Thursday, October 2, 2014

San Francisco Medical Society Blog

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Providing news to the San Francisco Medical Community.


PQRS GPRO Registration Deadline Extended

CMS has extended the registration deadline for the Physician Quality Reporting System (PQRS) Group Practice Reporting Option (GPRO) due to a glitch in the system. Physicians have until October 3, 2014 11:59 PM EDT to complete registration, and the American Medical Association is working on CMS to extend the deadline further.

The Physician Value-Physician Quality Reporting System (PV-PQRS) registration system can be accessed at https://portal.cms.gov. The PV-PQRS registration system allows group practices to register to participate in the PQRS Group Practice Reporting Option (GPRO) in 2014 via Qualified PQRS Registry, EHR, or Web Interface (for groups with 25 or more eligible professionals (EPs) only). In order to register, groups must have an approved IACS account and indicate and select their reporting method for the 12-month period. The 2014 PQRS data submission window will be in the first quarter of 2015.  If you have questions about how to register or set up an IACS account please contact the QualityNet Help Desk at (866) 288-8912 or via email at Qnetsupport@hcqis.org from 7AM- 7 PM CST. 

Please note: It is very important that practices do not wait until Friday to register for IACS accounts – they need to register now, as the turn-around time for approval is 24 hours.


CDC and Texas Health Department Confirm First Ebola Case Diagnosed in the U.S.

Press release from the CDC, issued on September 30, 2014

The Centers for Disease Control and Prevention (CDC) confirmed today, through laboratory tests, the first case of Ebola to be diagnosed in the United States in a person who had traveled to Dallas, Texas from Liberia. The patient did not have symptoms when leaving West Africa, but developed symptoms approximately four days after arriving in the U.S. on September 20.

The person fell ill on September 24 and sought medical care at Texas Health Presbyterian Hospital of Dallas on September 26. After developing symptoms consistent with Ebola, he was admitted to hospital on Sept. 28. Based on the person’s travel history and symptoms, CDC recommended testing for Ebola. The medical facility isolated the patient and sent specimens for testing at CDC and at a Texas lab participating in the CDC’s Laboratory Response Network. CDC and the Texas Health Department reported the laboratory test results to the medical center to inform the patient. Local public health officials have begun identifying close contacts of the person for further daily monitoring for 21 days after exposure. A CDC team was dispatched to Dallas on September 30.

“Ebola can be scary. But there’s all the difference in the world between the U.S. and parts of Africa where Ebola is spreading. The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities,” said CDC Director, Dr. Tom Frieden. “While it is not impossible that there could be additional cases associated with this patient in the coming weeks, I have no doubt that we will contain this.”

The ill person did not exhibit symptoms of Ebola during the flights from West Africa and CDC does not recommend that people on the same commercial airline flights undergo monitoring, as Ebola is only contagious if the person is experiencing active symptoms. The person reported developing symptoms several days after the return flight. Anyone concerned about possible exposure may call CDC-Info at 800-CDC-INFO for more information.

CDC recognizes that even a single case of Ebola diagnosed in the United States raises concerns. Knowing the possibility exists, medical and public health professionals across the country have been preparing to respond. CDC and public health officials in Texas are taking precautions to identify people who have had close personal contact with the ill person and health care professionals have been reminded to use meticulous infection control at all times.

We do know how to stop Ebola’s further spread: thorough case finding, isolation of ill people, contacting people exposed to the ill person, and further isolation of contacts if they develop symptoms. The U.S. public health and medical systems have had prior experience with sporadic cases of diseases such as Ebola. In the past decade, the United States had 5 imported cases of Viral Hemorrhagic Fever (VHF) diseases similar to Ebola (1 Marburg, 4 Lassa). None resulted in any transmission in the U.S.

CDC has been anticipating and preparing for a case of Ebola in the United States. We have been:

  • Enhancing surveillance and laboratory testing capacity in states to detect cases
  • Developing guidance and tools for health departments to conduct public health investigations
  • Providing recommendations for  healthcare infection control and other measures to prevent disease spread
  • Providing guidance for flight crews, Emergency Medical Services units at airports, and Customs and Border Protection officers about reporting ill travelers to CDC
  • Disseminating up-to-date information to the general public, international travelers, and public health partners

The data health officials have seen in the past few decades since Ebola was discovered indicates that it is not spread through casual contact or through the air. Ebola is spread through direct contact with bodily fluids of a sick person or exposure to objects such as needles that have been contaminated. The illness has an average 8-10 day incubation period (although it ranges from 2 to 21 days); CDC recommends monitoring exposed people for symptoms a complete 21 days. People are not contagious after exposure unless they develop symptoms.

More information is available at www.cdc.gov/ebola.


Prohibition, Then and Now

TAXING SODA: A DISSENTING VIEW

By Michel Accad, MD

The SFMS has a strong "support" position on Proposition E, the soda tax. We have had one member, cardiologist Michel Accad, MD, voice opposition to our position. His editorial "Prohibition Then and Now" is published below.

