References cited in Our Bodies’ Best Buddies by Elisabeth M. Bik
References cited in The "Second Genome" and Women's Health by Linda C. Giudice, MD, PhD
References cited in Pre- and Probiotic Foods for a Healthy Gut by Jo Ann T. Hattner, MPH RDN and Susan Anderes, MLIS
References cited in The NIH Human Microbiome Project by Erica Goode, MD
References cited in Why the Microbiome Matters: One Primary Care Physician's Journey toward Understanding Its Significance by Payal Bhandari, MD
Originally published on SFgate.com on September 12, 2014
By Michael H. Rokeach, MD
As an emergency-room doctor in San Francisco for more than 30 years, I see some of the city’s most critical patients — people suffering heart attacks, life-threatening infections, gunshot wounds and more. Proposition 46, which seeks to increase the limit on the amount of medical malpractice lawsuit awards, is a critical threat to the health care of all Californians. The thoughtful response is to oppose it.
The initiative is a complicated, costly measure — written and funded by trial attorneys — which makes sweeping changes to California’s health system without any input from health care experts or medical practitioners.
It’s also deceptive. It uses alcohol and drug testing of doctors (whether they are on or off duty — unprecedented in the U.S.) to disguise the real intent, which is to lift the cap on the medical malpractice lawsuit awards to $1.1 million from $250,000, thereby raising attorney fees, while increasing costs for everybody else.
But, worst of all, it’s bad for health care and health access for low-income communities. It will cost the state and local governments hundreds of millions of dollars and it will make it harder for community clinics such as Planned Parenthood to provide specialty services.
With millions of newly insured patients looking for quality care under the Affordable Care Act, I can’t think of a worse possible time to increase cost and decrease access to trusted health providers. Vote NO on Prop. 46.
Michael H. Rokeach is an emergency-room physician and past president of the San Francisco Medical Society.
David Pating, MD, an SFMS board member and chief of addiction medicine at Kaiser San Francisco, was appointed and sworn in as a member of the San Francisco Health Commission by Mayor Ed Lee.
The Health Commission oversees all activities of the health services of the City and County of San Francisco, including the Department of Public Health and San Francisco General Hospital. Dr. Pating joins SFMS past-President Edward Chow, MD, Commission President, and his nomination was strongly endorsed by the SFMS.
Dr. Pating, an Assistant Clinical Professor in Psychiatry at UCSF and vice-chair of the California Mental Health Services Oversight and Accountability Commission, has been a guest editor of the SFMS journal San Francisco Medicine, and president of the California Society of Addiction Medicine, among many other positions and contributions.
The Centers for Medicare and Medicaid Services (CMS) published a new final rule that would provide eligible professionals participating in the Medicare and Medi-Cal electronic health record (EHR) incentive program an additional year to upgrade their certified electronic health record technology (CEHRT) and revises the meaningful use timeline. The rule will go into effect on October 1, 2014.
The final rule would allow eligible professionals to use 2011 Edition CEHRT or a combination of 2011 and 2014 Edition CEHRT for the 2014 EHR reporting period to demonstrate meaningful use. Eligible professionals that were scheduled to begin Stage 2 in 2014 will not be required to begin Stage 2 until 2015 if they attest that they could not fully implement 2014 Edition CEHRT due to delays in availability of 2014 Edition CEHRT for the 2014 reporting period. The final rule would also revise the meaningful use timeline for Stage 3 to begin in 2017 for eligible professionals.
CMS, however, emphasizes that beginning in 2015, all providers will be required to report using 2014 Edition CEHRT to successfully demonstrate meaningful use.
SFMS members can access detailed information on the federal EHR incentive program and meaningful use via CAM’s On-Call Documents #4301 “Electronic Health Records: Federal Incentive Program,” #4302 “Meaningful Use of Electronic Health Records,” and #4305 “EHR Meaningful Use: Stage 2.” These and other resources are complimentary to SFMS members and at $2/page to non-members.
30 county medical societies and dozens of statewide groups—representing more than 40,000 doctors—joined the growing coalition opposed to Prop 45.
“We all want to reduce the cost of health care and strive every day to enhance its quality, but our health care system is too complex to make major changes through a ballot measure pushed by one special interest group,” said Dr. Pedram Salimpour, President of the Los Angeles County Medical Association. “If we are going to make major changes, patients, doctors, nurses, clinics and hospitals should all be part of the solution.”
Prop 45 was drafted and filed in 2011, prior to the implementation of the President’s historic Affordable Care Act, and failed to qualify for the 2012 ballot, forcing it to this year’s November ballot.
Academics and health care experts, including Covered California board members, have raised serious concerns about Prop 45 creating obstacles for those who need health insurance through the state’s exchange, largely due to the initiative allowing outside groups and individuals to file lengthy legal challenges against Covered California plans.
At the August Covered California board meeting, board members expressed their opposition to the measure, saying that it could have “significant detrimental impacts” to the exchange’s operations.
County medical societies that have announced their opposition to Prop 45 include: