Membership Matters

CMA sponsored bill would reduce administrative burdens in Physician Practices

The California Medical Association (CMA) is sponsoring a legislative effort to reduce administrative burdens in physician practices, so physicians can spend less time on paperwork and billing and more time dedicated to patient care.

Senate Bill (SB) 250 introduced by Senator Richard Pan, M.D., will reduce administrative burdens by reforming prior authorization and billing processes. As it stands, health plans already collect all the data needed to streamline the prior authorization process in their current utilization review system. The bill would relieve physicians from repetitively submitting prior authorizations for a set period of time, with a review at the end of that period to determine if that physician may continue to be exempt from prior authorization requirements. The bill would also streamline the billing process for physicians in hospital settings by requiring payors to collect enrollee costsharing amounts directly (including deductibles) – based on the agreements they make with their enrollees – freeing physicians from having to act as collectors, and, instead, allowing them to provide quality, coordinated care to their patients. Physiciansarespendingincreasingquantitiesoftimefiling paperwork,fightingwithhealthplansandinputtingredundant information into their electronic health records (EHR) instead of spending time with their patients. These administrative burdens cost time, money and other resources that could be better spent coordinating care for patients with chronic and/ or complex conditions or seeing more patients.

In a 2019 physician survey, the American Medical Association (AMA) found that, on average, providers complete 32 prior authorizations per week; taking nearly 2 working days out of the week to complete. Burdensome prior authorization processes also contribute to more adverse events, especially because they can result in treatment delays. In a follow-up AMA physician survey, 91 percent of physicians said that prior authorizations interfere with continuity of care for patients and have a negative impact on clinical outcomes.

The COVID-19 pandemic will have a lasting impact on the health of our communities. SB 250 will help to ensure that patients receivethecaretheyneedinatimelyandefficientmanner.

SFMMS Joins Day of Action Against Gun Violence

Physicians across the Bay Area participated on Saturday in a day of action against gun violence.

SFMMS leaders marched with hundreds of others across the Golden Gate Bridge in an event organized by Moms Demand Action. Meanwhile, an SFMMS-sponsored gun buyback program in Marin County attracted a surprisingly high number of participants who turnedintheirfirearmstobedestroyed.

SFMMS President, Dr. Michael Schrader, and SFMMS Immediate Past-President, Dr. Monique Schaulis, are quoted in the Chronicle's coverage.

CMA calls for immediate action to address epidemic of gun violence

Over the past month, a series of tragic and senseless mass shootings have, once again, ripped communities and families apart, destroyed and ended lives far too soon, and further exposed the epidemic of gun violence that grips our nation.

The latest attack hit very close to home, when a man opened fireinamedicalofficebuildingonthecampusofSaintFrancis Hospital in Tulsa, Okla., killing four people—including two physicians—and injuring several others before taking his own life.

“The physicians of California stand in solidarity with our health care colleagues in Oklahoma and send not just our deepest condolences, but our outrage that such senseless acts of violence continue to plague our nation,” said California Medical Association (CMA) President Robert E. Wailes, M.D. "As healers, physicians are often on the front lines of gun violence, but the latest shooting in Oklahoma targeted physicians in a space that should be devoted to peace and healing. This cannot stand. CMA calls for reform to end this terrible epidemic of gun violence.”

The Tulsa hospital shooting comes just eight days after 19 school children and two teachers were slaughtered in Uvalde, Texas, and two weeks after a white supremacist attack in a Buffalo, New York, supermarket killed 10 people and an attack at a church in California where one of our own—John Cheng, M.D.—took heroic measures to stop another act of senseless gun violence, and in the process gave his life to save others.

“We cannot become numb to the nearly daily reports of gun violence and mass shootings. We cannot sit idly by and do nothing whilemorethan45,000Americansdieeachyearbygunfire,”said Dr. Wailes. “This is a uniquely American public health crisis. We must come together with a united front and call for meaningful action to save lives.” Since1975,moreAmericanshavediedfromfirearmsthanin all the wars in U.S. history going back to the American Revolution. Gun violence is a public health crisis, and as with other public health areas, evidence-based interventions are needed for reducing deaths and injuries.

CMA has long-standing policy recommendations for reducing firearm-relatedtrauma,injuryanddeath.CMAstronglysupports H.R. 7910, the “Protecting Our Kids Act,” an omnibus package ofeightbillsfocusedonpreventingfirearmviolence.Withgun violence soaring, it is imperative for Congress to act now.

“CMA declared gun violence a public health crisis in 2016 and physicians will continue to demand action to end this senseless epidemic of indiscriminate violence, whether in our schools, our health facilities or our streets,” said Dr. Wailes.

What You Can Do

As physicians, our mission is to heal and to maintain health. Physicians are in a unique position to assess risk, provide education and change behaviors related to firearm violence. In 2017, the CMA Firearm Violence Prevention Technical Advisory Committee, composed of physician experts, performed a comprehensive review and analysis of CMA policy, epidemiological dataandcurrentscientificresearchanddeveloped a CMA position statement on the prevention of firearmviolence. “Physicianshavearesponsibilityastrustedpublichealthfigurestorespondtothe harmsassociatedwithfirearmviolence,bothasindividualcliniciansandascommunity advocates,” says Dr. Wailes. “I ask my fellow physicians to make a commitment to ask yourpatientsaboutfirearmswhenappropriateandfollowthroughwithsupportand resources to keep them safe. We can make a difference, one patient at a time.”

In 2019, California Assembly Bill 521 authorized three years of funding for the California Firearm Violence Research Center at UC Davis. Building on the prior work of the UC Davis What You Can Do Initiative, the BulletPoints Project gives clinicians the knowledgeandtoolstheyneedtoreducetheriskoffirearminjuryanddeathintheir patients.

Visit BulletPointsProject.org for more information on what you can do, as physicians, to help stop gun violence.

San Rafael’s outdoor smoking rules applauded

As the former chief of general surgery at MarinHealth Medical Center and past president of the San Francisco Marin Medical Society, I would like to thank the San Rafael City Council for banning smoking in open spaces and adopting new rules for smoking outside multifamily housing complexes (“San Rafael bans smoking year-round in open space,” May 4). Cigarettesmokingisoneoftheleadingcausesofwildland,homeandworkplacefires. Ithascausedapproximately30%ofallfire-relateddeathsinAmerica.SanRafael’saction will also reduce exposure to secondhand smoke. It moves our state one step closer to achievingtheCaliforniaTobaccoEndgameCenterforOrganizingandEngagement’sgoal of eliminating tobacco-related health disparities by 2035.

— Dr. John Maa, San Francisco

SFMMS President Michael Schrader, M.D. Speaks Out to Defend Abortion Rights

San Francisco City Attorney David Chiu joins the Bar Association of San Francisco, representatives of major law firms,andhealthcareprovidersatapressconferenceto announce the formation of new coalition to provide legal services to those who will be impacted when the U.S. Supreme Court strikes down Roe v. Wade.

SFMMS Addiction Medicine Conference Recording Available

The Annual SFMMS/David E Smith MD addiction conference featured well-received presentations on timely and tough topics, and is now available via the SFMMS website: https://www.sfmms.org/news-events/events.

Editor Gordon L. Fung, MD, PhD, FACC, FACP Managing Editor Steve Heilig, MPH Production Maureen Erwin

SFMMS OFFICERS

President Michael C. Schrader, MD, PhD, FACP President-elect Heyman Oo, MD, MPH Secretary Jason Nau, MD Treasurer Dennis Song, MD Immediate Past President

Monique Schaulis, MD, MPH

SFMMS STAFF

Executive Director

Conrad Amenta Associate Executive Director, Public Health and Education

Steve Heilig, MPH Director of Operations and Governance

Ian Knox Director of Engagement

Molly Baldridge, MPH Staff Associate

Ashley Coskey

2022 SFMMS BOARD OF DIRECTORS

Edward Alfrey, MD Melinda Aquino, MD Ayanna Bennett, MD Julie Bokser, MD Kristina Casadei, MD Anne Cummings, MD Manal Elkarra, MD Mihal Emberton, MD Beth Griffiths, MD Robert A. Harvey, MD Harrison Hines, MD Ian McLachlan, MD Jason R. Nau, MD Heyman Oo, MD Sarita Satpathy, MD Monique Schaulis, MD Michael C. Schrader, MD Yalda Shahram, MD Neeru Singh, MD Dennis Song, MD Kristen Swann, MD Kenneth Tai, MD Melanie Thompson, DO Matthew D. Willis, MD, MPH Joseph W. Woo, MD Andrea Yeung, MD