Thursday, July 31, 2014

San Francisco Medical Society Blog


Providing news to the San Francisco Medical Community.

Article References for July/August 2014 San Francisco Medicine

References cited in Physicians Making Change: Challenging Lethal but Legal Corporate Practices by Nicholas Freudenberg, DrPH

  1. Freudenberg N. Lethal but Legal Corporations, Consumption and Protecting g Public Health. New York: Oxford University Press, 2014.
  2. World Health Organization. Global status report on noncommunicable diseases, 2010. Description of the global burden of NCDs, their risk factors and determinants. Geneva, Switzerland: WHO, 2011.
  3. Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P et al. and Lancet NCD Action Group; NCD Alliance. Priority actions for the noncommunicable disease crisis. Lancet. 2011; 377(9775):1438–1447.
  4. Stuckler D, McKee M, Ebrahim S, Basu S. Manufacturing epidemics: The role of global producers in increased consumption of unhealthy commodities including processed foods, alcohol, and tobacco. PLoS Med. 2012; 9(6):e1001235.
  5. Kessler D. The End of Overeating: Taking Control of the Insatiable American Appetite. New York: Rodale, 2009.
  6. Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med. 2007; 356:2457–2471.
  7. Bradsher K. High and Mighty SUVs: The World’s Most Dangerous Vehicles and How They Got That Way. New York: Public Affairs; 2002.
  8. Schwartz MB, Vartanian LR, Wharton CM, Brownell KD. Examining the nutritional quality of breakfast cereals marketed to children. J Am Diet Assoc. 2008; 108(4):702-5.
  9. Rising J, Alexander L. Marketing of menthol cigarettes and consumer perceptions. Tob Induc Dis. 2011; 9 Suppl 1:S2.
  10. Mosher JF. Joe Camel in a bottle: Diageo, the Smirnoff brand, and the transformation of the youth alcohol market. Am J Public Health. 2012 Jan; 102(1):56-63.
  11. Freedman A. Fire power: Behind the cheap guns flooding the U.S. cities is a California family. Wall Street Journal. March 9, 1992:1.
  12. DiSantis KI, Grier SA, Odoms-Young A, Baskin ML, Carter-Edwards L, Young DR, Lassiter V, Kumanyika SK. What "price" means when buying food: Insights from a multisite qualitative study with Black Americans. Am J Public Health. 2013; 103 (3):516-22.
  13. Cohen J. AIDS drugs. Brazil, Thailand override big pharma patents. Science. 2007; 316 (5826):816.
  14. Powell LM, Han E, Chaloupka FJ. Economic contextual factors, food consumption, and obesity among U.S. adolescents. J Nutr. 2010; 140 (6):1175-80.
  15. Grier SA, Kumanyika S. Targeted marketing and public health. Annu Rev Public Health. 2010; 31: 349-69.
  16. Doyle J. Taken for a Ride: Detroit’s Big Three and the Politics of Pollution. New York: Four Walls Eight Windows, 2000.
  17. Hemenway D. Private Guns, Public Health. Ann Arbor, MI: University of Michigan Press; 2004.
  18. Bock C, Diehl K, Schneider S, Diehm C, Litaker D. Behavioral counseling for cardiovascular disease prevention in primary care settings: A systematic review of practice and associated factors. Med Care Res Rev. 2012; 69 (5):495-518.
  19. The Prescription Project. Persuading the Prescribers: Pharmaceutical Industry Marketing and Its Influence on Physicians and Patients. Pew Charitable Trusts, 2013.
  20. The Prescription Project. Conflicts-of-Interest Policies for Academic Medical Centers: Recommendations for Best Practices. Pew Charitable Trust. 2013.
  21. Susman J. Do things really go better with Coke?J Fam Pract. 2009; 58:630
  22. Simon M. And Now a Word From Our Sponsors: Are America’s Nutrition Professionals in the Pocket of Big Food? American Academy of Nutrition and Dietetics. Oakland, CA: EatDrinkPolitics, 2013.
  23. Bernstein S. Academic and Market Research on Divestment. Pension Consulting Alliance, 2014.
  24. Wines M. Stanford to Purge $18 Billion Endowment of Coal Stock. New York Times, May 6, 2014, p. A15.

