (OUD). During this session, learn about the need for primary care to provide expanded access to treatment of OUD, as well as addiction treatment myths and facts. Plus, get a general office-based MAT overview and learn what support is available for physicians and clinics from the Michigan Opioid Collaborative, as well as how some payors are incentivizing physicians to offer MAT. Avani Sheth, MD, MPH, medical director, board-certified family medicine and preventive medicine and public health, Neighborhood Service Organization (Detroit) and Audrey Hazelbaker, LMSW, Michigan Opioid Collaborative, Department of Psychiatry, University of Michigan (Ann Arbor) SUMMER 2021 | MAFP.COM


Continuous Improvement to the ABFM Certification Process by Elizabeth Baxley, MD, and Ashley Webb, MS

The American Board of Family Medicine (ABFM) continually evaluates the certification process to assess ways in which improvements can be made to increase relevance and reduce burden for Diplomates as they maintain their board certification. Based on feedback from participating physicians, this approach of continuous cycles of improvement is a promise ABFM has made to Diplomates to ensure it is providing up-to-date information and activities that align with each physician’s scope of practice. ABFM looked at each area of the certification process and is eager to communicate regular updates to all Diplomates.

Self-Assessment and Lifelong Learning

In early 2020, ABFM launched a redesign of its Knowledge Self-Assessment activities (KSAs). This included a thorough review of each KSA activity to update the items, critiques, and references to be current with best available evidence. It also resulted in converting all items to a single best-answer format. To address a concern Diplomates have expressed with the multiple true/false format, ABFM no longer requires 80% of items be answered 16 SUMMER 2021 | MAFP.COM

correctly in each content category. Now, only the attainment of 80% of overall items must be correct, allowing multiple attempts as needed to receive credit. The KSA platform also was improved to provide ease of participation and an enhanced user experience. As part of this effort, ABFM also added a new KSA on palliative care and has combined some existing topics (e.g., coronary artery disease and heart failure are now combined in the KSA on heart disease) to make room for additional new KSA topics in the future. This process involves a number of Diplomates serving as volunteers for item writing and peer review of the revamped KSAs before they are made available. The revision process will continue throughout 2021, at which time ABFM will turn its attention to adding new KSAs to expand the clinical areas offered. ABFM also has a new activity for Diplomates in the form of an ABFM National Journal Club. This will provide a service to help family physicians keep up to date with the most important, practice-changing, peer-reviewed literature that is relevant to family physicians. A

pilot of the National Journal Club will begin in summer 2021, with articles that can be accessed through the Physician Portfolio for any Diplomate who chooses to enter the pilot. For each article reviewed and questions answered, the Diplomate will receive one certification point. Completion of 10 articles will fulfill the KSA requirement for your current stage.

Cognitive Expertise—The Exam

Probably one of the most exciting advancements that has been made to the certification process is the addition of the Family Medicine Certification Longitudinal Assessment (FMCLA). ABFM introduced the FMCLA in 2019 as an alternative to the one-day exam that is more consistent with ongoing learning, retention, and application to practice. The FMCLA gives Diplomates the opportunity to complete their exam requirement in the comfort of their home, office, or wherever they choose, by delivering 25 questions per quarter for a period of three to four years, until they reach the requisite 300 items for scoring. The quarterly items can be completed at your own pace. Five minutes is permitted for each question, which doubles the average amount of time


Probably one of the most exciting advancements that has been made to the certification process is the addition of the Family Medicine Certification Longitudinal Assessment (FMCLA), an alternative to the one-day exam that is more consistent with ongoing learning, retention, and application to practice.

per question on the one-day examination, allowing for reference use. One of the main differences between the FMCLA and the one-day exam is that participants will immediately learn if their answer is correct and they will be able to review a critique and references. The feedback from two cohorts of participating physicians has been uniformly positive, with the single most common response being, “I am learning as I go.” Participation is limited to current Diplomates, who are eligible to sign up for the FMCLA in the fall of the year before their next examination is due. Participants get a score prediction after the first year of participation, so it is easy to track your progress against the passing standard. The FMCLA option has been offered to Diplomates due for their examination in 2020; beginning in 2022, this will be a permanent option in the certification portfolio.

