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ACA: How would you improve it?
With the March 24 demise of the American Health Care Act, Republican leaders in Congress and in the White House have said that the Affordable Care Act will remain in place for the foreseeable future. While the ACA has brought about a number of health reforms that benefit physicians and their patients, other provisions have increased physician hassle and headache.
[polldaddy:9708248]
Check back soon to see if your colleagues agree on what part of the ACA should be changed, or email me your thoughts on the business of medicine.
On Twitter @denisefulton
With the March 24 demise of the American Health Care Act, Republican leaders in Congress and in the White House have said that the Affordable Care Act will remain in place for the foreseeable future. While the ACA has brought about a number of health reforms that benefit physicians and their patients, other provisions have increased physician hassle and headache.
[polldaddy:9708248]
Check back soon to see if your colleagues agree on what part of the ACA should be changed, or email me your thoughts on the business of medicine.
On Twitter @denisefulton
With the March 24 demise of the American Health Care Act, Republican leaders in Congress and in the White House have said that the Affordable Care Act will remain in place for the foreseeable future. While the ACA has brought about a number of health reforms that benefit physicians and their patients, other provisions have increased physician hassle and headache.
[polldaddy:9708248]
Check back soon to see if your colleagues agree on what part of the ACA should be changed, or email me your thoughts on the business of medicine.
On Twitter @denisefulton
MACRA advice: Do the MIPS bare minimum this year
ORLANDO – Confused about what MACRA, MIPS, and APMs mean for you and your practice this year?
Clifford Lober, MD, offered some very simple advice at the annual meeting of the American Academy of Dermatology: “If you take nothing else from this annual meeting – not this session, but the whole meeting – submit one quality measure or one improvement activity or the required advancing care information base measures – one time, on one patient” to the MIPS program, Dr. Lober said. “If you do that, you will save 4% of your Medicare payments in 2019.”*
MIPS is a system of bonuses and penalties based on data the Medicare program started collecting on Jan. 1, 2017; it incorporates the legacy quality measure reporting systems including the Physician Quality Reporting System, meaningful use, and the value-based modifier program, said Dr. Lober, a dermatologist in private practice in Kissimmee, Fla.
Based on feedback from physicians and other stakeholders, Medicare announced last fall that physicians could “pick their pace” as to how they wanted to report data to MIPS in 2017, the first baseline year of the program. They could:
- Choose to not participate. These physicians will see an automatic 4% reduction in their Medicare payments in 2019.
- Test QPP. Report on one quality measure or improvement activity for one patient. Of note: This information does not have to be submitted electronically; paper submission is okay. These physicians will avoid the 4% Medicare pay cut.
- Participate for part of the year. These physicians will report for 90 consecutive days of their choice on more than one quality measure, more than one improvement activity, or more than the required measures in the advancing care information performance category. Reporting must start before Oct. 2, 2017. These physicians may earn a pay increase.*
- Participate for the full year. Submit a full year of data to Medicare. These physicians may get a pay increase.
Dr. Lober said pointedly, “The first choice – doing nothing – is the dumbest move you could make.”
He also noted that the CMS regulations say verbatim that “positive adjustments are based on data on the performance information submitted, not the amount of information or the length of time submitted.”
A few physicians and other clinicians are exempted from the QPP for 2017. Those who are in their first year of participating in Medicare Part B are exempt, as are those who bill less than $30,000 or have fewer than 100 Medicare patients.*
“The low-value exemption alone, CMS actuaries think, will exempt 32.5% of clinicians in the United States – a huge exemption,” Dr. Lober said, adding that when it comes to dermatologists, it’s estimated that about 18.3% will be exempt from MIPS.
Despite the new political landscape in Washington, Dr. Lober said that he does not think MACRA will go away.
“One of the things I want to say out front is, what is the likelihood of MACRA being repealed?” he said. “Somewhere between slim and none or even none and none. It was supported by both Democrats and Republicans and I think it’s here to stay. It might be modified, but it’s here to stay.”
He urged physicians to reach out to CMS if they have comments about the MIPS, APMs, and the Quality Payment Program, noting that despite the formal comment period being closed, agency officials have been receptive to comments and suggestions.
*This article was updated on March 13, 2017 at 3:30 p.m.
[email protected]
On Twitter @denisefulton
ORLANDO – Confused about what MACRA, MIPS, and APMs mean for you and your practice this year?
Clifford Lober, MD, offered some very simple advice at the annual meeting of the American Academy of Dermatology: “If you take nothing else from this annual meeting – not this session, but the whole meeting – submit one quality measure or one improvement activity or the required advancing care information base measures – one time, on one patient” to the MIPS program, Dr. Lober said. “If you do that, you will save 4% of your Medicare payments in 2019.”*
MIPS is a system of bonuses and penalties based on data the Medicare program started collecting on Jan. 1, 2017; it incorporates the legacy quality measure reporting systems including the Physician Quality Reporting System, meaningful use, and the value-based modifier program, said Dr. Lober, a dermatologist in private practice in Kissimmee, Fla.
Based on feedback from physicians and other stakeholders, Medicare announced last fall that physicians could “pick their pace” as to how they wanted to report data to MIPS in 2017, the first baseline year of the program. They could:
- Choose to not participate. These physicians will see an automatic 4% reduction in their Medicare payments in 2019.
- Test QPP. Report on one quality measure or improvement activity for one patient. Of note: This information does not have to be submitted electronically; paper submission is okay. These physicians will avoid the 4% Medicare pay cut.
