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JOURNAL OF THE IOWA MEDICAL SOCIETY | OCTOBER - DECEMBER 2023 | QUARTER FOUR

ADVOCACY IN ACTION | IMS YEAR IN REVIEW EDITORIAL: THE IOWA PHYSICIAN SHORTAGE IMS 2023 Q4 Journal-COVERS_SP.indd 2

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Iowa Medicine Q4 2023 |

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CONTENTS IN THIS ISSUE: President’s Column . . . . . . . . . . . . . . . . . . . . . . . . 4 Elevate Your IMS Membership . . . . . . . . . . . . . . . . . 6 Advocacy in Action . . . . . . . . . . . . . . . . . . . . . . . . 8 IMS Year in Review . . . . . . . . . . . . . . . . . . . . . . . .10 Deep Dive Topic: Iowa Needs Doctors – The Physician Shortage . . . . . . 12 AMA Interim Meeting Report . . . . . . . . . . . . . . . . . 16 I am an IMS Member . . . . . . . . . . . . . . . . . . . . . . . 18

Q4 | October-December 2023 IMS Mission: To advance the practice of medicine through advocacy, education, and engagement with physicians throughout Iowa to ensure the highest quality of care for the patients they serve.

IMS President: Jessica Zuzga-Reed, DO

IMS CEO: Steven W. Churchill

Executive Editor: Sara Opie

Physician Editorial: The Iowa Physician Shortage from a Psychiatry Perspective . . . . . . . . . . . . . . . . 20

Managing Editor: Sydney Maras

To Advertise:

University of Iowa Dean . . . . . . . . . . . . . . . . . . . . 22

Contact Heather Lee Phone: 515.421.4776 Email: hlee@iowamedical.org

IMS Awards Nominations . . . . . . . . . . . . . . . . . . . 28

Subscriptions:

Doc 2 Doc: An IMS Pod Talk

Join host and IMS Past President Brian Privett, MD, for a monthly discussion with subject matter experts surrounding current events that impact medicine in our state. New episodes released on the first Wednesday of every month!

Annual Subscription $45

Iowa Medicine, Journal of the Iowa Medical Society (ISSN 0746-8709), is published quarterly by the Iowa Medical Society, 515 E. Locust St., Ste. 400, Des Moines, IA 50309. Periodicals postage paid at Des Moines, Iowa and at additional mailing offices.

Postmaster: Send address changes to Iowa Medicine, 515 E. Locust St., Ste. 400, Des Moines, IA 50309.

Editorial Content: The Society is unable to assume responsibility for the accuracy of submitted material. Editorial inquiries should be directed to the Editor, Iowa Medicine, 515 E. Locust St., Ste. 400, Des Moines, IA 50309.

Copyright 2023 Iowa Medical Society: Opinions expressed by authors do not necessarily represent the official policy of the Iowa Medical Society. Iowa Medicine does not assume responsibility for those opinions. Products and services advertised in Iowa Medicine are neither endorsed nor guaranteed by the Iowa Medical Society unless specifically noted.

listen & learn more here: doc2doc.buzzsprout.com

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PSYCHOLOGY AND WEALTH BRITTANY HEARD, CFP®, CKA®, CFT-I™, CDFA®, Lead Advisor The different ways people react to and treat wealth and finances is fascinating. Although not everyone can be put in a box, there are five main personality types when it comes to psychology and wealth: Neuroticism/Emotional Stability, Conscientiousness, Agreeableness, Extraversion, and Openness. A person can be any one of these or a mix of them. The article called “Personality and Wealth” by Mark Fenton-O’ Creevy and Adrian Furnham describes how these different types of personalities impact how you may think and act about finances. Neuroticism/Emotional Stability According to Fenton-O’ Creevy and Furnham, “Neuroticism concerns having habitual levels of emotional volatility and anxiety versus emotional stability and calmness.” Someone with higher levels of neuroticism may tend to be more conservative with investing, save less, and have fewer liquid assets (such as cash). They can be more prone to experiencing financial stress because they are not always capable of planning for the future, choosing which financial products are best for them, and having trouble making ends meet. This type of person may have lower lifetime earnings and may need greater support in managing anxiety around investing and navigating market volatility. Conscientiousness Conscientiousness is a person’s preference for following the rules, hard work, careful planning and organization. Individuals with this trait focus on the diligent completion of tasks, avoiding the feeling of being disorganized, unstructured, and unreliable. This type of person works hard and has career success. He or she often has higher lifetime earnings and educational success and works hard to effectively manage their finances. High conscientiousness correlates to high net worth, as well as participation in retirement plans and saving. This person does not experience financial distress. Agreeableness Agreeableness is, “…the extent to which a person is warm, agreeable, cooperative, trusting, and motivated to help others and act in their interests,

versus cold, disagreeable, distrusting, aggressive, and disregarding of other’s interests,” according to Fenton-O’ Creevy and Furnham. Someone who is very agreeable may have lower wages, lower savings, and higher debt. This person may not have a high net worth or participate in retirement plans. It is possible that this type of person is so busy worrying about pleasing others that they don’t often take care of themselves. This type of person also may be more vulnerable to financial scams and predatory financial products. Extraversion According to Fenton-O’ Creevy and Furnham, “Extraversion concerns sociability and assertiveness versus social reservation and timidity) and is also associated with impulsiveness.” Someone high in extraversion often has career success, a modest relationship with income, and some impulsive habits. This person may have lower savings and higher debt. This type of person often has higher wealth accumulation but will regularly purchase overpriced assets. This person has a greater illusion of control than the other personalities and may have lower savings and investments but higher value of physical items because of impulsiveness and purchasing items. This type of person may need additional support to make regular savings. Openness “Openness concerns active imagination, preference for variety, intellectual curiosity, and willingness to challenge authority versus closed-mindedness, dogmatism, and conservative attitudes. It is the personality factor most strongly associated with intellect and intelligence,” write to Fenton-O’ Creevy and Furnham. Someone with high openness may take greater care in choosing financial products. This person may have less planning for the future