Performance Improvement

Perhaps the most significant changes within the certification activity portfolio have been to Performance Improvement (PI) activities. Participation in PI is an important part of ABFM certification because it demonstrates that, as a board-certified family physician, you can reflectively look at your practice, identify gaps in care delivery or outcomes, do something to close those gaps, and then re-measure to see if what you did resulted in an improvement. This does not require a continuity practice, as ABFM now has options for any type of practice that a family physician is engaged in, including locum tenens, urgent or emergent care, hospital-only practice, and more. This includes new offerings such as acute care, behavioral health, hospice and palliative

medicine, and more. Additionally, for physicians who are no longer seeing patients in any setting, ABFM no longer requires a PI activity—in this case, all 50 points come from KSA activities. ABFM also has focused on providing credit for the quality improvement activities physicians are already doing in their practices through development of a SelfDirected PI activity. This allows for up to 10 physicians working in a single practice to submit an improvement activity they have recently completed, or they may design an activity around anything they wish to improve in their practice—thus ensuring relevancy to their daily work. For larger groups, such as accountable care organizations, large group practices, health systems, and state chapters, ABFM now has an Organizational PI activity, in which a local sponsor can manage a group PI activity and simply attest to the participating physicians for them to receive certification credit. In response to the COVID-19 pandemic, ABFM added a specific self-directed activity for Diplomates to describe the changes they made in their practice— regardless of type and location—to accommodate the provision of safe and effective care. Over 10,000 Diplomates have successfully submitted PI activity applications to date. Additionally, in response to a renewed national focus on health equity and social justice, ABFM developed and deployed a Health Equity PI activity, also modeled after the selfdirected pathway, to assist Diplomates in addressing needed changes in their practice or community to make care more equitable and conscious of the needs of a diverse population to improve the patient experience.

With increasing options comes the challenge of choosing a suitable PI activity. For this reason, ABFM created the PI Locator. This allows you to answer a series of short questions on practice type, areas of interest, and any activities in which you are already participating; it then synthesizes your answers to produce a shorter list of options most relevant to you.

Process Improvements

ABFM has been busy making the certification process easier to understand and manage. At the end of April 2021, ABFM launched its new and improved Physician Portfolio. Designed with physician input, MyABFM Portfolio is a clean, purpose-driven redesign of the individual portfolio that family physicians use for certification. Our goal is to minimize the time you spend understanding and accessing your activity requirements.

Elizabeth Baxley, MD is executive vice president of the American Board of Family Medicine. In this role, she leads all aspects of ABFM activity that relate to the experience of boardcertified family physicians with ABFM, including residency, the early clinical years, credentials, and communications. Ashley Webb, MS director of outreach at the American Board of Family Medicine, is the liaison between ABFM and chapters of the American Academy of Family Physicians. SUMMER 2021 | MAFP.COM



‘Stay Well’ Program Offers Relief from Pandemic-related Occupational Stress by Paula Detwiller Stress is a normal part of most healthcare professions, but over the past year, as COVID-19 swept across the nation, occupational stress among healthcare workers reached extreme levels. Pierre Morris, MD, family physician and program director of Wayne State University School of Medicine / Ascension Providence Rochester Family Medicine Residency, remembers when his staff’s anxiety began ramping up. “During the spring of 2020, at the peak of the pandemic, our residents and attending physicians were confused and terrified as little was known about the COVID-19 virus. We all knew the potential consequences of infection, and how quickly our hospital and ICU had reached capacity. We were also keenly aware of the challenges of securing appropriate personal protective equipment, which was in very short supply,” said Dr. Morris. In a survey of 1,119 healthcare workers conducted by Mental Health America between June and September 2020, 93% of respondents reported experiencing stress, 86% reported experiencing anxiety, and 76% reported exhaustion and burnout. Seventy percent were having trouble sleeping and more than half were experiencing physical symptoms, such as headache or stomachache. Dr. Morris says the residency program and hospital system he works for has come a long way in the past year, “but we continue to experience the continued anxiety and stress caused by the cyclical behavior of COVID-19 and the broader social impact that continues to restrict our lives.”