- Participate for part of the year. These physicians will report for 90 consecutive days of their choice on more than one quality measure, more than one improvement activity, or more than the required measures in the advancing care information performance category. Reporting must start before Oct. 2, 2017. These physicians may earn a pay increase.*
- Participate for the full year. Submit a full year of data to Medicare. These physicians may get a pay increase.
Dr. Lober said pointedly, “The first choice – doing nothing – is the dumbest move you could make.”
He also noted that the CMS regulations say verbatim that “positive adjustments are based on data on the performance information submitted, not the amount of information or the length of time submitted.”
A few physicians and other clinicians are exempted from the QPP for 2017. Those who are in their first year of participating in Medicare Part B are exempt, as are those who bill less than $30,000 or have fewer than 100 Medicare patients.*
“The low-value exemption alone, CMS actuaries think, will exempt 32.5% of clinicians in the United States – a huge exemption,” Dr. Lober said, adding that when it comes to dermatologists, it’s estimated that about 18.3% will be exempt from MIPS.
Despite the new political landscape in Washington, Dr. Lober said that he does not think MACRA will go away.
“One of the things I want to say out front is, what is the likelihood of MACRA being repealed?” he said. “Somewhere between slim and none or even none and none. It was supported by both Democrats and Republicans and I think it’s here to stay. It might be modified, but it’s here to stay.”
He urged physicians to reach out to CMS if they have comments about the MIPS, APMs, and the Quality Payment Program, noting that despite the formal comment period being closed, agency officials have been receptive to comments and suggestions.
*This article was updated on March 13, 2017 at 3:30 p.m.
[email protected]
On Twitter @denisefulton
ORLANDO – Confused about what MACRA, MIPS, and APMs mean for you and your practice this year?
Clifford Lober, MD, offered some very simple advice at the annual meeting of the American Academy of Dermatology: “If you take nothing else from this annual meeting – not this session, but the whole meeting – submit one quality measure or one improvement activity or the required advancing care information base measures – one time, on one patient” to the MIPS program, Dr. Lober said. “If you do that, you will save 4% of your Medicare payments in 2019.”*
MIPS is a system of bonuses and penalties based on data the Medicare program started collecting on Jan. 1, 2017; it incorporates the legacy quality measure reporting systems including the Physician Quality Reporting System, meaningful use, and the value-based modifier program, said Dr. Lober, a dermatologist in private practice in Kissimmee, Fla.
Based on feedback from physicians and other stakeholders, Medicare announced last fall that physicians could “pick their pace” as to how they wanted to report data to MIPS in 2017, the first baseline year of the program. They could:
- Choose to not participate. These physicians will see an automatic 4% reduction in their Medicare payments in 2019.
- Test QPP. Report on one quality measure or improvement activity for one patient. Of note: This information does not have to be submitted electronically; paper submission is okay. These physicians will avoid the 4% Medicare pay cut.
- Participate for part of the year. These physicians will report for 90 consecutive days of their choice on more than one quality measure, more than one improvement activity, or more than the required measures in the advancing care information performance category. Reporting must start before Oct. 2, 2017. These physicians may earn a pay increase.*
- Participate for the full year. Submit a full year of data to Medicare. These physicians may get a pay increase.
Dr. Lober said pointedly, “The first choice – doing nothing – is the dumbest move you could make.”
He also noted that the CMS regulations say verbatim that “positive adjustments are based on data on the performance information submitted, not the amount of information or the length of time submitted.”
A few physicians and other clinicians are exempted from the QPP for 2017. Those who are in their first year of participating in Medicare Part B are exempt, as are those who bill less than $30,000 or have fewer than 100 Medicare patients.*
“The low-value exemption alone, CMS actuaries think, will exempt 32.5% of clinicians in the United States – a huge exemption,” Dr. Lober said, adding that when it comes to dermatologists, it’s estimated that about 18.3% will be exempt from MIPS.
Despite the new political landscape in Washington, Dr. Lober said that he does not think MACRA will go away.
“One of the things I want to say out front is, what is the likelihood of MACRA being repealed?” he said. “Somewhere between slim and none or even none and none. It was supported by both Democrats and Republicans and I think it’s here to stay. It might be modified, but it’s here to stay.”
He urged physicians to reach out to CMS if they have comments about the MIPS, APMs, and the Quality Payment Program, noting that despite the formal comment period being closed, agency officials have been receptive to comments and suggestions.
*This article was updated on March 13, 2017 at 3:30 p.m.
[email protected]
On Twitter @denisefulton
AT AAD 17
Teledermatology shows potential for grading patch test results
ORLANDO – Store-and-forward teledermatology may be useful for grading patch test results.
Erin Warshaw, MD, and Sara Hylwa, MD, both of the University of Minnesota, Minneapolis, sought to compare readings of patch test results both in person and via store-and-forward teledermatology. They patch tested patients at the Hennepin County (Minn.) Medical Center with the North American Contact Dermatitis Group screening series; photos were obtained at the 48-hour reading and the final reading (96-160 hours).
Almost all (101 of 107) of patients eligible for the trial were enrolled. Patients were overwhelmingly female (72%) with an average age of 50 years in this single-site study. Most screening panels were applied to the back.
Teledermatology assessment was categorized as successful if it matched the in-person assessment and as a failure if it did not; investigators labeled assessed pairs that did not fully match as indeterminate. Successful matches indicated there was no clinically significant difference between teledermatology and in-person assessment, indeterminate matches indicated that there was possible clinically significant difference, and failure to match indicated definite clinically significant difference.
All readings that were negative both in person and via teledermatology were excluded from the analysis.
At 48 hours, 47.2% of 705 reading pairs were labeled successful and 51.3% were labeled indeterminate. Failure, or complete disagreement, occurred in 1.6%, or 11 individual antigen pairs.
More successes – and failures – were seen at the final reading, with 53.8% of 420 final readings labeled successful, 39.8% labeled indeterminate, and 6.4%, or 27 individual antigen pairs, labeled as failures.
In general, teledermatology was more likely to miss or downplay the severity of reactions in the indeterminate pairs, Dr. Warshaw said. “This makes intuitive sense because when you are with a patient live, often the lighting catches an irritant wrinkle reaction or you can feel the lesion and be much more likely to call it irritant or a mild reaction than you would be from a flat photo.”
In the failure group, teledermatology generally overstated reactions, she added.
Dr. Warshaw said that logistical changes would be needed to make teledermatology more effective for reading patch test reactions in her practice. Their method of marking the patch test grid is to use a surgical marker on the corners, but a highlighter to mark the grid between the antigens. The highlighter simply did not show up well in photographs, she noted.
While not perfect, teledermatology does have promise for reading patch test reactions, she added. “I would love to save patients from having to come for their 48-hour reading... In Minnesota we have these horrible snowstorms. Last week there was a blizzard that was predicted. A third of our patients live 2 hours away from the clinic. If they could have taken photographs instead of trying to come through a blizzard for their final reading, that would be helpful.”
Dr. Warshaw noted that their study assessed only the 70 antigens of the North American Contact Dermatitis Research Group series and that it could have been strengthened by using additional series or the patients’ own products.
[email protected]
On Twitter @denisefulton
ORLANDO – Store-and-forward teledermatology may be useful for grading patch test results.
Erin Warshaw, MD, and Sara Hylwa, MD, both of the University of Minnesota, Minneapolis, sought to compare readings of patch test results both in person and via store-and-forward teledermatology. They patch tested patients at the Hennepin County (Minn.) Medical Center with the North American Contact Dermatitis Group screening series; photos were obtained at the 48-hour reading and the final reading (96-160 hours).
Almost all (101 of 107) of patients eligible for the trial were enrolled. Patients were overwhelmingly female (72%) with an average age of 50 years in this single-site study. Most screening panels were applied to the back.
Teledermatology assessment was categorized as successful if it matched the in-person assessment and as a failure if it did not; investigators labeled assessed pairs that did not fully match as indeterminate. Successful matches indicated there was no clinically significant difference between teledermatology and in-person assessment, indeterminate matches indicated that there was possible clinically significant difference, and failure to match indicated definite clinically significant difference.
All readings that were negative both in person and via teledermatology were excluded from the analysis.
At 48 hours, 47.2% of 705 reading pairs were labeled successful and 51.3% were labeled indeterminate. Failure, or complete disagreement, occurred in 1.6%, or 11 individual antigen pairs.
More successes – and failures – were seen at the final reading, with 53.8% of 420 final readings labeled successful, 39.8% labeled indeterminate, and 6.4%, or 27 individual antigen pairs, labeled as failures.
In general, teledermatology was more likely to miss or downplay the severity of reactions in the indeterminate pairs, Dr. Warshaw said. “This makes intuitive sense because when you are with a patient live, often the lighting catches an irritant wrinkle reaction or you can feel the lesion and be much more likely to call it irritant or a mild reaction than you would be from a flat photo.”
In the failure group, teledermatology generally overstated reactions, she added.
Dr. Warshaw said that logistical changes would be needed to make teledermatology more effective for reading patch test reactions in her practice. Their method of marking the patch test grid is to use a surgical marker on the corners, but a highlighter to mark the grid between the antigens. The highlighter simply did not show up well in photographs, she noted.
While not perfect, teledermatology does have promise for reading patch test reactions, she added. “I would love to save patients from having to come for their 48-hour reading... In Minnesota we have these horrible snowstorms. Last week there was a blizzard that was predicted. A third of our patients live 2 hours away from the clinic. If they could have taken photographs instead of trying to come through a blizzard for their final reading, that would be helpful.”
Dr. Warshaw noted that their study assessed only the 70 antigens of the North American Contact Dermatitis Research Group series and that it could have been strengthened by using additional series or the patients’ own products.
[email protected]
On Twitter @denisefulton
ORLANDO – Store-and-forward teledermatology may be useful for grading patch test results.
Erin Warshaw, MD, and Sara Hylwa, MD, both of the University of Minnesota, Minneapolis, sought to compare readings of patch test results both in person and via store-and-forward teledermatology. They patch tested patients at the Hennepin County (Minn.) Medical Center with the North American Contact Dermatitis Group screening series; photos were obtained at the 48-hour reading and the final reading (96-160 hours).
Almost all (101 of 107) of patients eligible for the trial were enrolled. Patients were overwhelmingly female (72%) with an average age of 50 years in this single-site study. Most screening panels were applied to the back.
Teledermatology assessment was categorized as successful if it matched the in-person assessment and as a failure if it did not; investigators labeled assessed pairs that did not fully match as indeterminate. Successful matches indicated there was no clinically significant difference between teledermatology and in-person assessment, indeterminate matches indicated that there was possible clinically significant difference, and failure to match indicated definite clinically significant difference.
All readings that were negative both in person and via teledermatology were excluded from the analysis.
At 48 hours, 47.2% of 705 reading pairs were labeled successful and 51.3% were labeled indeterminate. Failure, or complete disagreement, occurred in 1.6%, or 11 individual antigen pairs.
More successes – and failures – were seen at the final reading, with 53.8% of 420 final readings labeled successful, 39.8% labeled indeterminate, and 6.4%, or 27 individual antigen pairs, labeled as failures.