Call us at 515-226-9000 or visit fostergrp.com/IMS

and lower ability to make ends meet. This person has a lower correlation with retirement savings. Overall, conscientiousness is the strongest predictor of wealth, regarding property wealth, savings/investing, and physical items. Conscientiousness is more highly correlated with wealth than either gender or education. While we may think that conscientiousness is something we are simply born with or born without, we can increase our conscientiousness with behavioral changes. We can practice conscientious behaviors by organizing our homes and offices, starting assignments early, and scheduling out our day. Also, one of the reasons for hiring a Financial Advisor is that they can play this “conscientious” role in your life, particularly if it is not the personality type with which you are most aligned. Perhaps you are trying to reach a goal but don’t feel like you are accomplishing it the way you want, and you feel you are not conscientious enough. As you work with your financial advisor and are trying to achieve a goal, envision the desired future and the obstacles needed to overcome, to reach that desired future. Try imagining what it will feel like to have the goal completed. What will you be doing? Whom will you be with? Where will you be? How will you be feeling? Write out your goal. Having written savings goals can help you be more conscientious and able to follow-through. At Foster Group, we want to guide you as you work to achieve your goals. Fenton-O’Creevy, M., & Furnham, A. (2023). Personality and wealth. Financial Planning Review, 6(2), e1158. https:// doiorg/10.1002/cfp2.1158 Javaras, K., Williams, M., & Baskin-Sommers, A. (2017). Psychological Interventions Potentially Useful for Increasing Conscientiousness. American Psychological Association

Interested in more content on the latest current events? Check out our Financial Perspectives and sign up for our eNewsletter.

6601 Westown Parkway, Suite 100 | West Des Moines, Iowa | fostergrp.com/IMS PLEASE SEE IMPORTANT DISCLOSURE INFORMATION at https://www.fostergrp.com/disclosures. A copy of our written disclosure Brochure as set forth on Part 2A of Form ADV is available at www.fostergrp.com. ©2022 Foster Group, Inc. All Rights Reserved.

Iowa Medicine Q4 2023 |

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PRESID ENT ’ S CO LUMN

PAVE THE WAY

For Phenomenal International Physicians JESSICA ZUZGA-REED, DO IMS President

“

he key is not to prioritize what’s on your schedule, but to schedule your priorities.” These words of Stephen Covey hit very close to home for me as I imagine they do for many of you. My clinical practice has been shortstaffed on and off for the last three years relying heavily on locum/per diem help. Prioritizing aspects of my life including my family, personal time, and non-clinical roles such as IMS Presidential duties has proven to be incredibly challenging. Balancing all of these things with a short-staffed, in-house critical care schedule is a feat unto itself, but incredibly worthwhile and rewarding. There is much work to be done to improve healthcare. Prioritizing our goals as an organization attempting to lead these improvements is always a beneficial exercise. The new IMS Strategic Plan has placed the physician workforce shortage at the very top of our priority list. A study done by the Association of American Medical Colleges in 2022 projected the US will be short around 40,000 to 120,000 physicians by 2035. Most Iowa

physicians don’t need a study to demonstrate or quantify our workforce shortage. It is palpable in our everyday practices. However, these numbers speak volumes to our elected officials. Communities throughout our state are in need of physicians in all aspects of medicine— primary care to sub-specialties. One important

step to mitigate this problem is improving the pathway for our amazing international physician colleagues to join our workforce. Federal laws currently allow each state to provide 30 J-1 Visa waivers to international physicians annually. Many states do not utilize all of their allotted waiverswasting an untapped resource. Whereas other states, like Iowa, have a surplus of applications.

IMS has set a goal to increase the number of J-1 Visa Waivers allotted in Iowa by 2026. In November, I had the privilege of traveling to Washington DC along with our AMA Delegation. In addition to attending the AMA Interim Meeting, we met with our Iowa Congressional Members to discuss this workforce priority of improving care delivery to Iowans in all communities. Senators Ernst and Klobuchar (MN) have co-authored legislation titled the DOCTORS Act supporting re-allocation of unused J-1 waivers to states that need them. In our conversations we spoke about this being a “no brainer.” We couldn’t agree more! This legislation would be a great initial step in the right direction to achieve our goal— more physicians practicing in Iowa. I encourage all of you to learn more about this legislation and other aspects of immigration policies that may facilitate the phenomenal international physicians we’ve already trained to remain in our communities. ■

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Wherever healthcare happens, so can infections. Schedule a FREE ICAR on-site visit. Millions of people in the U.S. get healthcare-associated infections each year—including Iowans. But they don’t have to. With a FREE Infection Control Assessment and Response (ICAR) on-site visit, your hospital, clinic, long-term care or other healthcare facilities will get a fresh perspective on improving programs preventing infections. We offer the latest tools and training to turn ideas into action for better patient care and outcomes—at no charge to you. And with ongoing support after your visit, our experts will be available whenever you need them.

To schedule your free on-site visit, email us at hai-ar@idph.iowa.gov or visit HHS.Iowa.gov/HAI-Prevention for more information. Iowa Medicine Q4 2023 |

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MEMBERSHIP

2024 OFFERS EVEN MORE FROM IMS

appy New Year! As a valued member of IMS we want to express our gratitude for your ongoing support and engagement. Additionally, we want to thank all of you who have already renewed your membership for 2024! The past year has been filled with incredible events like Physician Day on the Hill (PDOTH), insightful discussions at our Crucial Conversations and other educational offerings, and meaningful connections made at student/ physician networking events. All of this and the passage of Tort Reform was made possible by members like you. Your commitment has played an important role in fostering a community that shares knowledge, experience, and a passion for healthcare in Iowa and the role IMS provides.

As we embark on a new year together, we are excited to announce a lineup of even more engaging events across the state, providing exclusive content (both digital and print) and continuing our Doc2Doc podcast with you, our physician members in mind. Your renewed

membership will not only grant you access to these exciting opportunities, but will advance your support for IMS’s advocacy efforts to continue to lead the charge at the state and federal level. If you haven’t yet, please consider renewing your membership today! With your IMS membership you can expect: • We will be the champion for and ensure the physician voice helps shape public policy in the healthcare arena • We are a trusted source for curated content and timely information critical to the practice of medicine • We will provide education, technical assistance, and resources to help our members continue to grow professionally • We ensure alignment throughout the house of medicine by providing management services and support for county and specialty societies • We offer member-exclusive benefits, such as discounted medical malpractice insurance when getting this insurance from COPIC

We provide a sense of community for physicians, residents, and medical students throughout Iowa by offering networking and leadership opportunities. Renewing your membership is quick and easy. Simply scan the QR code, log in, and hit the renew button. 100% Group Dues Discounts This program offers clinics, practices, and systems discounted membership when all their physicians are members. Group size starts at two physicians with commitments ranging from one to five - years, and discounts from 5% - 40%. Membership is billed annually and payable by check, credit card or ACH Transfer. Another advantage of this program is the opportunity to have certain non-physician leadership as non-dues contacts so they receive IMS communications, as well as the ability to give a staff member access to keep physician rosters updated. ■