References cited in Disarming Nuclear Weapons by Robert Gould, MD

  1. AMA Policy 520.999
  2. AMA Policy 520.997
  3. CMA Resolution 118-97 "Abolition of Weapons of Mass Destruction."
  4. American Public Health Association. The role of public health practitioners, academics and advocates in relation to armed conflict and war. 2009. Available at Accessed July 2, 2014.
  5. Wittner L. Does war have a future? IPPNW Peace and Health Blog. June 3, 2014. Available at Accessed July 2, 2014.
  6. Available at Accessed July 2, 2014.
  7. Wolfstahl J. Even nuclear planners can’t have it all. Commentary. CQ Roll Call Opinion, May 29, 2013. Available at Accessed July 2, 2014.
  8. Hartung WD and Anderson C. Bombs versus budgets. Inside the nuclear weapons lobby. International Policy Report. June 2012. Available at Accessed July 2, 2014.
  9. Perlo-Freeman S and Solmirano C. Trends in world military expenditure, 2013.  Stockholm International Peace Research Institute. April 2014. Available at Accessed July 2, 2014.\
  10. Grimmett RS and Kerr RK. Conventional arms transfers to developing nations, 2004-2011. Congressional Research Service. August 24, 2012. Available at Accessed July 2, 2014.
  11. West courts india in hopes of arms deals. New York Times. June 30, 2014. Available at Accessed July 2, 2014.
  12. Wiist WH, et al. The role of public health in the prevention of war. Rationale and competencies. American Journal of Public Health. Vol. 105, No. 6. June 2014. Available at Accessed July 2, 2014.
  13. Rotarian Action Group for Peace. Peace education – nuclear weapons. Available at Accessed July 2, 2014.
  14. Physicians for Social Responsibility. Available at Accessed July 2, 2014.
  15. Council of Delegates of the International Red Cross and Red Crescent Movements. Working towards the elimination of nuclear weapons. Resolution adopted November 26, 2011. Available at Accessed July 2, 2014.

Physician Payments Sunshine Act: Key Steps Physicians Need to Take

The Physician Payments Sunshine Act (Sunshine Act) requires manufacturers of drugs, medical devices and biologicals that participate in U.S. federal health care programs to report certain payments and items of value given to physicians and teaching hospitals. The Centers for Medicare & Medicaid Services (CMS) has been charged with implementing the Sunshine Act and has called it the Open Payments Program.

As part of this program, manufacturers are now required to submit reports on payment, transfer and ownership information. Physicians have the right to review their reports and challenge reports that are false, inaccurate or misleading. However, the time frame for initiating disputes and having data corrected or publicly marked as disputed is extremely limited. Key steps and dates are below.

Step 1: Complete CMS e-verification process today
CMS requires a two-phase registration process. In phase 1, which is now open, physicians complete CMS' e-verification process via the CMS Enterprise Portal (EIDM). Click here to access step-by-step instructions

Step 2: Register with CMS' Open Payments system
Once physicians have completed Step 1 and gained access to EIDM, physicians can move onto phase two and register in CMS' Open Payments System. Click here to access
key information from CMS

Step 3: Review and dispute data within 45 days
Physicians can request their individual report, review it and flag disputes after completing Step 2. CMS has indicated that it will not resolve disputes, but errors can be reported to manufacturers through the Open Payments System or directly through Open Payments contacts listed on most manufacturer websites. Physicians must initiate disputes by mid-August to have potentially erroneous data flagged in the initial public release.

Questions? E-mail CMS’ Open Payments Help Desk at or call (855) 326-8366

Other important dates:

9/30: Data released publicly
CMS publishes majority of data including physician-specific information

12/31: Last day to file dispute for 2013 report data
This is the deadline for initiating a dispute of incorrect data reported for transfers made and ownerships held in 2013. If a physician waits until after data has been made public to initiate a dispute, the data will not be marked as disputed in the public database until the agency updates the information, which could be six months to a year later.

SFMS Summer Physician Networking Social a Success

Residents, fellows, and physicians participated in SFMS Physician Networking Mixer at Ironside last week. Attendees took advantage of the opportunity to meet SFMS leaders and connect with colleagues from various specialties and practice settings.

SFMS President-Elect Roger Eng, MD welcomed member physicians and provided a brief update on the issues SFMS is championing on behalf of our members, including the No On 46/MICRA campaign as well as SFMS' endorsement of the San Francisco soda tax initiative. 

With great attendance and positive feedback from all, SFMS plans to organize similar social networking events in the coming months. Participants are also encouraged to attend the SFMS General Meeting on September 8 for another networking opportunity. Additional information can be found on the SFMS website or follow SFMS on Twitter (@SFMedSociety).

Click here to view the event photos.

SFMS would like to thank Cooperative of American Physicians (CAP) for their support of our summer Networking Mixer. CAP is a physician-owned medical professional liability insurance company established in 1975 to manage the escalating cost of medical professional liability coverage. From its medical malpractice coverage and access to supplemental lines of business owners’ coverage to its expert medical liability management services and products, CAP offers health care professionals the tools to reduce their liability risks, improve patient safety and satisfaction, and minimize operational costs.