In general, teledermatology was more likely to miss or downplay the severity of reactions in the indeterminate pairs, Dr. Warshaw said. “This makes intuitive sense because when you are with a patient live, often the lighting catches an irritant wrinkle reaction or you can feel the lesion and be much more likely to call it irritant or a mild reaction than you would be from a flat photo.”
In the failure group, teledermatology generally overstated reactions, she added.
Dr. Warshaw said that logistical changes would be needed to make teledermatology more effective for reading patch test reactions in her practice. Their method of marking the patch test grid is to use a surgical marker on the corners, but a highlighter to mark the grid between the antigens. The highlighter simply did not show up well in photographs, she noted.
While not perfect, teledermatology does have promise for reading patch test reactions, she added. “I would love to save patients from having to come for their 48-hour reading... In Minnesota we have these horrible snowstorms. Last week there was a blizzard that was predicted. A third of our patients live 2 hours away from the clinic. If they could have taken photographs instead of trying to come through a blizzard for their final reading, that would be helpful.”
Dr. Warshaw noted that their study assessed only the 70 antigens of the North American Contact Dermatitis Research Group series and that it could have been strengthened by using additional series or the patients’ own products.
[email protected]
On Twitter @denisefulton
Key clinical point:
Major finding: Teledermatology readings failed to match in-person final readings 6% of the time.
Data source: Single-site study of 101 patients patch tested with the North American Contact Dermatitis Group series.
Disclosures: Dr. Warshaw declared no relevant conflicts of interest.
Ecofriendly surfactant is allergen of the year
ORLANDO – Alkyl glucosides, mild surfactants derived from natural, sustainable sources, have been named allergen of the year by the American Contact Dermatitis Society.
The ecofriendly nature of these compounds has led to their inclusion in more personal care products in the last decade and a half. Alkyl glucosides are derived from coconut, palm, or rapeseed oil with glucose supplied by corn, wheat starch, or potatoes. They can be found in rinse-off products such as shampoos, shower gels, and liquid cleansers but also in leave-on products such as deodorants, sunscreens, and moisturizers, investigators said at the annual meeting of the American Contact Dermatitis Society, held just prior to the start of the American Academy of Dermatology’s annual meeting.
Camille Loranger, MD, of the department of dermatology, McGill University Health Center, Montreal, presented her institution’s experience with allergic contact dermatitis caused by alkyl glucosides. A total of 3,095 patients were patch tested at the clinic between January 2009 and June 2016. Researchers used the North American Contact Dermatitis Group 65-allergen series, which includes decyl glucoside (5% in petrolatum). Slightly more than half of patients (1,628) also were tested for reactions to lauryl glucoside (3% in petrolatum) as part of an additional cosmetic series. Twenty patients in the larger series reacted to decyl glucoside, while 15 of those who tested for lauryl glucoside reacted. Of those 15 patients, 6 were found to be allergic to decyl glucoside as well (Dermatitis. 2017 Jan/Feb;28[1]:5-13).
Allergy to alkyl glucosides became more common over time in the McGill series. The rate of positivity was low in the early years of the series, but increased from 1.37% of 437 patients in 2014 to 2.2% of 227 patients tested in the first half of 2016, Dr. Loranger said.
“Most of our patients were women with an average age of 48 years,” she added. “Body sites most commonly affected were the head and the hands. Only one case could be attributed to occupational exposure.”
Most patients – 86% – also were atopic (asthma, eczema, and rhinitis).
Products identified as most commonly causing a positive reaction were leave-on moisturizers and hand creams.
Donald V. Belsito, MD, professor of dermatology at Columbia University, N.Y., introduced the allergen of the year, pointing out that the compounds selected are not necessarily “bad actors.”
“The allergen of the year is really chosen to educate dermatologists about allergens that may be of low prevalence but a high relevance,” Dr. Belsito said. The allergens selected “are difficult to test for because they are tested for at irritant concentrations. It doesn’t mean they are these horrible substances that are damaging the world necessarily.”
The ACDS has been naming an allergen of the year since 2004.
[email protected]
On Twitter @denisefulton
ORLANDO – Alkyl glucosides, mild surfactants derived from natural, sustainable sources, have been named allergen of the year by the American Contact Dermatitis Society.
The ecofriendly nature of these compounds has led to their inclusion in more personal care products in the last decade and a half. Alkyl glucosides are derived from coconut, palm, or rapeseed oil with glucose supplied by corn, wheat starch, or potatoes. They can be found in rinse-off products such as shampoos, shower gels, and liquid cleansers but also in leave-on products such as deodorants, sunscreens, and moisturizers, investigators said at the annual meeting of the American Contact Dermatitis Society, held just prior to the start of the American Academy of Dermatology’s annual meeting.
Camille Loranger, MD, of the department of dermatology, McGill University Health Center, Montreal, presented her institution’s experience with allergic contact dermatitis caused by alkyl glucosides. A total of 3,095 patients were patch tested at the clinic between January 2009 and June 2016. Researchers used the North American Contact Dermatitis Group 65-allergen series, which includes decyl glucoside (5% in petrolatum). Slightly more than half of patients (1,628) also were tested for reactions to lauryl glucoside (3% in petrolatum) as part of an additional cosmetic series. Twenty patients in the larger series reacted to decyl glucoside, while 15 of those who tested for lauryl glucoside reacted. Of those 15 patients, 6 were found to be allergic to decyl glucoside as well (Dermatitis. 2017 Jan/Feb;28[1]:5-13).
Allergy to alkyl glucosides became more common over time in the McGill series. The rate of positivity was low in the early years of the series, but increased from 1.37% of 437 patients in 2014 to 2.2% of 227 patients tested in the first half of 2016, Dr. Loranger said.