Group Dues Membership Structure Practice/Group Size

Commitment and Discount 1 Year

3 Years

5 Years

2-9 Physicians

$489.00 each (5%)

$463.00 each (10%)

$437.00 each (15%)

10-19 Physicians

$463. 00 each (10%)

$437.00 each (15%)

$412.00 each (20%)

20-74 Physicians

$412.00 each (20%)

$386.00 each (25%)

$360.00 each (30%)

75 or more Physicians

$386.00 each (25%)

$360.00 each (30%)

$309.00 each (40%)

As a reminder, all eligible IMS members can receive a 10% premium discount on COPIC medical liability coverage. Contact your insurance broker or IMS for details. 6 | Iowa Medicine Q4 2023

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We’re shining brightly—now as

The story of Children’s Hospital & Medical Center has always been defined by light. Since 1948, we’ve stood as a glowing ray of hope for kids and families searching for a healthier tomorrow. And so, as a new day breaks, we continue to deliver exceptional care for every child—only now, under a different name. We are Children’s Nebraska. A new name with the same purpose: supporting the light within every child. Providing everything from routine checkups to lifesaving procedures. All while advancing the art and science of pediatric care. Today, tomorrow and far into the future. See the whole story at ChildrensNebraska.org/Shine Iowa Medicine Q4 2023 |

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ADVO C AC Y

ADVOCACY IN ACTION KADY REESE IMS Director of Policy and Government Relations

he mission of the Iowa Medical Society is “to advance the practice of medicine through advocacy, education, and engagement with physicians throughout Iowa to ensure the highest quality of care for the patients they serve.” While advocacy, education, and engagement may be recognized independently in our mission for the unique and vital contributions of each, true success recognizes that even one cannot be done successfully without the other. In putting our advocacy to action, we will educate – our patients, our peers, our policymakers – and we must be engaged – tuned in and responsive to calls to action - to ensure that healthcare-related decisions are being informed by healthcare experts. Whether at the capitol in DC or Des Moines, or in conversations at town halls and with local leaders, IMS and our members are the leading voice in medicine, working to make Iowa a premier destination for physicians to live, work, and serve their communities.

Advancing Federal Priorities The IMS advocacy team was in Washington, DC, November 14-15, taking advantage of time following the AMA Interim meeting to meet with the Iowa’s Congressional Delegation. During this time, IMS leaders were able to meet with all six of Iowa’s delegation:

• Senator Joni Ernst • Senator Chuck Grassley • Representative Ashley Hinson (IA-02) • Representative Randy Feenstra (IA-04) • Representative Mariannette Miller-Meeks (IA-01) • Representative Zach Nunn (IA-03) The focus of our discussions centered on our top two federal priorities: increasing Iowa’s access to J-1 Visa Waivers and increasing Medicare reimbursement rates. The timing of these conversations was pivotal as there is active legislation that has been introduced – by Senator Ernst and Representative Miller-Meeks – seeking amendments for both of these priorities. Conversations across the board were supportive, recognizing the pragmatic, commonsense approaches that will have significant positive impact on Iowa physicians and the patients they serve.

Increase J-1 Visa Waivers Directing Our Country’s Transfer of Residency Slots (DOCTORS) Act • Will enable reallocation of already authorized, unused waivers through the Conrad 30 program to states who have fully utilized their existing allocations. Healthcare Workforce Resilience Act • Will authorize the “recapture” of 40,000 unused employment visas and direct them to the critical shortage of physicians (15,000) and nurses (25,000).

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Strengthening Medicare for Patients and Providers Act • Would tie the Medicare physician fee schedule (PFS) to the Medicare Economic Index (MEI), ensuring physicians get automatic inflation updates the same as other provider groups. Medicare Payment Components within the latest Finance Committee bill* • Will enable short-term, immediate fixes to Medicare payment structures, including extending the GPCI 1.0 floor rate through December 2024; extension of Medicare Advanced Payment Model (APM) Payment Incentives; and increase in Support for Physicians and Other Professionals in Adjusting to Medicare Payment Changes (doubling the PFS statutory increase to 2.50% for 2024).

Preparing for the 2024 Iowa Legislative Session Monday, January 8 marks the first day of the 2024 legislative session. While this is the first official day of the session, the work to advance our

priorities begins well before - and continues after – the 100 scheduled days of active session. In preparation for the session, the IMS advocacy team has been hard at work meeting with healthcare partners and legislators, speaking about the key issues keeping physicians up at night – the workforce shortage – for both physicians and support staff; stagnant reimbursement rates and growing administrative burden – reform and modernize prior authorization; access to care – maternal health and mental health; and ensuring patients have physician-led care teams – the best practice for best care and better outcomes. As we prepare to mobilize the full weight of the physician voice during the upcoming legislative session, here are four ways you can engage and ensure your physician voice is heard: 1. Physician Day on the Hill: Register and attend Physician Day on the Hill (PDOTH) on Tuesday, February 6! This IMS organized event is a great opportunity to speak with your legislators and have IMS staff available to help with the conversations. Last year we had more than 100 physicians in white coats filling the Capitol rotunda!

2. The IMS Advocate: Sign up for our electronic newsletter distributed weekly while the legislature is in session. This resource contains week-by-week legislative and policy updates important to Iowa physicians. 3. IMS Advocacy Website: Check out the updated Advocacy web page. You’ll find information about IMS’ state and federal legislative priorities, issue toolkits and talking points, a Legislator Look-up, and links to the Iowa Medical Political Action Committee and Policy Forum.

ADVO C AC Y

Increase Medicare Reimbursement Rates

4. IMS Action Alerts: Sign up for IMS Action Alerts! An easy way to get of-the-moment updates on key legislative priorities with Call to Action alerts for specific legislation and readymade templates for reaching out to your legislators. ■

IMS Advocacy Team

Kady Reese Director of Policy and Government Relations

Ryan Roberts Policy Analyst and Grant Management Assistant

Kate Walton IMS Contract Lobbyist

Maddy Bradley IMS Contract Lobbyist

Matt Eide IMS Contract Lobbyist

*Since this issue went to print, the Preserving Seniors’ Access to Physicians Act, HR. 6683, was introduced, seeking to provide a complete elimination of the standing 3.37% Medicare cut for physicians. Iowa Medicine Q4 2023 |

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YE AR IN RE VIE W

2023 YEAR IN REVIEW The following timeline reflects the busy year we had on behalf of our members. With your involvement, we have a lot to be proud of in 2023. Here are the highlights: JANUARY

2023 IMPAC Donations

January 9

$38,525

First day of Iowa’s state legislative session FEBRUARY

2023 IMSF Donations (49 Donors) $7,653.61

February 7 Another great year for Physician Day on the Hill (PDOTH) attendance, (more than 100 people registered to attend) February 16 Tort Reform passed and signed into law!

