Primed and AAFP accreditation

Can you send me any more information that prompted the PriMed issue? I have written them numerous times and asked why they do not list AAFP accreditation, and they assure me they will have it when we attend. That never happens. The argument that drug companies sponsor it and it is biased has been around for years even at our national meetings. Only if we let them be biased should it be a problem. The speakers that I have heard do emphasize the products they are sponsored by, but what makes the meetings credible are the questions fielded from the audience.

Some very good teachers of family medicine give many of the lectures, and they are supplementing their income by doing so. What should happen is that we should push for all Primed speakers be Family Medicine or Internal Medicine, primary care teaching, physicians.

May I suggest that the RIAFP work on getting a grant to support development of our own programs throughout the year, with the use of our members as speakers, including practicing MDs without bias. In other words, start a Primary Care Speakers Bureau, with financial help initially from a grant, and I am sure Brown University and lits faculty would help.

Our own meetings should be one day, probably Saturdays, and at key, easily reached locations. When the pharmaceutical companies see what we are doing, then they will want to be a part by exhibiting and contributing "no strings" money only. RI Primary Care CME Cooperative would be a good name.

Finally, not one of the Primed online free CME programs give us AAFP Credit!! I have written them many times and now given up.

Let me know when the next important RIAFP meeting is scheduled. I am starting 3 days a week in January, and maybe can contribute some time, if needed.

I am furious about what Primed is doing in RI. I will be contacting national today to see if there is anything they can do to intervene.
Margaret Sun

I do not like the idea of a Friday only mtg

I do not like the idea of a Friday only mtg. because many RIAFP members are able to attend Sat. only. Also, I've enjoyed the Fri. and Sat. evening dinners. I think at this point we should keep the original dates as you have mentioned you are going to do. I also am in favor of direct communication with PriMed to hear there version/timeline of how things developed. You probably have already done this, but I would see if AAFP has heard of other examples of this around the country. You might also research what AAP and ACP have experienced since I would think they would be also targets of PriMed if, indeed, this was a purposeful attempt to draw RIAFP members away from their annual event.

RIAFP and Primed

_

Sorry to be a lawyer about this, but is there decent evidence of their intention both here and in other locations? Is this something you’d consider suing them over, either for an injunction on their co-scheduling the conference or for damages?
__________________________________

Would suggest a single day on June 6th or to to go June 6th to Lunch on June 7th
___________________________

We need to defend our meeting and our Academy!!! Let's keep our dates, build the best meeting in history, broaded our audience, and beat them at their own game.

The RIH/Miriam Department of Family and Community medicine will be there in force.

______________________________

Probably by bringing in the other primary care specialties and having something of a policy focus, with big political names. There will be an election in November, and candidates will be looking for places to speak...

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All docs need to know, if they don’t already, that PriMed is all “lectures” sponsored by the pharmaceutical industries to sell their drug! Without dissemination of this information and a boycott by ALL physicians and other health care providers, PriMed will continue to succeed.

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I think to be effective in attracting folks away from Primed we'd have to change the meeting date by about a month or more. I visited the web site. They are offering only 8.75 CME and will have "case-based" CME but have not yet declared what the cases will about. We may have a chance to blitz our members to get them to come. I don't know.....

May I suggest that we all get some input from some trusted colleagues to see what they think and then meet January 2.

_____________________

Kim

I think Don raised an interesting question. I e-mailed him to ask if we would need proof of intent to have a lawyer send a "cease and desist" type of letter. I would think the legal standard for damages or an injunction would be much higher.

I would vote for either keeping the meeting in June as we planned and really pushing the membership to support our chapter or moving to early April if the hotel has availability. I guess some of my choice would depend on what feedback you get.

_________________________________________

I agree with Dr Fine,

Let’s keep the same program and fight..
we will be there.
_____________________________--

Dear Kim,

Perhaps I am naïve. But what does Pri-Med have to gain by competing with the RIAFP? I do not think the drug companies (who seem to be the $ behind pri-med) are that stupid.