“Most of our patients were women with an average age of 48 years,” she added. “Body sites most commonly affected were the head and the hands. Only one case could be attributed to occupational exposure.”
Most patients – 86% – also were atopic (asthma, eczema, and rhinitis).
Products identified as most commonly causing a positive reaction were leave-on moisturizers and hand creams.
Donald V. Belsito, MD, professor of dermatology at Columbia University, N.Y., introduced the allergen of the year, pointing out that the compounds selected are not necessarily “bad actors.”
“The allergen of the year is really chosen to educate dermatologists about allergens that may be of low prevalence but a high relevance,” Dr. Belsito said. The allergens selected “are difficult to test for because they are tested for at irritant concentrations. It doesn’t mean they are these horrible substances that are damaging the world necessarily.”
The ACDS has been naming an allergen of the year since 2004.
[email protected]
On Twitter @denisefulton
ORLANDO – Alkyl glucosides, mild surfactants derived from natural, sustainable sources, have been named allergen of the year by the American Contact Dermatitis Society.
The ecofriendly nature of these compounds has led to their inclusion in more personal care products in the last decade and a half. Alkyl glucosides are derived from coconut, palm, or rapeseed oil with glucose supplied by corn, wheat starch, or potatoes. They can be found in rinse-off products such as shampoos, shower gels, and liquid cleansers but also in leave-on products such as deodorants, sunscreens, and moisturizers, investigators said at the annual meeting of the American Contact Dermatitis Society, held just prior to the start of the American Academy of Dermatology’s annual meeting.
Camille Loranger, MD, of the department of dermatology, McGill University Health Center, Montreal, presented her institution’s experience with allergic contact dermatitis caused by alkyl glucosides. A total of 3,095 patients were patch tested at the clinic between January 2009 and June 2016. Researchers used the North American Contact Dermatitis Group 65-allergen series, which includes decyl glucoside (5% in petrolatum). Slightly more than half of patients (1,628) also were tested for reactions to lauryl glucoside (3% in petrolatum) as part of an additional cosmetic series. Twenty patients in the larger series reacted to decyl glucoside, while 15 of those who tested for lauryl glucoside reacted. Of those 15 patients, 6 were found to be allergic to decyl glucoside as well (Dermatitis. 2017 Jan/Feb;28[1]:5-13).
Allergy to alkyl glucosides became more common over time in the McGill series. The rate of positivity was low in the early years of the series, but increased from 1.37% of 437 patients in 2014 to 2.2% of 227 patients tested in the first half of 2016, Dr. Loranger said.
“Most of our patients were women with an average age of 48 years,” she added. “Body sites most commonly affected were the head and the hands. Only one case could be attributed to occupational exposure.”
Most patients – 86% – also were atopic (asthma, eczema, and rhinitis).
Products identified as most commonly causing a positive reaction were leave-on moisturizers and hand creams.
Donald V. Belsito, MD, professor of dermatology at Columbia University, N.Y., introduced the allergen of the year, pointing out that the compounds selected are not necessarily “bad actors.”
“The allergen of the year is really chosen to educate dermatologists about allergens that may be of low prevalence but a high relevance,” Dr. Belsito said. The allergens selected “are difficult to test for because they are tested for at irritant concentrations. It doesn’t mean they are these horrible substances that are damaging the world necessarily.”
The ACDS has been naming an allergen of the year since 2004.
[email protected]
On Twitter @denisefulton
AGA, other medical organizations respond to Trump’s immigration order
Organizations representing physicians and medical students have expressed their concern regarding President Trump’s executive order of Jan. 27 that curtails entry into the United States by travelers from seven Muslim-majority countries. The order also suspends for 120 days entry into the United States for all persons seeking refugee status, and it bars refugees from Syria indefinitely.
Following are direct excerpts from statements issued by medical organizations.
American Gastroenterological Association
Science and illness ignore borders and political divides. That is why AGA is concerned that the recent U.S. executive order on immigration could limit scientific exchange, delay patient care, and impair medical training.
AGA is committed to diversity, which we define as inclusive of race, ethnicity, and national origin. Diversity within training programs and laboratories in the United States built today’s practice of gastroenterology. Scientists from around the world publish in our journals, work in our laboratories, train in our programs, and present data at Digestive Disease Week.® This exchange leads to better patient care, and very sick patients travel to the U.S. from around the world for the best digestive health care.
In light of these concerns, AGA adds our support to a growing number of medical institutions urging the administration to consider the devastating impact of the executive order on the health of the nation that will result from turning away patients, health professionals, and researchers. The recent immigration policy is clearly detrimental to America’s leadership role in advancing health care, and to the standing of the United States within the international community.
American Academy of Family Physicians
“We are deeply concerned that steps your Administration has taken will have a chilling effect on our nation’s physician workforce, biomedical research, and global health. It is often America’s physicians who answer the call to assist people around the world when a public health crisis occurs. Imagine a world where physicians fail to answer the call of the needy because they fear they may not be able to return to their home and families in the United States.
Many family physicians are international medical graduates (IMG), who have completed all or part of their education and training in the United States. They are professionals who dedicate their careers to the service of their patients in communities large and small, urban and rural. In fact, 20% of our membership and over 25% of family medicine residents [comprise] IMGs. The AAFP applauds and supports wholly the contributions of these individual family physicians to their patients and communities and we celebrate their diversity.
We recognize that one of your primary responsibilities as President is to ensure the safety and security of the country and its citizens. This is, without question, a daunting responsibility. But we strongly urge that the methods of doing so be examined carefully, so that the many people who can add so much to our country through immigration have the opportunity to do so, and those who are doing so already are treated with the respect and dignity they deserve.”
