THE EXCHANGE

On a surprisingly lovely March evening, before heading to The Fulton, my husband and I stopped at The Exchange for drinks and dinner. The experience started with a trip up the exclusive-feeling elevator from the King Street entrance. The location is perfect for a short walk from multiple parking garages downtown. They offer an indoor/outdoor seating arrangement. The host assured us that it was a delightful evening to sit on the patio with the table fire pit and heaters surrounding us to keep away the chill. Despite being just above the bustling city, it was generally very quiet and, as promised, a warm and inviting atmosphere.

Our server quickly greeted us with a friendly smile and the menus. Unfortunately, we did strike out early with our first three beverage requests not being available. The server was able to offer comparable alternatives. We ordered a few shareable platters: the Iceberg Wedge Salad, Korean Fried Cauliflower and Crispy Pork Bao Buns. The wedge salad was small for two of us to share, but the dressing was very good. The pork bao buns were tasty, and the bun was light and fluffy. The cauliflower was not over battered and had a nice zing. The food was served hot, and the timing was excellent. We indulged in dessert, for the sake of Lancaster Physician readers. A cappuccino and the Japanese Cloud Cake rounded out our meal. The sauce on the cake had just the right amount of sweetness, but the cake itself was denser than I expected.

As we sat on the patio, overlooking the buildings of Lancaster and enjoying the sunset and our meal, we were pleased that we chose The Exchange for weekday date night. The server was friendly and attentive without being intrusive. Admittedly, we were disappointed by the missing drink-menu items and the food was good but not out of this world. However, the view and atmosphere are unmatched in Lancaster.

We are likely to return for a drink and appetizer just to again experience the al fresco dining.

For the start of the 2023-24 legislative session, we saw a new addition of 49 newly elected “freshman” legislators, not to mention a change in leadership in the State House as democrats take control of the chamber for the first time in just over a decade. PAMED’s legislative team is already at work getting to know members of this freshman class while continuing to work with incumbent lawmakers to reintroduce key pieces of legislation that died at the end of last year.

With the start of a new legislative cycle, the Board of Trustees considered the results of a survey conducted throughout January that asked members to rank potential PAMED legislative priorities.

Some of the issues PAMED will tackle include:

Scope of practice – PAMED continues to oppose efforts by non-physician providers to expand their scope of practice while treating them with the proper respect due their training. We continue to work to keep team-based health care delivery physician-led.

Noncompete clauses/restrictive covenants – PAMED supports reasonable limitations on restrictive covenants in physician contracts to ensure patients have access to a physician of their choice. However, PAMED also recognizes that the use of non-compete agreements by independent practices are critical to their long-term viability.

Reproductive rights – PAMED supports shared decision-making between a physician and their patients concerning reproductive health matters, including abortion. PAMED opposes legislative measures that expose physicians to criminal or civil liability for sound reproductive health-related medical decisions, or that expose patients to criminal or civil liability for receiving medical care or a change in pregnancy status.

Telemedicine – Telemedicine reform would include mandated coverage, payment parity, and a requirement that the physicians providing care to a patient residing in the Commonwealth be licensed to practice medicine in Pennsylvania.

Mental health services access – PAMED supports increased access and funding for mental health services for all Pennsylvania patients.

PBM accountability – Pharmacy benefit managers or PBMs (corporate intermediaries that manage the prescription drug formularies for public and private health insurers) determine which medicines will be covered by health insurance plans and how much patients will pay for their prescription drugs. The marketplace often pays more than necessary because of the control PBMs have. PAMED will advocate for transparent competition among PBMs and address the ways PBMs profit at the expense of patients, employee health plans, and taxpayers.

This is not to say that other issues will not get addressed by our government relations team as they arise.

Several legislative bills that PAMED is keeping its eye on include:

Senate Bill 25, Legislation on Independent Practice

Legislation that would enable the independent practice of certified registered nurse practitioners (CRNP) was introduced as

Senate Bill 25. It would remove the collaborative agreement currently required to practice independently from physicians.

PAMED opposes this legislation and supports the need for physician oversight of all non-physician practitioners, including, but not limited to, CRNPs, CRNAs, nurse midwives, and physician assistants.

Senate Bill 521, Legislative Introduced on Noncompete Agreements

Senate Bill 521 was introduced, acknowledging the impact that noncompete clauses, or restrictive covenants, have on patient care. PAMED is reviewing this memo and will have more information in the future.

PAMED is also supporting a co-sponsorship memo from Senate Ryan Aument on legislation that will help expedite the health insurance credentialing process. PAMED expects the proposal to be introduced as a bill in the near future. The current proposal will lead to improved continuity in the credentialing process and provide predictability to medial practices trying to meet patient demand for care. PAMED will keep you informed when official action is taken.

For more information about any of the items mentioned above, please visit the Advocacy Section of PAMED’s web site at www.pamedsoc.org/advocacy