I think the idea of a one day meeting--perhaps at the Warwick Crowne plaza would attract the docs from the city and "us country folks in South County".

A few years back there used to be a couple of single day meetings in different seasons. I found these easier to attend. They were also less costly-- or seemed that way because the cost was spread out.

Thanks for all you do.

____________________________

How can we complain directly to PriMed?

Have they been addressed re this?

_______________________________

Hi,
Thanks for the info about PriMed.
I will make every attempt to attend this year's RIAFP conference,
however you decide to hold it.
I hope the national AAFP can be of some assistance in at least
publicizing this trend if not objecting to it more formally.
I have attended a couple of PriMed events and find them biased. The
information you are sharing today seals my decision to boycott them
altogether from now on, and I would urge the RIAFP to suggest that all
its members do the same.
Thanks again for the info, and Happy New Year!

Doctor of Nursing Practice? Anyone have thoughts?

I only made 164K

sarah said...

I think you'd be hard pressed to find a family doc making that kind of money in Rhode Island. The data are obviously flawed. In fact keep your eyes open for a follow up article in the Projo this Sunday July 1. They have promised us a comment and correction, and maybe this could lead to another article about what is wrong with primary care in RI.

June 27, 2007 7:58 PM

A.J. said...

Okay, I confess. I didn't make 170K. I only made 164K. But hey, I'm only 4 years out of residency after all. Keep in mind, I work an honest 45hours a week, I take call 2 or 3 times a month, and I make weekend rounds once a month. All my patients are insured, most are quite appreciative of my care, and a typical day has me seeing on average about a dozen patients. What's my secret?
I'm a prison doctor.
And you know what else?
I love it!
Primary care (of adult men, albeit) at its best!
Oh, and you may be wondering why am I so open about my salary? Well, as a state employee, I had the honor of finding my salary posted on the internet last week, compliments of the Boston Herald. Hey, I've got nothing to hide. Maybe this will help us recruit more docs into Correctional Health!
A.J. Rubineau, MD MPH
Associate Program Medical Director
U Mass Correctional Health

June 29, 2007 1:09 AM

my salary

I was appalled by the article in ProJo. What is wrong with the Dept of Labor? Where did they get the information? I don't know anyone in RI who makes that much as a family doctor. Do you think it was a rumor started by someone trying to impress a date? Thanks to Al Puerini and others who let Mr. Smith know the reality of practicing primary care in RI. Look for the corrected information this weekend.
Margaret A. Sun, MD
President

170K?

I make less than I made 10 years ago! With static reimbursement and rising costs I have no idea how these figures can be accurate. The sad thing is that the disproportionate increase in med school tuition makes primary care out of reach for many graduates. The other sad thing is that to generate these kinds of numbers it seems a provider would need to emphasize quantity over quality. Using salary.com for Providence, Hartford, CT and Worcester MA gives $160, $175 and $166K. Still much higher than I would have thought, but without an advantage over adjacent states. Please tell me what I'm doing wrong!!!!
Betsy Farnum

PROJO Article: The following is from an email exchange I thought would be valuable to this conversation.
Kim


Mr. Smith:

I do not know where you got your data from. I am an internist and work like a dog and don't even come close to the claimed salary that you report. How did you get your data? And did you confirm that data? I ask that you do further research and write a more responsible article using confirmed data. This is article will only fuel the exodus of more doctors out of the State of RI. The insurers will eat us alive with this unconfirmed data and proceed to cut our pay; and then we will leave the state even more. Do you have a primary care doctor? If you don't go try to find one that is taking new patients!

My income over the last 5 years has declined each year. My 1040 income last year is about 45K less than the average that you report in your article, and I have one of the busiest practices in a 20+ internal medicine group. There is a disconnect between what the table states and reality.

Please respond promptly.