APRIL

April 21 Jessica Zuzga-Reed, DO, became the 174th President of the Iowa Medical Society at the President’s Reception and Awards Ceremony

April 28 110th day of Iowa’s state legislative session MAY

Nearly 500 IMS members contributed to the annual member survey

JULY – AUGUST

IMS Board of Directors and staff participated in a retreat and completed a new strategic plan for 2024 – 2026 August 11 U.S. Senator Joni Ernst introduced the Directing Our Country’s Transfer of Residency Slots (DOCTORS) Act — that reallocates unused waiver slots through the existing Conrad 30 program to states that used all thirty waivers in the previous year to increase access to healthcare for rural Iowans.

OCTOBER

IMS realized a 21% increase in social media followers since June 2023 2024

IMS manages five specialty and county societies: (Iowa Chapter of the American Academy of Pediatricians, Iowa Neurological Association, Iowa Academy of Otolaryngology, Iowa Association of Pathologists, and the Scott County Medical Society)

77% increase

Quadrupled

The amount of money raised for IMPAC donations compared to last year

in event attendance over last year

22% growth in “IMS 100% Group Dues” member organizations from last year

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ARTIFICIAL INTELLIGENCE IN MEDICINE The use of artificial intelligence (AI) applications is the most important new information technology in decades that will change health care. This creates an ongoing necessity for health care systems to regularly assess the impact and risks of AI as its development and deployment is outpacing legal, medical, and business changes. The implications carry enormous benefits, risks, and unforeseen consequences. AI APPLICATIONS IN MEDICINE AI will be able to assist with just about every cognitive task a health care provider performs. The interactive dialog capabilities can be used for patient interactions such as prescription management, diagnosing conditions, performing risk assessments, and referrals. Some patients will be more comfortable interacting with AI than humans with respect to sensitive issues. Many are likely to have already interacted with a diagnostic AI tool online prior to seeing a health care professional. Providers might also use AI to help them in the informed consent process, adverse event reporting, summarizing records and incoming reports, and reviewing results. The following highlights four potential uses of AI, benefits and risks, and some strategies to address those risks.

VIRTUAL SCRIBING AND CLINICAL DOCUMENTATION The benefits of using a tool to quickly and accurately generate a record of clinical interactions are obvious. Patients will need to be aware of and consent to the use of the recording devices in place to generate the records. Providers will need to learn to “narrate their examinations” to populate the record. A policy to erase the work product of the recording at regular intervals, as well as open access to the final record generated from that work product will help allay patients’ fears about how their information was captured and what is going in their permanent medical record. The need to provide the processes required by the Cures Act will be even

more important. One can also predict that patients’ awareness of the record and their requests to edit, amend, or delete materials in it will increase and the provider or their staff will need to be cognizant of the necessary HIPAA processes and documentation. Finally, and most importantly, given how AI works and its inherent ability to produce fluent but possibly inaccurate, misleading, or even harmful output, the provider will absolutely need to read and verify the content of the notes generated by AI. The option of “dictated but not read,” in this case becomes “AI generated but not read” and this will not be an accepted practice.

OFFICE ADMINISTRATION TASKS Much of office administration will have AI tools adaptable to everyday practice in the near future. The need to accurately assign a visit, schedule its length, collect the necessary pre-visit information, obtain authorizations, etc. will be adopted quickly by short-staffed practices and systems. The interactions with third party payors are likely to be highly automated on their end, which will necessitate efficient and accurate automation on the provider side. Generating requests for authorization can be done effectively by AI as it becomes more adept at extracting from EHRs.

OFFICE TRIAGE AND AI TELEMEDICINE CLINICAL ASSESSMENT Phone triage and pre-visit clinical assessment have the ability to become very automated. This will be more sophisticated than the current algorithmically generated barrage of

questions and will be able to process open-ended speech and generate interactions that will look surprisingly human. Awareness that this is being done via AI will be necessary for the patient, and the option to reach a human should be made available. Plus, the documentation from that interaction will need to be audited to ensure that the system is performing as expected. Ultimately the machine-generated clinical assessment will be the work product of licensed providers, and the responsibility and liability will likely rest with them, however, issues of product liability will arise and create new concerns around responsibility for errors.

RISK STRATIFICATION AND PAYOR PREMIUM PRICING FOR PATIENTS, PROVIDERS, AND FACILITIES As payors increasingly adopt AI tools and access to the entire population’s data and outcomes becomes available and sortable (by patient, provider, facility, region, specialty, or any other meaningful criterion), there will be inevitable ranking and quality measures of providers and facilities. This will further drive the capture of clinical data by AI tools on the provider and facility side. There might be some increased efficiency in the capture of value-based purchasing and other quality measures, but that will likely be offset by the sheer increase in the numbers of such measures. “If you can measure it, you can adjust the payment for it” might be Edward Deming’s new adaptation of the measure and manage mantra.

COPIC is the preferred, endorsed medical professional liability insurance provider for IMS members. callcopic.com | 800.421.1834 Copyright 2023 COPIC Insurance Company. All rights reserved. Iowa Medicine Q4 2023 |

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D EEP D IVE TO PIC

IOWA NEEDS DOCTORS – THE PHYSICIAN SHORTAGE I

owa is facing a physician shortage like never before. With physicians at the epicenter of the problem, the ripple effect is apparent – a doctor shortage leads to staff shortages, creating challenges for patient care, stress, burnout, and the inability to provide quality healthcare services. The facts about the physician shortage paint a clear picture of today’s demanding environment. Iowa is at a pivotal point in its ability to attract and retain physicians of any stripe – whether they are generalists or specialists – and Iowa needs doctors. We asked several of our members to weigh in on the current situation in Iowa, and where we go from here to find solutions.