It Can Help to Talk About It

Anticipating the emotional distress that COVID-19 would bring, a behavioral health team from the Michigan Department of Health and Human Services (MDHHS) 18 SUMMER 2021 | MAFP.COM

created a statewide crisis counseling program in April 2020, called Stay Well, to help front-line workers and other heavily impacted individuals. Stay Well, which is funded by a Federal Emergency Management Agency (FEMA) grant, offers: •

The Stay Well counseling line, providing emotional support from trained crisis counselors, 24 hours a day, seven days a week. To reach a Stay Well counselor, dial the state’s COVID-19 hotline at 888.535.6136 and press “8.” Counseling is free and confidential.

Virtual support groups for first responders, healthcare professionals, and direct care workers (among other vulnerable populations). These sessions are held via Zoom and moderated by Stay Well counselors. Participants have an opportunity to connect with others who can relate to their experiences and reactions. To register, visit Michigan.gov/ StayWell.

Psychoeducational webinars. Tailored to specific audiences, these webinars help viewers understand that their emotional reactions to pandemic stressors are normal. The webinar for first responders and healthcare workers acknowledges the feelings associated with compassion fatigue and offers coping tips. The webinar for direct care workers explains burnout and suggests ways to alleviate it. You can schedule a live webinar for your group by contacting Senior Outreach Specialist Erin Wallace at brightleafllc@gmail.com, or watch recorded webinars at Michigan.gov/ StayWell.

Early Intervention is Key

The Stay Well program’s motto, “Be Kind to Your Mind,” is a gentle reminder that there

should be no shame or stigma associated with getting emotional support if the ongoing pandemic is getting you down. In fact, it can keep serious mental health issues at bay. “We know that people who face constant, overwhelming stress can develop mental health conditions such as anxiety, depression, or stress-related disorders,” said psychiatrist Dr. Debra Pinals, MDHHS’ medical director for behavioral health. “That’s why it’s important for healthcare workers to take stock of their mental wellness and seek help.” Dr. William Fales, state medical director in the Division of EMS and Trauma, agrees. He adds that family physicians should also ask patients about their mental health—particularly about signs of depression or substance overuse—as part of routine primary care encounters. “Often that’s perfunctory,” Dr. Fales said. “But if the patient is a first responder or another type of frontline worker, the doctor should really engage with them and say, ‘It’s been a tough year, you must be under stress. Have you heard about Stay Well?’” For more information, including written mental health guidance for COVID-19 frontline workers, visit Michigan.gov/ StayWell.

Paula Detwiller, scientific writer and editor, serves as a liaison between the Michigan Department of Health and Human Services’ Behavioral Health and Developmental Disabilities Administration and the department’s communications office. In this role, she manages communication efforts for the Stay Well program.


Senator Rick Outman Improving Statewide Access to Primary Care by Matt Black

focused on the state budget. Committee hearings continued virtually due to the pandemic, with advocates highlighting the importance of funding different programs. Sen. Outman has been at the center of these public budget meetings and has continued to talk with interested parties to hear about their priorities. MAFP has been grateful for the opportunity to share our family medicine priorities with both the senator and his staff.

With a shift in new leadership at the outset of 2021, Sen. Rick Outman (R-Six Lakes) was appointed chair of the Senate’s Michigan Department of Health and Human Services (MDHHS) Appropriations Subcommittee—the state’s largest budget committee. The seat was open after Sen. Peter MacGregor resigned from the Legislature to serve as Kent County treasurer. Sen. Outman is in the latter half of his first term in the Senate, having previously served three terms in the Michigan House of Representatives in 20102016. During his tenure in the House, he was on the Families, Children, and Seniors Committee, which often includes both health policy and human services legislation. Today, with his dedication to preserving Michigan’s land and environment, he also chairs the Senate Committee on Environmental Quality. As is customary, during the early months of the year, the Michigan Legislature largely