American Academy of Pediatrics
“The executive orders signed today are harmful to immigrant children and families throughout our country. Many of the children who will be most affected are the victims of unspeakable violence and have been exposed to trauma. Children do not immigrate, they flee. They are coming to the United States seeking safe haven in our country and they need our compassion and assistance. Broad scale expansion of family detention only exacerbates their suffering ... The AAP is non-partisan and pro-children. We urge President Trump and his administration to ensure that children and families who are fleeing violence and adversity can continue to seek refuge in our country. Immigrant children and families are an integral part of our communities and our nation, and they deserve to be cared for, treated with compassion, and celebrated. Most of all, they deserve to be healthy and safe. Pediatricians stand with the immigrant families we care for and will continue to advocate that their needs are met and prioritized.”
American Association of Medical Colleges
“The United States is facing a serious shortage of physicians. IMGs play an important role in U.S. health care, representing roughly 25% of the workforce. Current immigration pathways – including student, exchange-visitor, and employment visas – provide a balanced solution that improves health care access across the country through programs like the National Interest Waiver and the Conrad 30 J-1 Visa Waiver. In the last decade, Conrad 30 alone has directed nearly 10,000 physicians into rural and urban underserved communities. Impeding these U.S. immigration pathways jeopardizes critical access to high-quality physician care for our nation’s most vulnerable populations.
Our ability to attract top talent from around the world also enriches the research laboratories at medical schools and teaching hospitals that are working toward cures and has helped position the United States as a global leader in medical research, strengthening our economy and bolstering the public’s health. Because disease knows no geographic boundaries, it is essential to ensure that we continue to foster, rather than impede, scientific cooperation with physicians and researchers of all nationalities, as we strive to keep our country healthy.”
American College of Cardiology
“The ability to share ideas and knowledge necessary to address [the global epidemic of cardiovascular disease] is imperative. Policies that impede this free-flow of ideas will have a detrimental impact on scientific discovery, as well as the lives of patients around the world. If we are to realize a future where cardiovascular disease is no longer the number one killer of men and women worldwide we must ensure that our system of scientific exchange allows for health care professionals to learn from each other regardless of their nationality.
Additionally, IMGs, naturalized citizens, and legal residents make up a significant portion of the health care workforce in hospitals and practices across the country. More than 25% of current practicing physicians are IMGs, with cardiology ranking among the top when broken down by medical specialty. Policies that bring the immigration status of those already here into question, while also limiting the ability of others to legally train in the United States going forward, will only serve to exacerbate the already existing cardiovascular workforce shortage, especially in rural America. Such policies also threaten the care continuum of patients who rely on these providers for their medical care.”
American College of Physicians
“The executive order could deny entry or reentry to tens of thousands more persons, including medical students and physicians who are being trained in the United States and/or are delivering direct patient care. ... It also creates a precedent for barring entry of IMGs based on their religion and country of origin. ... Approximately 30% of ACP members are IMGs.”
American Society of Clinical Oncology
ASCO is deeply concerned about the potential impact of the recent executive order on cancer research, patient care, and international scientific collaboration.
Our more than 40,000 members in 148 countries lead the charge to conquer cancer in all its forms and in every nation. Tens of thousands of people from more than 100 countries participate in our scientific meetings to exchange advances and ideas to improve patient care. Millions of cancer survivors are alive today because of the progress made possible by scientific collaboration. Progress against this disease will falter if the close-knit global community of cancer care providers is divided by policies that bar members of certain nationalities from entering the United States to conduct research, care for people with cancer, or participate in scientific and medical conferences.
American Society of Hematology
We express our deep concern about the Administration’s executive order that has denied U.S. entry to people who bring unique expertise to the practice of medicine and the conduct of cancer and biomedical research. Our nation depends on the contributions of the greatest minds from around the world to maintain the high quality of our biomedical research enterprise and health care services.
The benefits of scientific collaborations are amplified by our diversity. Limiting the exchange of ideas, practices, and data across cultures has the potential to significantly retard scientific progress and adversely affect public health. Any loss of researchers and physicians will render the United States less competitive over time, and our traditionally strong research institutions and the patients they serve will be negatively affected.
We remain deeply concerned that restricting travel will prohibit participation in scientific meetings, where cutting-edge science and treatment methods are often first introduced. These in-person meetings and other global exchanges are vitally important because they provide unparalleled opportunities for collaborations and information-sharing. Such scientific and medical meetings are absolutely essential to the conquest of cancer and blood diseases.
(Statement issued on behalf of ASH, American Association for Cancer Research, Association of American Cancer Institutes, American Society for Radiation Oncology, The American Society for Pediatric Hematology/Oncology, and LUNGevity Foundation.)
The text of the executive order can be found on the White House website.
[email protected]
On Twitter @denisefulton
Organizations representing physicians and medical students have expressed their concern regarding President Trump’s executive order of Jan. 27 that curtails entry into the United States by travelers from seven Muslim-majority countries. The order also suspends for 120 days entry into the United States for all persons seeking refugee status, and it bars refugees from Syria indefinitely.
Following are direct excerpts from statements issued by medical organizations.
American Gastroenterological Association
Science and illness ignore borders and political divides. That is why AGA is concerned that the recent U.S. executive order on immigration could limit scientific exchange, delay patient care, and impair medical training.
AGA is committed to diversity, which we define as inclusive of race, ethnicity, and national origin. Diversity within training programs and laboratories in the United States built today’s practice of gastroenterology. Scientists from around the world publish in our journals, work in our laboratories, train in our programs, and present data at Digestive Disease Week.® This exchange leads to better patient care, and very sick patients travel to the U.S. from around the world for the best digestive health care.