Consider this: • Iowa ranks 44th in the nation for healthcare provider-to-patient ratio (AAMC) • Rural communities, on average, have 20% fewer primary care providers than metro regions. (Journal of the American Medical Association (JAMA) • Iowa has 402 psychiatrists or one for every 7,961 people (Becker’s Behavioral Health, June 2023) • 34 of Iowa’s 118 community hospitals have closed their obstetric units since 2000. (Iowa Hospital Association) • There are fewer than 200 cardiologists in Iowa currently and the vast majority practice in urban areas. (Axios)

Is it a crisis or a shortage? William Yost, MD, Chief Academic Officer at Unity Point Health and Vice President of Medical Education and Research:

“No question we have a physician shortage in Iowa and occupy the bottom of physician/patient ratios in general, particularly in areas like emergency medicine, women’s health, primary care, and psychiatry among others. This creates problems with patients having access to providers. That leads patients to seek medical help from Illinois, Nebraska, or Mayo Clinic, or delay necessary care, and illustrates the fact that even when there is a specialist who can provide the necessary care, access is still limited. This is why we need to see more young people going into areas like pediatrics, internal medicine, and OB/Gyn, especially doing so in rural communities. Another problem is the maldistribution of physicians to the cities. It is unconscionable for women in rural Iowa to have to drive 80, 90, 100 miles to get the care they need. That same sentiment applies to neurology patients, where there are too few neurologists and the profession is struggling to get physicians to move into the community to practice, even to Des Moines. It’s situations like this that make the shortage a crisis.”

Feeding the pipeline is essential Joel Wells, DO, family physician at Wayne County Hospital and part-time faculty for Mercy One Family Medicine residency program:

“We have a maldistribution of doctors. We have passed the point of a healthy doctor/patient ratio. a very fragile medical system, where if someone moves on, or retires there is no one to replace them. Our system is such that we need all types of medically trained staff from doctors, to physician assistants, nurses, and others who all contribute and step in, but that physician leads the team and we need to constantly be filling that pipeline.” “The physician shortage that we have long feared – and warned was on the horizon — is here. It’s an urgent crisis, hitting every corner of this country.” – American Medical Association president Jesse Ehrenfeld, MD, October 2023

Paul Manternach, MD, Senior Vice President for Physician Integration/Chief Medical Officer, Mercy One – North Iowa:

“We have multiple needs in North Iowa and the physician shortage

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We have also leveraged our community partnerships with the Cerro Gordo Medical Alliance, Medical Society, and the Mason City Chamber of Commerce. They help with community tours, gift baskets, family events, and help create a direct mail video informational card that is specific to the community, hospital, and medical specialty being recruited. This sophisticated approach has yielded positive results for MercyOne North Iowa, with 18 MDs/DOs joining in 2023. We also have ten signed for next year and two commits for 2025. This full court press pays off, once we get them here and they see what we all have to offer, we have about a 60-70 percent acceptance rate. Despite all these great efforts, sadly we still have 31 openings across the entire North Iowa region which simply highlights the physician shortages and needs of rural Iowa.” Dr. Yost: “Three examples come to mind when we think about feeding the employment pipeline: 1. OB fellowships – this program is limited to a family med resident who is a fresh graduate, includes a one-year training period, and works with an obstetrician to

perform c-sections, deliveries, and teaches med students and residents. 2. UPH, Broadlawns, Mercy, and UIHC have started an expanded track to train child and adolescent psychiatrists. The impetus for this was, in part, due to the fact that when calling these providers, there was often a three-month wait. The expanded track is sponsored by the University of Iowa and is funded by the state – four fellows will get the opportunity to train and work in the community. 3. To attract neurologists, we started a fund through the UPH Foundation to provide housing and stipend to a neurology resident to come here for one to three months to see what it’s like to practice in the community.” Dr. Wells: “Essentially, the free market has failed the health care system – in this instance, people won’t go where the need is nor where the jobs are offered. People go to the good jobs in larger cities, with higher pay, less time on call, and lower stress. This isn’t just happening with new physicians looking for a job either - highly trained physicians experiencing severe stress from work are opting for less burdensome jobs, even if it means not getting to utilize all their education. This vast underutilization of skill is not good for patients or the system – it is a lot of time and money put into their training with no return on that investment. Not to mention the loss of a specialist.”

What are possible solutions?

D EEP D IVE TO PIC

has impacted us dramatically. We, therefore, have invested in an individual who is responsible for sourcing appropriate candidates for us. She does technology mining that allows us to have a focused message about openings in Mason City/ North Iowa. She works closely with our recruiter but truly focuses on finding us candidates.

The answer has many layers. For its part, IMS is leading a statewide effort over the next three years to make significant change. Our top priority for the next three years is to expand the physician workforce. To aid in the recruitment and retention of physicians, we will be/ are actively pursuing: • An increase of $1.5 million in full funding of the Rural Physician Loan Repayment Program • Policy efforts to implement the Iowa Rural Healthcare Workforce Strategic Action Plan • An increase in funding for additional positions within existing residency and fellowship programs • Opportunities for new residency and fellowship programs for Iowa’s most in-need specialties • Pursuit of tax credit incentives for preceptors and new physicians beginning their practice in Iowa Increasing J1-VISA waivers are another strategy to help mitigate the problem. IMS supports the DOCTORS Act, bipartisan legislation driven by U.S. Senator Joni Ernst, that allows states that have filled their residency waivers to tap into unused slots to meet demand so rural and underserved communities have access to a physician. IMS also supports the bipartisan Healthcare Workforce Resilience Act, also spearheaded by Senator Ernst. This act seeks to help end workforce shortages by allowing for the “recapture” of green cards Iowa Medicine Q4 2023 | 13

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D EEP D IVE TO PIC

that were authorized by Congress but unused in previous years, which includes 25,000 visas for nurses and 15,000 visas for physicians. Dr. Yost: “We need to recognize that people who are from a particular state and who are educated there are more likely to stay in that state. • 47.3% of Iowa’s physician workforce, actively practicing physicians, graduated from an ACGME-accredited program in the state. • Nearly (60%) of the individuals who completed residency training from 2013 through 2022 are

For more information on IMS state and federal legislative priorities, visit the Advocacy section of our website. To listen to U.S. Senator Joni Ernst and IMS board member, Dr. Peter Tonui discuss the physician shortage, download our Doc 2 Doc podcast available on the IMS website. Follow us on social media throughout the legislative session and look for the hashtag #iowaneedsdoctors as we track progress on this issue.

practicing in the state where they did their residency training (nationwide). Let’s also encourage more collaboration between communitybased educators and decentralize education – give students and residents an opportunity to go into smaller communities and work with surgeons and neurologists, as well as family physicians. If a resident could see what this specialty is really like, then they will often choose to join the specialty – practicing in one community or area isn’t always the same as another place.” Rebecca Lundquist, MD, Director of Broadlawns UnityPoint Psychiatry Residency Program:

“There are potential solutions to the psychiatrist shortage that don’t always involve adding psychiatrists all over the state. We need to use our psychiatrist workforce more effectively. We need legislators to be asking us:

• Why the PCP’s and OBs in their district don’t have access to same day consultations with a psychiatrist when they need it. • Why there isn’t access to appointments for patients in their district to be seen for consults either in the comfort of their home or in a telepsych station in their PCP’s office, why their constituents aren’t evaluated in a timely manner live or by tele when they present in a psychiatric crisis to their local ED or PCP office. • Why we don’t have a functioning state hospital system that allows for intermediate care (lengths of stay over six months) so that our acute care hospitals can manage more acute care length stays. Dr. Manternach: “I am extremely supportive of doing all we can to make our state a premier destination for highly trained physicians to live, work, and serve their communities.” ■

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IMS represents more than 6,000 physicians, residents, and students in over 85 counties across the state of Iowa. Our mission is: To advance the practice of medicine through advocacy, education, and engagement with physicians throughout Iowa to ensure the highest quality of care for the patients they serve. Member Benefits Include: Advocacy for you and the House of Medicine in Iowa Reliable, up-to-date healthcare news at your fingertips online and via email Conferences and educational trainings 10% discount for COPIC medical malpractice insurance. Leadership and personal growth opportunities Networking and personal development through virtual and in-person, peer-to-peer events IMS member Rob Lee, MD

JOIN OR RENEW TODAY: www.iowamedical.org For more information: email: hlee@iowamedical.org call or text: (515) 421-4776 15 | Iowa Medicine Q4 2023

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AMA INTERIM MEE TIN G

AMA 2023 INTERIM MEETING REPORT VICTORIA SHARP, MD, MBA Chair, Iowa Delegation, AMA HOD

he American Medical Association (AMA) House of Delegates (HOD) addressed several timely issues during its interim meeting at Gaylord National Resort and Convention Center, National Harbor, Maryland November 10-14. Nearly 700 physicians, residents, and medical students met to help fulfill the AMA’s core mission of promoting medicine and improving public health. This year’s theme was advocacy.

The Iowa delegation consisted of Rob Lee, MD, Doug Martin, MD, Doug Peters, MD, Victoria Sharp, MD, Brian Privett, MD, and our IMS staff, Steve Churchill, CEO, and Kady Reese, Director of Policy and Government Relations. IMS President Jessica Zuzga-Reed, DO, also joined our delegation as an alternate. Other Iowa Medical Society members and physician attendees, representing their specialty societies, included Past IMS President

Marygrace Elson, MD, Marta Van Beek, MD, Shane Hopkins, MD, Hillary Johnson-Jahangir, MD, Stephen Richards, DO, Erin Shriver, MD, and Megan Srinivas, MD. Medical students from the University of Iowa Carver College of Medicine- Colleen Bloesner, Sarah Costello, Abby Davison, Jeffrey Goddard, Daniel Moe, Sarvgna Raval, and Alix Sharp and Des Moines University- Mallory Britz, Kaitlyn Hanson, Jubilee Hou, Adrienne Nguyen, Jill Patel and Jordan Samuel were also involved in meeting activities. There were preliminary meetings with both our Iowa delegation and the North Central Medical Conference (Iowa, Minnesota, Nebraska, North and South Dakota) to review over 150 reports and resolutions for consideration. Resolutions and testimony are based on expertise, best evidence in medical and health policy literature, and state medical associations and national medical specialty societies perceptions and priorities. Our delegation participated in six reference committees: Amendments to Constitution and Bylaws, Legislative Advocacy, Advocacy on Medical Education, AMA Governance and

Finance, Advocacy on Medical Service, Medical Practice and Insurance and Advocacy in Science and Public Health. Detailed reference committee testimony, thoughtful HOD debate and votes led to new and updated AMA policies and direction for the AMA Board of Directors and staff. A few of these are highlighted below and additional details can be found on the AMA HOD’s interim meeting website. • Fix Medicare physician pay — this is a top priority. Through various actions at the Interim Meeting, it was made unmistakably clear that the unsustainable Medicare payment system poses a dire threat to patients’ access to high-quality physician care across the nation. In addition to this year’s 2% cut in Medicare physician pay, doctors face a further 3.37% cut set to take effect this month. After adjusting for inflation, physician pay fell by 26% since 2001. • Medical Boards must have oversight of all health professions, including nonphysicians. • Only allow properly trained and licensed physicians be involved in determining medical necessity on prior authorizations. • Require health insurers to collect patient cost-sharing (i.e., co-pays) and pay physicians their full allowable amount for the healthcare services provided, unless physicians opt-out.

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AMA INTERIM MEE TIN G

• Hold health plans accountable for physician network inadequacies. • Allow Medicare Advantage patients out-of-network referrals for consultation for enrollment in clinical trials. In addition to the actions taken at the interim meeting, members of our delegation and CCOM fourth year medical student Alix Sharp were able to meet with all of Iowa’s federal legislators to advocate for their help fixing Medicare physician pay and to help with increasing the physician workforce by reallocating J-1 Visas to allow more IMG physicians who complete their residency training in Iowa to stay and practice in Iowa. The next AMA HOD Annual meeting will be in Chicago June 8-12, 2024, and the next Interim AMA HOD meeting will be held in Orlando, FL November 9-12, 2024. ■

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I AM AN IMS MEMBER

LISA MUNCY-PIETRZAK , MD Dr. Muncy-Pietrzak is an internal medicine specialist with the VA Health Care System in Iowa City. Background grew up in eastern Kentucky playing basketball, cheerleading, and traveling at every opportunity. Though I knew I wanted to pursue a medical career, after a year of college, I detoured to serve in the United States Air Force and then the Air National Guard. I was a medical service specialist and my assignments included being stationed (that is, working) at Andrews Air Force Base outside of Washington DC, and during Desert Storm, being deployed to an aeromedical staging facility in England.