Throughout the budget process, Sen. Outman has taken the approach of investing in communities to help them navigate through the pandemic. The initial budget passed by the Senate MDHHS subcommittee allocated an additional 10% in funding for local health departments and included an increase to the MIDOCs program, an MAFP priority, which invests in community-based residency positions. This approach to the budget highlights Sen. Outman’s dedication to expanding healthcare access in rural areas of Michigan. “It is important to make sure everyone in the state has access to quality healthcare,” he said when talking about his healthcare priorities. The inability to properly manage health conditions and provide preventive care are of great concerns to the senator. “We all have family members, friends, or neighbors who are struggling with health issues that could have been managed earlier in their lives,” he said, expressing how important primary and preventive care are to improving individual health outcomes, alleviating suffering, and reducing healthcare costs for both the patient and the healthcare system.

He views improving statewide access to primary care services for everyone in Michigan, including to family physicians, the best way to increase preventive care and boost the effectiveness of care management. Being surrounded by friends and family who work within the healthcare industry have impacted Sen. Outman’s viewpoint, he said. During most of his wife’s career, she served as a nurse’s aide, and he has a daughter who is a nurse working in the emergency department. This exposure, and his experience as a business owner, has helped shape his understanding of the healthcare system and healthcare needs in Michigan. One of the greatest surprises of serving in the Legislature, said the senator, has been the impact that legislators and the actions taken within the Capitol can directly have on the lives of citizens each day. Because of this, he stressed how important it is for family physicians to keep an open dialogue with all their elected officials, answering questions and raising concerns with how legislation may impact the delivery of care. Outside of the Legislature, Sen. Outman is actively engaged in the community where he grew up. After attending and graduating from Lakeview Community Schools, he has remained involved with the schools through the wrestling team and local wrestling clubs. He is also active with other community organizations, including Montcalm County Farm Bureau and the Montcalm County Soil and Conservation District. He and his wife, Kristine, have two daughters, Keelie and Katelyn, and a son, Patrick. They are proud grandparents of two grandchildren. SUMMER 2021 | MAFP.COM


MDHHS Launches We Treat Hep C Initiative Increasing Access and Awareness of Hepatitis C Treatment Michigan Department of Health and Human Services (MDHHS) is working to eliminate hepatitis C through the Apr. 1 launch of the We Treat Hep C Initiative and the release of the statewide plan on eliminating hepatitis C. Improving patient health outcomes, accurate diagnosis, and progression through the hepatitis C care cascade are vital. MDHHS encourages clinicians to follow the Centers for Disease Control and Prevention’s new recommendations for universal hepatitis C testing among the following populations: • All adults 18 years and older (onetime testing) • All pregnant women during every pregnancy • Individuals with certain exposures and medical conditions • Individuals with ongoing risk factors (periodic testing) • Anyone who requests it, regardless of risk disclosure 20 SUMMER 2021 | MAFP.COM

It is important for patients to receive testing for both hepatitis C antibody and hepatitis C RNA to confirm infection. Return for follow-up confirmatory testing is a significant barrier to patients; therefore, hepatitis C reflex testing should be considered to eliminate barriers that may prevent patients from achieving a hepatitis C cure. New direct-acting antivirals are effective at curing persons of their hepatitis C infection with daily oral therapy. MDHHS launched the We Treat Hep C Initiative to increase access to hepatitis C treatment among Michigan Medicaid and Healthy Michigan Plan beneficiaries. As part of this initiative, MDHHS entered into an agreement with AbbVie, the manufacturer of the hepatitis C directacting antiviral MAVYRET®. As of Apr. 1, Michigan Medicaid has removed prior authorization requirements, including prescriber and sobriety requirements, for the preferred hepatitis C medication, MAVYRET®.

To expand clinical capacity to treat patients for hepatitis C, MDHHS is partnering with organizations to support clinicians in hepatitis C management: •

Henry Ford Health System’s Hepatitis C Clinical Consultation Program: A free consultation line available MondayFriday 8 am-5 pm for all healthcare professionals with questions about hepatitis C disease management and treatment. Call 313.575.0332.