San Francisco Medical Society Hails Landmark Soda Tax Legislation to Fund Physician Education, Health, and Nutrition Programs

Legislation to create a tax of two cents per ounce on the distribution of soda and other sugar-sweetened beverages in San Francisco was officially placed on the November 4, 2014 ballot at today’s regular Board of Supervisors meeting.

The legislation has been endorsed by the San Francisco Medical Society and the California Medical Association to reduce the incidence of diabetes, obesity and tooth decay.

Dr. Lawrence Cheung, President of the San Francisco Medical Society stated, “As a forward thinking city, San Francisco is once again leading the nation in progressive public health policies. We will be the first major city in the country to actively decrease the consumption of sugar sweetened beverages as a way to combat our society's high rates of diabetes, obesity and heart disease. Revenue generated from this tax will go directly to programs that will improve our city's health and to those neighborhoods that need it most.

Dr. Shannon Udovic-Constant, a pediatrician who authored the pioneering California Medical Association resolution regarding sugar sweetened beverages stated, “Our members have been actively involved in the effort to put a soda tax on the ballot here in San Francisco and in helping to build a grassroots army of dedicated volunteers to help take this critical public health message to all San Franciscans. We are excited that the Board of Supervisors has taken this final step to place the soda tax on the November ballot.“

SFMS Executive Director Mary Lou Licwinko stated, “We are delighted with the actions of the Board of Supervisors to put this important issue before San Francisco voters. SFMS has long championed a soda tax and, once again, San Francisco is leading the country on an important public health issue.

The tax on the distribution of soda and other sugar-sweetened beverages in San Francisco is estimated to generate up to $54 million annually, which will be legally dedicated to fund active recreation and nutrition programs in schools, parks, and recreation centers; food access initiatives, drinking fountain and water bottle filling stations; and dental health services. Disadvantaged/low-income communities, including those most impacted by the diabetes and obesity epidemics, will be prioritized in funding decisions.

For more information, or for media inquiry, please contact Steve Heilig at (415) 561-0850 x270 or

8 Things You Should Know About the 2015 Medicare Physician Fee Schedule Proposed Rule

If the policies set forth in the 2015 Medicare Physician Fee Schedule proposed rule take effect, physicians will be in for a lot of changes—many of them unfavorable—next year. Here are the top eight things that you should know:

  1. A 21% payment cut is scheduled for April 1. CMS observed in a fact sheet that current payment rates will apply through March as a result of a temporary payment patch enacted earlier this year and projected that payment rates will be cut by 20.9% April 1 unless Congress intervenes. The agency stated its support for repeal of the flawed sustainable growth rate formula that has triggered such large cuts.
  2. Global surgical packages will be eliminated. The rule proposes to discontinue all 10-day global surgical packages by 2017 and 90-day packages the following year. Packages instead would include only preoperative care and care given the day of surgery.
  3. Payments will be adjusted by the Value-Based Payment Modifier beginning next year. Despite continued AMA opposition, CMS plans to levy steeper payment adjustments and to continue basing the adjustments on costs and quality data two years before the adjustment is applied.
  4. Physicians in groups of 100 or more will see payment penalties or bonuses next year, determined by their group’s cost and quality performance in 2013. Bonuses and penalties based on 2014 performance will be applied to groups of 25-100 starting in 2016.

    All physicians will be subject to the modifier beginning in 2017, at which point the potential penalty will double to 4 percent. The pool of money available for bonuses depends on how much is collected in penalties so potential bonuses are not yet known.

  5. Quality reporting requirements will be increased in the face of penalties. CMS has reiterated a 2% payment penalty for physicians who don’t meet the 2015 Physician Quality Reporting System (PQRS) requirements and is proposing additional requirements physicians will need to fulfill.At the same time, the agency is proposing to cut the period physicians have to request an informal review of a PQRS penalty from 90 days to just 30 days.
  6. PQRS data will be publicly reported. The rule proposes making all 2015 measure data from group practices available in 2016. The agency also is hoping it will be able to publish later that year individual measures for all physicians on Physician Compare, a website plagued by accuracy and usability problems since it launched in 2010.
  7. Chronic care management services will be covered. Beginning next year, Medicare will pay $43.67 per patient per month for chronic care management provided by a physician’s office and $32.58 for care provided by a facility. Such services involve non-face-to-face care coordination for patients with multiple serious chronic conditions that are expected to last at least 12 months or until death.

  8. More telehealth services will be covered beginning in 2016. The proposed changes include greater access for patients in rural locations by expanding the number of rural sites.

  9. A new timeline for changing physician codes and service values would take effect in 2016. This revised timeline will mean physicians can submit recommendations no later than Jan. 15 for the following year.
  10. Source: AMA Wire, July 18, 2014 

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