I attended the University of Kentucky and earned a Bachelor of Health Sciences degree in Health Administration and received the University’s Hamburg Award for Interdisciplinary Excellence. I received my medical degree from the University of Louisville School of Medicine. After completing the Georgetown University Residency Program in

Internal Medicine at Washington Hospital Center, I moved to Colorado and opened a practice that eventually evolved to apply a functional medicine approach to illness and to integrate complementary therapies with allopathic medicine. I practiced medicine in the Vail Valley for a number of years and was the Physician in Residence to the New York Philharmonic and the Philadelphia Orchestra during Bravo! Vail Valley Music Festival during that time. I moved from Vail for family reasons, and in 2020, a few months after the start of COVID, and 10 days after the derecho, I moved to Cedar Rapids to start a career with the Veterans Administration. I am now the Medical Director for Integrative and Whole Health for the Iowa City VA. What sparked your interest in medicine or decision to become a physician? At the age of seven, I had the strong sense of just knowing that I wanted to be a physician when I saw a church bulletin picture of a missionary doctor with a young boy who had injured his arm. Hobbies I enjoy traveling and experiencing other cultures. When I’m not traveling, I can be found in local farmers markets or antique shops. I also enjoy reading, tennis, paper crafting and making gifts for friends and family. Why are you a member of IMS? Connection to others with similar interests and goals

is key to building a strong community. I’m grateful to be a member of IMS and to have opportunities to collaborate with other physicians on medical, leadership, and policy issues. Who is someone you admire and why? Or who is the unsung hero in your life? Throughout her life, my mother has been my rock and support. After my father died, my mother encouraged and supported me through college and medical school. Many of my peers continue to live in our hometown and weren’t encouraged to attend college. Best advice for new physicians? Remember that our bodies require certain nutrients, movement, and stress management to function normally, and that disease is not always due to a lack of a prescription medicine. What changes in medicine are you excited about? Or what future developments will make a positive change in the field of medicine? I’m excited and a bit apprehensive about the impact that AI will make on medicine. If we use it strategically, our ability to diagnose and treat illness will be profoundly enhanced. The challenge we’ll face is loss of autonomy and positions to disciplines with less training and expertise. As we move forward, it will be important to focus on the therapeutic relationship that connects physicians and patients. ■

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PHYSICIAN ED ITORIAL

THE IOWA PHYSICIAN SHORTAGE

from a Psychiatry Perspective REBECCA LUNDQUIST, MD

Director of Broadlawns UnityPoint Psychiatry Residency Program

he psychiatry shortage is a nationwide shortage that has been worsening for decades and is expected to worsen until 20251, when we are projected to (finally) start graduating more psychiatrists than retire, though some experts believe the shortage will last much longer than this. Psychiatry had huge challenges in attracting medical students to choose the specialty that was dire in the 90s and 00s that was related to stigma, reimbursement and an identity crisis as the profession changed to be more medical and yet not quite medical enough. Prior to the 1990s, psychiatrists made their livings either in private practice, often psychotherapy based or working in state hospitals, private psychiatric hospitals or community mental health centers. The transition to a specialty that has become more like other medical specialties, with hospital employed physicians who were generating revenue through insurance payments was rough.

In Iowa, we have had severe psychiatrist shortages in all counties other than Johnson county for much longer, and it is likely that most areas of Iowa have never had adequate psychiatrist availability. In 20172, Iowa was 47th in per capita psychiatrists with significant maldistribution to Johnson (and to a lesser extent Polk) county making the situation in most of the state likely even worse than it appeared. In most areas of the state where

there are a lack of psychiatrists, there is a definite crisis. It is estimated that nearly 1,000 psychiatrists are needed in Iowa to be out of a shortage by the SAMHSA definition – in 2017 we had 225 total psychiatrists in Iowa. In 2019, there were only 54 child psychiatrists in Iowa3. Lack of access to child and adolescent psychiatrists is in some ways an even larger crisis for Iowa than the lack of generalist psychiatrists. So where do we go from here? We need psychiatry to be integrated into primary and obstetrical care across the state. • We need to encourage the large hospital systems to reach their satellites across the state with tele-psychiatry models including integrated care/collaborative care. Large systems are more likely to be able to hire psychiatrists to work in the more populated areas of the state than rural areas and these models allow psychiatrists to extend their reach.

phase for these models, educating physicians and staff, would help immensely. • Primary care physicians and obstetricians tell us that their reimbursement models often don’t allow them to take the time to screen and consult psychiatry, even when consultation is available. I have been told by obstetricians that this is a major barrier for them in identifying patients who need psychiatric and addictions care. Encourage employers to allow psychiatrists to be paid to truly supervise ARNPs and PAs working in psychiatry. • Psychiatrists are already spending too much time re-doing assessments and treatment plans that are done by people without the right training in caring for patients that are way too complex, so the system is paying already in the time sink for psychiatrists caused by this. Tele-psychiatry should be reimbursed equivalent to face-to-face visits.

• Insurance companies need to be mandated to pay for collaborative care if they can’t agree to do it on their own. Some, but not all payers in the state have already agreed.

• This is critical in severe shortage areas, and planning to take care of the mental health needs of the population of Iowa is challenging when we aren’t sure if this is going to happen.

• State funding that could be used to aid in the implementation

I get asked by legislators when they will have a psychiatrist in their district, and I get it, wanting that is

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• Why the PCPs and OBs in their district don’t have access to same day telephone consultation with a psychiatrist when they need it. • Why there isn’t access to appointments for patients in their district to be seen for consults either in the comfort of their home or in a telepsych station in their PCP’s office and why their constituents aren’t evaluated in a timely manner live or by tele when they present in a psychiatric crisis to their local ED or PCP office.

I want the big hospital systems and the other major potential employers to hear what is needed to retain and attract psychiatrists to the state. Larger than average salaries and loan repayment programs aren’t enough and won’t be enough. We have a lot of work to do. By bringing our minds together, pooling resources where we can, and driving change through our advocacy efforts at IMS during the upcoming session, I am confident we can make progress. ■

Footnotes: 1. Projected Workforce of Psychiatrists in the United States: A Population Analysis | Psychiatric Services (psychiatryonline.org) 2. University of Iowa Department of Psychiatry Rural Track Residency Training Program – 2017 3. Iowa Public Radio – 2019 (based on University of Iowa Department of Psychiatry Rural Track Residency Training Program)

PHYSICIAN ED ITORIAL

totally understandable. Instead, I would want them to consider:

• Why we don’t have a functioning state hospital system that allows for intermediate care (lengths of stay over six months) so that our acute care hospitals can manage more acute care patient stays and relieve congestion in our emergency departments. • Reforming Iowa’s commitment laws so that psychiatrists are able to have more say in who does and who does not need care on a locked psychiatric unit. We are wasting bed space on patients who clearly don’t need that level of care, and wasting psychiatrist time when we have patients we believe need this level of care because the paperwork burden is high (as well as time spent waiting to testify in court). • Inviting IMS members into middle and high schools across the state to get kids excited about primary care and psychiatry as a career, especially in the many underserved areas of our state.