Warren Licht, MD


Dear Dr. Licht:

The data in the story comes from the Rhode Island Department of Labor and Training, specifically their Labor Market Information Unit, which compiles salary information for all occupations in the state. According to a spokesman for the DLT, they survey about 2,000 Rhode Island employers every year on salary figures. For physicians, that would include places such as Rhode Island Hospital. We were reporting the figures they released to the public. If you have questions about the methodology, I’d suggest you contact them directly. I deal with Laura Hart, 462-8090.

Andy Smith.


Mr. Smith:

I spoke with Laura Hart today and she is going to research the data and see what it all means. She agreed that perhaps there may be clumping of data and that it may not fairly represent RI doctors' situation. Personally I think that your article did more than report data; you had many commentaries that used the data and made inferences that frankly are not true. I think that as a journalist you should have done a better job in confiming your sources of this data before publishing such an article. I am very disappointed.

I told Ms. Hart to not only contact myself with her research of the data but to contact you and the RIMS. I hope that you are able to take that follow-up from her and re-write another follow-up piece that rectifies any misrepresentation of the data. Even with that follow-up piece, I am afraid your article is too damning for us as a specialty (Primary Care) to reverse public impression.

Sincerely,
Dr. Licht


From Al Puerini, MD:

I think the PCLC should act on this. If we were making the money they stated in the article, we wouldn't need a PCLC!!!
The article was truly outrageous and Warren's comments are right on!

Al

Albert J. Puerini, Jr., M.D.

Did anyone see the ProJo article on what Rhode Island Family Physicians make in Rhode Island. WHERE DO THEY GET THESE NUMBERS???

No one I know makes that much. AND, How do we make more than the Drs. In MASS or CONN. We must be seeing a lot more patients if this is correct.

Maybe the Rhode Island Medical Society needs to reply to this article.

John Bossian

The Graham Center has completed an economic impact analysis of what family physicians contribute to the state economy. This allowed us to craft an issue brief on the "Economic Impact of Family Physicians in Rhode Island."

The issue brief provides an overview of family medicine, the economic benefits, and a map - generated from Health Landscape - showing the distribution of family physicians in your state along with county HPSA designations all in a 2-page document. There is an additional piece which explains the methodology used in arriving at the figures.

To view this information please visit http://www.riafp.org it is posted on the homepage.

Thanks,
Kim

Another Blue Cross Trick

Right now I’m really upset so please bear with me if I ramble. Here is the issue you must watch out for. Apparently Blue Cross has decided it was paying us wrong when it came to it as a secondary.
Here is an example: You bill the primary $100, the primary adjusts the charges and has a allowable of $50. It pays you $40 and passes the co-payment to the patient of $10. Your biller sends the $10 to the secondary (Blue Cross) who states is allowable is $45 therefore they only pay the difference, What the primary paid minus their allowable--$5. They say in some cases you must collect the remainder from the patient, in some cases, you can’t.
In the above case, if the secondary was $20 or $30 above the primary , you would only get the $10.

If this is not bad enough, I had a patient today who was on a generic medication, his cost was $7 which was paid for by his secondary, He just found out that his secondary, (Blue Cross) would only pay up to it’s allowable and the patient now has to pay the rest.

What is going here???? Have others noted this trend??? When did this new policy start?? (the rep at Blue Cross could not tell me.
This may sound like a small issue but a promise to us and a promise from the secondary’s to pick up the co-pays or the drugs is a promise.
Give me your ideas or thoughts. Kim, if you like, post this on the Blogg. I don’t know how many people have signed up yet.

John Bossian

Reminders

Hello guys,

I think it will take a few reminders, but probably after a few months it will catch on. Once people realize it is easy and sort of fun, that might do it!

Kim

Hope

I hope more people use this
John

Members

I want to welcome all of you to the RIAFP blog (I can't believe I just typed that word). Hopefully, this will be a place for sharing ideas about life and medicine and healthcare in RI. I look forward to your thoughts.