Nearly one hundred years ago, the eighteenth amendment to the United States Constitution made it illegal to produce, transport, or sell alcoholic drinks. The prohibition was the culminating action of a “temperance movement,” a century-long grassroots effort aimed at curbing the consumption of alcohol. The movement arose in response to an epidemic of alcoholism and was guided by the compelling argument that alcohol is toxic and that alcoholism brings along serious social evils: chronic unemployment and family neglect or abuse.

Today, a similar movement is taking shape in response to the obesity epidemic. Excessive consumption of sucrose and fructose in ubiquitous “sugary” drinks has been identified as a main cause and found to be responsible for the high prevalence of diabetes and its associated health and socioeconomic complications: cardiovascular and renal disease, blindness, premature death, and exploding health care costs. The new temperance movement decries the excessive use of sweet beverages and calls for restricting their sale. These restrictions can come in the form of taxes or outright bans. The San Francisco Medical Society has supported this cause by recently promoting a “soda tax” signed by Mayor Ed Lee.

But is resorting to taxation and to the strong arm of government always a wise move? I propose some arguments to ponder:

First, the historical example of the old temperance movement should give us reason to pause. When taxation proved ineffective at reducing the ills of alcohol consumption, more drastic bans were promoted. But even the large reduction of alcohol consumption that occurred during the strict prohibition era failed to fulfill the promise of improved health and social conditions. In fact, the prevalence of alcoholism has shown little correlation with legal restrictions on alcohol sale. Why would a tax on Coke and Pepsi make us so much healthier when similar taxes on booze failed to make us more sober? And alternatives to natural sugars may not be benign. Many opportunists stand to benefit from our creating “favored status” categories for drinks and food.

Secondly, the attack on sweet beverages confuses the nature of the evil. Physicians should be mindful of Paracelsus’s useful aphorism: Dosis facit venenum—the dose makes the poison. To call fructose a “toxin” is an injustice to the word. Granted, some substances are addictive, and high-calorie sweet drinks may fall into that category. But only a strict determinist will place the syrup itself at the root of the obesity epidemic. It is drinking too many sweet things that is bad for us. The problem therefore is the behavior, not the chemical.

Finally, good and long-lasting habits come through persuasion and education, not restriction and coercion. Of course, proponents of the new law may quickly point out that poor and vulnerable children are the target of the food and drink industry. But if we think a soda tax can replace parental guidance and tender admonishments, then perhaps our sense of solidarity with the poor is what needs rectification.


2015 Medical Student Loan Repayment Program Application Available Now

Applications are now being accepted for the National Health Service Corps (NHSC) Students to Service Loan Repayment Program. The program offers up to $120,000 to medical students (MD and DO) in their final year of medical school in return for a commitment to provide primary health care full time for at least 3 years or half time for at least 6 years in a medically underserved area.

Through this program, medical students will not only pay off their student loans, but will also have access to educational, training, and networking opportunities, and will join a community of providers with a shared desire to serve patients with limited access to health care.

NHSC recommends that students begin applying early, as applications take approximately 3 weeks to prepare. The 2015 Students to Service application cycle closes at 7:30pm ET on November 13, 2014. 

Click here for more information and to access the application.


Flu and Infectious Disease Forum: Focus on Vaccine-Preventable Diseases

The San Francisco Department of Public Health and the San Francisco Immunization Coalition are pleased to invite physicians, nurse practitioners, nurses, pharmacists, health educators, and other clinicians and public health professionals interested in immunization and communicable disease to attend the San Francisco Flu and Infectious Disease Forum. Come hear critical updates from experts in the field of communicable and vaccine preventable disease.

Tuesday, October 21, 2014
8:30am - 12:00pm
SF Public Library, Koret Auditorium
100 Larkin St (1 block from Civic Center BART)
Free admission

Speakers:

James D. Cherry, MD, MSc
“Pertussis Resurgence 2014: Facts, Fiction, Myths and Misconceptions”
Distinguished Research Professor of Pediatrics, David Geffen School of Medicine at UCLA
Attending Physician, Pediatric Infectious Diseases, Mattel Children’s Hospital UCLA

Ina Park, MD, MS
“HPV Vaccine Implementation: Current Challenges and New Horizons”
Medical Director, California STD/HIV-Prevention Training Center
Chief of the Office of Medical and Scientific Affairs, CDPH, STD Control Branch

Cora Hoover, MD, MPH (Director) & Erin Bachus, MPH (Immunization Coord.)
“2014 Influenza and Immunization Update”
Communicable Disease Control and Prevention, Population Health Division
San Francisco Department of Public Health

Click here to register

Questions? Contact: Alecia Martin at (415) 437-6202 or at alecia.martin@sfdph.org.
Click here to view the event flyer.

The California State Board of Registered Nursing has approved the SFDPH Center for Learning and Innovation (CLI) - #CEP 03548, as a Provider of Continuing Education for Registered Nurses. CLI has been designated as a multiple event provider of continuing education by the National Commission for Health Education Credentialing, Inc. Provider # CA0039.

CEUS for nurses and health educators
3 CEUS for $15 total; please pay by check at event


CLI is unable to offer CMEs for physicians at this event.

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