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U OF I D E AN

MISSION-DRIVEN TO SERVE IOWA DENISE JAMIESON, MD, MPH University of Iowa Vice President for Medical Affairs and the Tyrone D. Artz Dean of the UI Carver College of Medicine

ince joining University of Iowa Health Care in August, I’ve had the opportunity to meet with and talk to a lot of Iowans—faculty, staff, and students throughout our academic medical center; colleagues across the university; Iowa legislators and other state leaders; and physicians and other health professionals serving communities around the state. I also had the pleasure of meeting Iowans at the state fair this past summer. This fall, I attended my first Iowa football game and felt the emotion sparked by the Hawkeye Wave, the Kinnick Stadium tradition where fans, players, and coaches show support for pediatric patients watching from the top level of UI Stead Family Children’s Hospital. It was a moving experience and just one example of what I see every day: Iowa is a special place. My first few months have been a great learning experience. I enjoy talking to people, hearing their stories, and finding out what’s important to them. What I’ve learned is that Iowans value their health

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care, whether it’s from us or other hospitals and health systems. Their trust is real, and it reinforces what drew me to UI Health Care: a clear mission to provide care for patients from across the entire state; deliver outstanding medical education and training; and lead research programs that inform and advance care here in Iowa and beyond. My Story I came to Iowa from Atlanta, where since 2019 I’d served as chair of the Department of Gynecology and Obstetrics at the Emory School of Medicine and chief of gynecology and obstetrics at Emory Healthcare. Before that, I spent 20 years at the Centers for Disease Control and Prevention in a variety of leadership roles, including serving as incident manager during CDC’s Zika emergency response. This honed my leadership skills in terms of building teams, making decisions, and moving forward. At Emory, I was able to

apply that experience to academic medicine. The principles of leadership are often the same; it’s specifics of an organizational culture that differ. For me, it’s important to foster a culture that’s collaborative, forward-looking, and positive. Maintaining excellence in research, education As an academic medical center and a state institution, our mission is broad, which means balancing opportunities and resources. Our research teams do a great job competing for and securing external funding, and we’ll continue to look for ways to provide faculty with the time and support needed to pursue basic science research and clinical studies. Our Carver College of Medicine curricula and programs are highly regarded, and we have great residency and fellowship programs across our specialties. One goal is to develop strategies and incentives for graduating students to train in Iowa; another is to encourage trainees to remain in Iowa to

Photo by UI Office of Strategic Communications, Photographer Justin Torner

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Increasing access to meet patient care needs Providing high-quality care for all Iowans is key to who we are. Demand for our services keeps growing; not surprisingly, we’re regularly near capacity. Therefore, we must find ways to increase access to services—particularly for patients in rural areas of the state and communities farther away from our main campus. We have major capital projects in the planning or construction stages that will transform how and where we provide care, conduct research, and deliver education and training in the coming years. Our medical campus

in North Liberty, scheduled for completion in 2025, will add more inpatient beds, operating rooms, and an emergency department, and it will be the main location for orthopedics and sports medicine services. Construction on a new inpatient tower on our main hospital campus, supported with a $70 million donation from the Richard O. Jacobson Foundation, is slated to begin in 2025. This new tower, along with renovation and expansion projects already underway or in planning stages—in emergency medicine, maternal health, burn treatment, and neurology, to give just a few examples—will go a long way in helping meet Iowans’ health care needs. UI Health Care and Mercy Iowa City: serving together And of course, the affiliation of Mercy Iowa City to become part of UI Health Care is an important opportunity for us to continue to

SAVE THE DATE:

improve access to care. For 150 years, the university and Mercy Iowa City have served the health care needs of patients in Iowa City and the region. Our selection by Mercy Iowa City was approved in bankruptcy court in early November, and we have begun the planning process for our two organizations to officially become one in early 2024. Mercy Iowa City patients are encouraged to schedule appointments as usual. Community providers not employed by UI Health Care are welcome to continue to practice at Mercy Iowa City, as it will remain an open medical staff model.

U OF I D E AN

practice. The real-world experiences that our learners get at hospitals and health organizations around the state that collaborate with us—our Des Moines area medical education consortium is a good example— offers students and trainees a tangible way to see themselves in Iowa for the long term.

We believe in continuing to enable Iowans to care for each other. Together, UI Health Care and Mercy Iowa City will preserve jobs, create new opportunities, and enhance access to high-quality care. It will position us to better serve the state. It’s what Iowans expect from us, and I’m proud and excited to be able to help fulfill our commitment. ■

IOWA MEDICAL SOCIETY’S

PHYSICIAN DAY ON THE HILL Tuesday, February 6, 2024

State Historical Building & Capitol Rotunda Wear your white coat, meet with legislators, and be the leading voice in medicine.

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PRESIDENT’S RECEPTION & AWARDS CEREMONY April 19, 2024

2024 NOMINATIONS NOW OPEN Each year the Iowa Medical Society recognizes physicians, laypersons, and organizations who have provided outstanding contributions to IMS, the profession of medicine, or public health by presenting the below awards. Award nominations are now open! Have a friend or colleague worthy of special recognition? Nominate them today via the IMS website! (see QR code below)

IMS/COPIC Physician Humanitarian Award

Presented each year to a physician in Iowa for volunteer medical services and contributions to their community through principles focused on human dignity, social justice, and compassion. This award specifically looks to recognize those individuals who unassumingly volunteer outside of the spectrum of their day to day lives. The recipient of the award designates a $10,000 donation from IMS/COPIC to be provided to a healthcare related 501(c)(3) organization within Iowa. Merit Award

Given to an IMS member physician who has served the IMS and the medical profession with distinction. John F. Sanford Award

Honors a layperson for contributions to public health or the field of healthcare. This award is named after the “founding father” of IMS, Dr. John F. Sanford, from Keokuk. Washington Freeman Peck Award

Given to a lay organization to honor their contributions to public health. This award is named after Dr. Washington Freeman Peck, the principal agent behind the establishment of the State University of Iowa Medical Department in Iowa City, the institutional forebear of the University of Iowa Carver College of Medicine.

To learn more and submit nominations, use this QR code: Please submit nominations by January 28, 2024 24 | Iowa Medicine Q4 2023

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THE TREATMENTS OF TOMORROW ARE HERE IN IOWA TODAY. I’m here for one purpose and that’s to give my patients the best medicine has to offer.” Our teams are made of experts with different backgrounds, specialties, and passions, because we know more collaboration leads to more options. Combined with the abilities that come with academic medicine, we don’t just deliver the latest life-saving treatments, we discover them. All so we can change medicine and lives right here in Iowa. Learn more at UIHC.org

Nandakumar Narayanan, MD, PhD N E U R O LO GY

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P E A C E

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COPIC is proud to be the endorsed carrier of the Iowa Medical Society. IMS members may be eligible for a 10% premium discount. CALLCOPIC.COM | 800.421.1834

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