In light of these concerns, AGA adds our support to a growing number of medical institutions urging the administration to consider the devastating impact of the executive order on the health of the nation that will result from turning away patients, health professionals, and researchers. The recent immigration policy is clearly detrimental to America’s leadership role in advancing health care, and to the standing of the United States within the international community.
American Academy of Family Physicians
“We are deeply concerned that steps your Administration has taken will have a chilling effect on our nation’s physician workforce, biomedical research, and global health. It is often America’s physicians who answer the call to assist people around the world when a public health crisis occurs. Imagine a world where physicians fail to answer the call of the needy because they fear they may not be able to return to their home and families in the United States.
Many family physicians are international medical graduates (IMG), who have completed all or part of their education and training in the United States. They are professionals who dedicate their careers to the service of their patients in communities large and small, urban and rural. In fact, 20% of our membership and over 25% of family medicine residents [comprise] IMGs. The AAFP applauds and supports wholly the contributions of these individual family physicians to their patients and communities and we celebrate their diversity.
We recognize that one of your primary responsibilities as President is to ensure the safety and security of the country and its citizens. This is, without question, a daunting responsibility. But we strongly urge that the methods of doing so be examined carefully, so that the many people who can add so much to our country through immigration have the opportunity to do so, and those who are doing so already are treated with the respect and dignity they deserve.”
American Academy of Pediatrics
“The executive orders signed today are harmful to immigrant children and families throughout our country. Many of the children who will be most affected are the victims of unspeakable violence and have been exposed to trauma. Children do not immigrate, they flee. They are coming to the United States seeking safe haven in our country and they need our compassion and assistance. Broad scale expansion of family detention only exacerbates their suffering ... The AAP is non-partisan and pro-children. We urge President Trump and his administration to ensure that children and families who are fleeing violence and adversity can continue to seek refuge in our country. Immigrant children and families are an integral part of our communities and our nation, and they deserve to be cared for, treated with compassion, and celebrated. Most of all, they deserve to be healthy and safe. Pediatricians stand with the immigrant families we care for and will continue to advocate that their needs are met and prioritized.”
American Association of Medical Colleges
“The United States is facing a serious shortage of physicians. IMGs play an important role in U.S. health care, representing roughly 25% of the workforce. Current immigration pathways – including student, exchange-visitor, and employment visas – provide a balanced solution that improves health care access across the country through programs like the National Interest Waiver and the Conrad 30 J-1 Visa Waiver. In the last decade, Conrad 30 alone has directed nearly 10,000 physicians into rural and urban underserved communities. Impeding these U.S. immigration pathways jeopardizes critical access to high-quality physician care for our nation’s most vulnerable populations.
Our ability to attract top talent from around the world also enriches the research laboratories at medical schools and teaching hospitals that are working toward cures and has helped position the United States as a global leader in medical research, strengthening our economy and bolstering the public’s health. Because disease knows no geographic boundaries, it is essential to ensure that we continue to foster, rather than impede, scientific cooperation with physicians and researchers of all nationalities, as we strive to keep our country healthy.”
American College of Cardiology
“The ability to share ideas and knowledge necessary to address [the global epidemic of cardiovascular disease] is imperative. Policies that impede this free-flow of ideas will have a detrimental impact on scientific discovery, as well as the lives of patients around the world. If we are to realize a future where cardiovascular disease is no longer the number one killer of men and women worldwide we must ensure that our system of scientific exchange allows for health care professionals to learn from each other regardless of their nationality.
Additionally, IMGs, naturalized citizens, and legal residents make up a significant portion of the health care workforce in hospitals and practices across the country. More than 25% of current practicing physicians are IMGs, with cardiology ranking among the top when broken down by medical specialty. Policies that bring the immigration status of those already here into question, while also limiting the ability of others to legally train in the United States going forward, will only serve to exacerbate the already existing cardiovascular workforce shortage, especially in rural America. Such policies also threaten the care continuum of patients who rely on these providers for their medical care.”
American College of Physicians
“The executive order could deny entry or reentry to tens of thousands more persons, including medical students and physicians who are being trained in the United States and/or are delivering direct patient care. ... It also creates a precedent for barring entry of IMGs based on their religion and country of origin. ... Approximately 30% of ACP members are IMGs.”
American Society of Clinical Oncology
ASCO is deeply concerned about the potential impact of the recent executive order on cancer research, patient care, and international scientific collaboration.
Our more than 40,000 members in 148 countries lead the charge to conquer cancer in all its forms and in every nation. Tens of thousands of people from more than 100 countries participate in our scientific meetings to exchange advances and ideas to improve patient care. Millions of cancer survivors are alive today because of the progress made possible by scientific collaboration. Progress against this disease will falter if the close-knit global community of cancer care providers is divided by policies that bar members of certain nationalities from entering the United States to conduct research, care for people with cancer, or participate in scientific and medical conferences.
American Society of Hematology
We express our deep concern about the Administration’s executive order that has denied U.S. entry to people who bring unique expertise to the practice of medicine and the conduct of cancer and biomedical research. Our nation depends on the contributions of the greatest minds from around the world to maintain the high quality of our biomedical research enterprise and health care services.
The benefits of scientific collaborations are amplified by our diversity. Limiting the exchange of ideas, practices, and data across cultures has the potential to significantly retard scientific progress and adversely affect public health. Any loss of researchers and physicians will render the United States less competitive over time, and our traditionally strong research institutions and the patients they serve will be negatively affected.
We remain deeply concerned that restricting travel will prohibit participation in scientific meetings, where cutting-edge science and treatment methods are often first introduced. These in-person meetings and other global exchanges are vitally important because they provide unparalleled opportunities for collaborations and information-sharing. Such scientific and medical meetings are absolutely essential to the conquest of cancer and blood diseases.