Midwest AIDS Training and Education Center (MATEC) Michigan: Offers free hepatitis C case-based office hours available for all healthcare professionals. To request an appointment with a physician specializing in hepatitis C, call 313.962.2000.

Michigan Opioid Collaborative‘s Hepatitis C Virtual Case


Published studies have shown that 50% of persons chronically infected with hepatitis C virus are unaware of their status and, despite the availability of curative therapies, less than 10% of those infected with the virus have been successfully treated. Conferencing: Offers biweekly education and case consultation on hepatitis C to support primary care and community providers with diagnosis, treatment planning, and medication management of people living with hepatitis C. Learn more at michiganopioidcollaborative. org/hep-c-treatment. •

Michigan State University and Michigan Center for Rural Health Infectious Disease Project ECHO® Trainings: Offers community collaboration to assist clinicians throughout northern Michigan and the Upper Peninsula to manage their

In 2019, a total of 6,036 new chronic hepatitis C virus diagnoses and 133 acute HCV cases were reported. In 2019, 2,847 new HCV diagnoses (~46%) occurred among residents of southeast Michigan in the city of Detroit and Wayne, Oakland, and Macomb counties.

infectious disease patients more effectively and confidently. Free CME for healthcare professionals is available. For more information on Michigan’s plan for eliminating hepatitis C or the We Treat Hep C Initiative, visit Mi.gov/ WeTreatHepC. For questions related to the initiative or MDHHS’ Elimination Plan, contact the MDHHS Viral Hepatitis Unit at MDHHSHepatitis@Michigan.gov. Michigan Department of Health and Human Services’ Viral Hepatitis

Unit coordinates Michigan’s viral hepatitis elimination efforts, providing subject matter expertise and technical assistance on surveillance of viral hepatitis, improving access to viral hepatitis testing and linkage to care, and providing oversight and strategic direction for expansion of statewide harm reduction capacity across Michigan. Since its inception in 2013, the MDHHS Viral Hepatitis Unit has supported integrated viral hepatitis surveillance and prevention efforts, utilizing a datadriven approach to inform public health intervention activities, working tirelessly to eliminate barriers to hepatitis C treatment.

Michigan has a hepatitis C virus prevalence of 69,100, which ranks seventh among all states in the U.S. SUMMER 2021 | MAFP.COM



Michigan Residency Programs Recognized for 100% Membership Thirty-two of Michigan’s 38 family medicine residency programs are among 625 nationwide being recognized for achieving 100% resident membership in the American Academy of Family Physicians for the 2020-2021 academic year. Of those, 30 of the programs pay membership dues for their residents. In all, 93% of Michigan resident physicians are members of the Academy: 229 (95.82%) PGY-3, 223 (92.92%) PGY-2, and 239 (91.92%) PGY-1. Do you know residents who are not members? Encourage them to join at aafp.org/membership/join/resident.html. Learn about AAFP member benefits at aafp.org/membership/ benefits.html. Learn about MAFP benefits at mafp.com/membership/ member-benefits.

Best wishes, 2021 medical school and residency program graduates, as you begin the next chapter of your family medicine career! Your family medicine family is celebrating with you and invites you to maintain your membership in the Academy—visit aafp.org/ membership and mafp.com/membership to learn how you will benefit! 22 SUMMER 2021 | MAFP.COM



