Letter from MDAdvantage Chairman and CEO Patricia A. Costante

Welcome to the winter issue of MDAdvisor. In this issue, we bring you a variety of articles on topics relevant to our healthcare community, ranging from employment law requirements to health equity to medical aid in dying legislation. We are particularly proud to introduce New Jersey’s latest Health Commissioner, Judith M. Persichilli, RN, BSN, MA. Commissioner Persichilli was a great resource to us as a member of our Editorial Board, and her extensive background as a nurse and hospital executive, along with her exceptional leadership skills, will no doubt serve the citizens of New Jersey well. Commissioner Persichilli is also an alumni of the EJI Excellence in Medicine Awards, having been honored in 2011 as an Outstanding Healthcare Executive. I am also excited to present to you this year’s EJI Excellence in Medicine Award honorees and scholarship recipients, as highlighted beginning on page 6. Being able to recognize the progress that has been made in healthcare since the awards were first bestowed in 1939 is an honor and a privilege, and my hope is that by highlighting these advances, we will be able to inspire the healthcare providers and leaders of tomorrow. This is our 10th year providing scholarships to medical and healthcare students, and we have expanded the scholarship program again to include two pharmaceutical students, allowing us to fund nine scholarships totaling $120,000. For more information on how to support the scholarship program and participate in this year’s event, visit EJIawards.org.

Sincerely,

Chairman & CEO MDAdvantage Insurance Company

The Editorial Board would like to acknowledge the following individuals who served as peer reviewers of manuscripts submitted to MDAdvisor in the past year, as well as those reviewers who prefer to remain anonymous. Our reviewers are an important part of the selection process and provide our authors with valuable insights. We gratefully acknowledge their comments and contributions.

Hon. Paul W. Armstrong, JSC (Ret.) John Bertagnolli, Jr., DO Margaret Chipowsky, Esq. Scott Dailey David Gallinson, DO Deborah A. Goss, MD Paul J. Hirsch, MD Sara Leonard, MD Alan J. Lippman, MD Elizabeth F. Lorell, Esq. Mark P. Merlini, Jr., Esq. Sandra Moss, MD, MA Donald L. Pendley, MA, CAE, CFRE, APR Dona Schneider, PhD, MPH

For information about volunteering to review content for MDAdvisor in your area of expertise, contact us at Editor@MDAdvisorNJ.com.

Material published in MDAdvisor represents only the opinions of the authors and does not reflect those of the editors, MDAdvantage Holdings, Inc., MDAdvantage Insurance Company and any affiliated companies (all as “MDAdvantage ® ”), their directors, officers or employees or the institutions with which the author is affiliated. Furthermore, no express or implied warranty or any representation of suitability of this published material is made by the editors, MDAdvantage ® , their directors, officers or employees or institutions affiliated with the authors.

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Letters to the editor are subject to editing and abridgment.

MDAdvisor (ISSN: 1947-3613 (print); ISSN: 1937-0660 (online)) is published by MDAdvantage Insurance Company. Printed in the USA. Subscription price: $48 per year; $14 single copy. Copyright © 2020 by MDAdvantage ® . Postmaster: Send address changes to MDAdvantage, 100 Franklin Corner Road, Lawrenceville, NJ 08648-2104.

The Majority of U.S. Medical Students are Women Women comprise the majority (50.9%) of enrolled U.S. medical students for the first time, according to 2019 data released by the Association of American Medical Colleges. This progress builds on the milestone reached in 2017 when, for the first time, women comprised the majority of first-year medical students. The 2019 data also show that the nation’s medical schools continue to make modest gains in attracting and enrolling more racially and ethnically diverse classes, although these groups remain underrepresented in the overall physician workforce.

U.S. Life Expectancy Declines for 3rd Consecutive Year Death rates from suicide, drug overdose, liver disease and dozens of other causes have been rising over the past decade for young and middle-aged adults, driving down overall life expectancy in the United States for three consecutive years, according to a recent study published in the Journal of the American Medical Association that looked at the past six decades of mortality data (Woolf & Schoomaker, 322(20):1996- 2016). Despite spending more on healthcare than any other country, the U.S. has seen increasing mortality and falling life expectancy for people ages 25 to 64. The broad trend detailed in this

study cuts across gender, racial and ethnic lines. About one-third of the estimated 33,000 excess deaths that the study said occurred since 2010 were in just four states: Ohio, Pennsylvania, Kentucky and Indiana. New Hampshire had the largest percentage rise in death rates among working-age people in this decade. The opioid epidemic is a major driver, but far from the sole cause.

U.S. Cancer Death Rate Drops by Largest Amount on Record The cancer death rate in the U.S. dropped 2.2% from 2016 to 2017, the largest single-year drop ever recorded, according to the latest report from the American Cancer Society. The drop is largely driven by progress against lung cancer, although the most rapid declines noted in the report occurred in melanoma. Falling smoking rates have played a big role in the decline in lung cancer deaths, as well as improvements in detection and treatment. For melanoma, the emergence of new drugs that enlist a patient’s own immune system in the cancer fight have made a difference. Despite the progress, cancer remains the second leading cause of death in the U.S. after heart disease, and declines in colorectal, breast and prostate cancer deaths have slowed. The report, published in CA: A Cancer Journal for Clinicians (January 8, 2020), projects 1.8 million new cancer cases and 600,000 cancer deaths in the U.S. in 2020.

Publisher Patricia A. Costante, FACHE Chairman & CEO MDAdvantage Insurance Company

Publishing & Business Staff Catherine E. Williams Senior Vice President MDAdvantage Insurance Company Janet S. Puro Vice President MDAdvantage Insurance Company Theresa Foy DiGeronimo Copy Editor Second Melody Design and Layout

Contributing Editors Steve Adubato, PhD

Editorial Board Paul J. Hirsch, MD, Editor-in-Chief Hon. Paul W. Armstrong, J.S.C. (Ret.) Jon R. Bombardieri Jeremy S. Hirsch, MPAP William G. Hyncik, ATC John Zen Jackson, Esq. Alan J. Lippman, MD

Emerging Medical Leaders Advisory Committee Fernando Arias, MD Nicole Caltabiano, DO Jodie Kunkel, PA-C A. Michael Luciani, MD Christina McArdle, DMD Morit Segui, MD

Published by MDAdvantage Insurance Company 100 Franklin Corner Road Lawrenceville, NJ 08648-2104 www.MDAdvantageonline.com Phone: 888-355-5551 Editor@MDAdvisorNJ.com

Indexed in the National Library of Medicine’s Medline ® database.

| By Janet S. Puro, MPH, MBA

| By Michael A. Pattanite, Jr., Esq., and Patrick F. Carrigg, Esq.

| By Jon Bombardieri

| By Steve Adubato, PhD

| Interviewed by Catherine E. Williams and Janet S. Puro, MPH, MBA

| By Hon. Paul W. Armstrong, J.S.C. (Ret.) and Janet S. Puro, MPH, MBA 36 Mentoring the Evolution of a Physician

| By Nancy Kehoe, RSCJ, PhD

| By John Zen Jackson, Esq.

| By Michael Caçoilo, MD