• Ascension Macomb-Oakland Hospital Family Medicine Residency • Ascension Providence/Michigan State University College of Human Medicine Family Medicine Residency • Ascension St. John Hospital Family Medicine Residency • Beaumont Health-Farmington Hills Family Medicine Residency • Beaumont Health-Grosse Pointe Family Medicine Residency • Beaumont Health-Troy Family Medicine Residency • Beaumont Health-Wayne Family Medicine Residency • Central Michigan University College of Medicine Family Medicine Residency • Detroit Medical Center-Sinai Grace/Michigan State University College of Osteopathic Medicine Family Medicine Residency • Garden City Hospital Family Medicine Residency • Henry Ford Allegiance Health Family Medicine Residency • Henry Ford Hospital/Wayne State University Family Medicine Residency • Henry Ford Macomb Hospital Family Medicine Residency • McLaren Health Care/Bay/Michigan State University Family Medicine Residency • McLaren Health Care/Flint/Michigan State Family Medicine Residency • McLaren/Oakland Family Medicine Residency • Mercy Health Grand Rapids Family Medicine Residency • Mercy Health Muskegon Family Medicine Residency • Metro Health University of Michigan Family Medicine Residency • Michigan State University/MidMichigan Medical CenterGratiot Family Medicine Residency • MidMichigan Medical Center-Midland Family Medicine Residency • Munson Medical Center Family Medicine Residency • Pontiac General Hospital Family Medicine Residency • ProMedica Monroe Regional Hospital Family Medicine Residency • Sparrow/Michigan State Family Medicine Residency • Spectrum Health/Michigan State University Family Medicine Residency • St. Joseph Mercy Livingston Hospital Family Medicine Residency • St. Mary Mercy Hospital Family Medicine Residency • UP Health System-Marquette Family Medicine Residency • University of Michigan Family Medicine Residency • Western Michigan University Homer Stryker M.D. School of Medicine-Battle Creek Family Medicine Residency • Western Michigan University Homer Stryker M.D. School of Medicine-Kalamazoo Family Medicine Residency

Saturday, Oct. 9 Livestreamed via Zoom Agenda and registration at mafp.com/events Supported in part by grant funding from AAFP Foundation through the Family Medicine Philanthropic Consortium.




Future of Family Medicine VIRTUAL

STUDENT CONFERENCE Explore the breadth & depth of family medicine

RESIDENCY PROGRAM CONNECTION $25 for MAFP members (student membership is FREE! Join at aafp.org/membership/join.html) $50 for non-members

MAFP Presidentelect Dr. Reddy Encourages COVID-19 Vaccination By Dana Lawrence On May 12, Gov. Gretchen Whitmer held a press conference to outline the state’s COVID-19 vaccination efforts, resulting in 55% of adults having received their first shot, and to announce its new push of distributing vaccine to primary care physicians. She identified family physicians as key to reaching vaccine-hesitant Michiganders and vaccinating the newly eligible 12-15 year-old population. All primary care physicians are asked to enroll as vaccine providers, if they have not done so already, and e-order vaccine through the Michigan Care Improvement Registry.

Speaking on behalf of the family medicine community during the press conference was Srikar Reddy, MD, FAAFP, president-elect of MAFP and a family physician affiliated with Ascension Health in South Lyon. "Family physicians are trusted sources for getting vaccinated and sharing evidence-based vaccine information; so, with the help of family physicians, the state’s capacity to vaccinate adults, children, and entire families will grow, helping us end this pandemic faster," he said.

MAFP ‘Academy’ Awardees Announced

When members convene for the virtual MAFP Annual Meeting & Awards Celebration on Saturday, July 24, the following individuals will be recognized with a 2021 “Academy” Award:


Keerthy Krishnamani, MD, MBA, 2019-2020 president of Michigan Academy of Family Physicians

MICHIGAN FAMILY PHYSICIAN OF THE YEAR Pamela Rockwell, DO, FAAFP, associate professor, Department of Family Medicine, University of Michigan; medical director, Dominos Farm Family Medicine Clinic


Mark Paschall, MD, program director, Ascension Family Medicine Residency

MICHIGAN FAMILY MEDICINE RESIDENT OF THE YEAR Sravani Alluri, MBBS, Class of 2021, Western Michigan University Homer Stryker M.D. School of Medicine Family Medicine Residency

OUTSTANDING MEDICAL STUDENT IN MICHIGAN Anthony Seely, Class of 2022, Wayne State University School of Medicine

For information about attending the MAFP Annual Meeting & Awards Celebration, visit mafp.com/get-involved/annual-meeting. 24 SUMMER 2021 | MAFP.COM


2021 Mentorship Program Underway

The second cohort of MAFP’s Mentorship Program launched Feb. 4, with eight mentor/mentee pairings: • Aisha Harris, MD | Tracey Frederick • Beth Peter, MD, FAAFP | Claire Stavenga • Mohamed Eldirani, MD | Mena Jirjees • Petagaye English, DO | Jenniefr Chinchilla Perez • Glenn Dregansky, DO | Mackenzie Schmidt • Jeff Van Wingen, MD | Esam Abobaker • Jinping Xu, MD | Marlin Amy Halder • Sheng Liu, MD | Eli Benchell Eisman, PhD, OMS-IV The Academy steadfastly provides member-wide opportunities for making connections, such as by hosting educational and networking events, engaging members in committees, and catalyzing online discussions through social media. Through the MAFP Mentorship Program, members have the opportunity to share expertise and offer guidance with

one another in a more personal way. Each physician, resident, and student has a unique set of knowledge, skills, and talents, as well as support needs, which may be shared and met through one-on-one relationships and conversations. Ultimately, the goal of the 10-month program is to advance members’ leadership skills, professional development, practice management, scholarly activities, and work-life balance. Have news about yourself, your practice, or a colleague? Email info@mafp.com. Dana Lawrence is director of communications and member services at Michigan Academy of Family Physicians. She directs the organization’s communications strategy, including media relations, public relations, and social media presence; works to increase family medicine awareness and member engagement; and is the lead of medical student and family medicine resident initiatives.

Membership has its privileges. Earn your advanced degree through the Michigan Academy of Family Physicians’ partnership with Davenport University and you can qualify for: •

Up to a $4,500 scholarship for members and members’ employees toward most undergraduate and graduate degree programs

20% tuition discount for spouses and dependents

20% discount on professional development courses offered through Davenport University

Learn more at davenport.edu/MAFP


Bringing On-demand and Virtual CME to You

VIRTUAL ANNUAL CONFERENCE PACKAGE On-demand Webinars: Stay on Course—Your Ticket to Family Medicine CME Available to watch at your leisure beginning July 24, 2021, through July 17, 2022 On-demand CME webinars include training on pain and symptom management, ethics, and human trafficking— required for medical licensure by the State of Michigan—as well as other clinical and practice management topics.

Live Webinar: Staying the Course to Transform Healthcare July 21, 7-8 pm ET

Free, live CME keynote presentation by AAFP President Ada Stewart, MD, FAAFP.

Live Webinar: Will Artificial Intelligence Expand Family Medicine Comprehensiveness? July 22, 7-8 pm ET

Free, live CME keynote presentation by AAFP Vice President and Chief Medical Informatics Officer Steven Waldren, MD, MS.

Detroit in Context: Assets, History, and Challenges July 23 | 7-8 pm ET

Free, expert-guided virtual tour of the people, places, and projects that make up Detroit’s past and present. Sponsored by Southeastern Michigan Academy of Family Physicians.

MAFP Annual Meeting & Awards Celebration July 24 | 12 pm-2 pm ET

Free livestream of MAFP’s annual business meeting of the membership. Elect new leadership and discuss and vote on resolutions. Virtual awards presentation will immediately follow the meeting. Visit mafp.com/events to register and for more information on upcoming events.


On-demand Webinars Available Until Aug. 7 Approved for 1 CME credit each • Common Cyberthreats to Medical Organizations • Cannabis: Breakin’ Good? or Breakin’ Bad? What Family Physicians Need to Know • Identifying & Caring for Victims of Human Trafficking

Virtual Knowledge Self-Assessments Approved for 8 CME credits each • Diabetes Sept. 25 | 8 am-12 pm ET • Health Counseling and Preventive Care Dec. 4 | 8 am-12 pm ET

Live Virtual Events

• Building an Integrated Behavioral Health Program in Primary Care Webinar Oct. 4 | 7-8 pm ET | Approved for 1 CME credit • Virtual Michigan Future of Family Medicine Student Conference Oct. 9 • Exploring Plant-based Medicine Webinar Oct. 11 | 7-8 pm ET | Approved for 1 CME credit • Virtual Women in Family Medicine Conference Nov. 13 • Overview of the 2019 ASCCP Risk Based Consensus Management Guidelines Webinar Nov. 9 | 6:30-7:30 pm ET | Application for CME credit has been filed with AAFP

SEPTEMBER 9 - 11, 2021


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