(Statement issued on behalf of ASH, American Association for Cancer Research, Association of American Cancer Institutes, American Society for Radiation Oncology, The American Society for Pediatric Hematology/Oncology, and LUNGevity Foundation.)
The text of the executive order can be found on the White House website.
[email protected]
On Twitter @denisefulton
Organizations representing physicians and medical students have expressed their concern regarding President Trump’s executive order of Jan. 27 that curtails entry into the United States by travelers from seven Muslim-majority countries. The order also suspends for 120 days entry into the United States for all persons seeking refugee status, and it bars refugees from Syria indefinitely.
Following are direct excerpts from statements issued by medical organizations.
American Gastroenterological Association
Science and illness ignore borders and political divides. That is why AGA is concerned that the recent U.S. executive order on immigration could limit scientific exchange, delay patient care, and impair medical training.
AGA is committed to diversity, which we define as inclusive of race, ethnicity, and national origin. Diversity within training programs and laboratories in the United States built today’s practice of gastroenterology. Scientists from around the world publish in our journals, work in our laboratories, train in our programs, and present data at Digestive Disease Week.® This exchange leads to better patient care, and very sick patients travel to the U.S. from around the world for the best digestive health care.
In light of these concerns, AGA adds our support to a growing number of medical institutions urging the administration to consider the devastating impact of the executive order on the health of the nation that will result from turning away patients, health professionals, and researchers. The recent immigration policy is clearly detrimental to America’s leadership role in advancing health care, and to the standing of the United States within the international community.
American Academy of Family Physicians
“We are deeply concerned that steps your Administration has taken will have a chilling effect on our nation’s physician workforce, biomedical research, and global health. It is often America’s physicians who answer the call to assist people around the world when a public health crisis occurs. Imagine a world where physicians fail to answer the call of the needy because they fear they may not be able to return to their home and families in the United States.
Many family physicians are international medical graduates (IMG), who have completed all or part of their education and training in the United States. They are professionals who dedicate their careers to the service of their patients in communities large and small, urban and rural. In fact, 20% of our membership and over 25% of family medicine residents [comprise] IMGs. The AAFP applauds and supports wholly the contributions of these individual family physicians to their patients and communities and we celebrate their diversity.
We recognize that one of your primary responsibilities as President is to ensure the safety and security of the country and its citizens. This is, without question, a daunting responsibility. But we strongly urge that the methods of doing so be examined carefully, so that the many people who can add so much to our country through immigration have the opportunity to do so, and those who are doing so already are treated with the respect and dignity they deserve.”
American Academy of Pediatrics
“The executive orders signed today are harmful to immigrant children and families throughout our country. Many of the children who will be most affected are the victims of unspeakable violence and have been exposed to trauma. Children do not immigrate, they flee. They are coming to the United States seeking safe haven in our country and they need our compassion and assistance. Broad scale expansion of family detention only exacerbates their suffering ... The AAP is non-partisan and pro-children. We urge President Trump and his administration to ensure that children and families who are fleeing violence and adversity can continue to seek refuge in our country. Immigrant children and families are an integral part of our communities and our nation, and they deserve to be cared for, treated with compassion, and celebrated. Most of all, they deserve to be healthy and safe. Pediatricians stand with the immigrant families we care for and will continue to advocate that their needs are met and prioritized.”
American Association of Medical Colleges
“The United States is facing a serious shortage of physicians. IMGs play an important role in U.S. health care, representing roughly 25% of the workforce. Current immigration pathways – including student, exchange-visitor, and employment visas – provide a balanced solution that improves health care access across the country through programs like the National Interest Waiver and the Conrad 30 J-1 Visa Waiver. In the last decade, Conrad 30 alone has directed nearly 10,000 physicians into rural and urban underserved communities. Impeding these U.S. immigration pathways jeopardizes critical access to high-quality physician care for our nation’s most vulnerable populations.
Our ability to attract top talent from around the world also enriches the research laboratories at medical schools and teaching hospitals that are working toward cures and has helped position the United States as a global leader in medical research, strengthening our economy and bolstering the public’s health. Because disease knows no geographic boundaries, it is essential to ensure that we continue to foster, rather than impede, scientific cooperation with physicians and researchers of all nationalities, as we strive to keep our country healthy.”
American College of Cardiology
“The ability to share ideas and knowledge necessary to address [the global epidemic of cardiovascular disease] is imperative. Policies that impede this free-flow of ideas will have a detrimental impact on scientific discovery, as well as the lives of patients around the world. If we are to realize a future where cardiovascular disease is no longer the number one killer of men and women worldwide we must ensure that our system of scientific exchange allows for health care professionals to learn from each other regardless of their nationality.
Additionally, IMGs, naturalized citizens, and legal residents make up a significant portion of the health care workforce in hospitals and practices across the country. More than 25% of current practicing physicians are IMGs, with cardiology ranking among the top when broken down by medical specialty. Policies that bring the immigration status of those already here into question, while also limiting the ability of others to legally train in the United States going forward, will only serve to exacerbate the already existing cardiovascular workforce shortage, especially in rural America. Such policies also threaten the care continuum of patients who rely on these providers for their medical care.”
American College of Physicians
“The executive order could deny entry or reentry to tens of thousands more persons, including medical students and physicians who are being trained in the United States and/or are delivering direct patient care. ... It also creates a precedent for barring entry of IMGs based on their religion and country of origin. ... Approximately 30% of ACP members are IMGs.”
American Society of Clinical Oncology
ASCO is deeply concerned about the potential impact of the recent executive order on cancer research, patient care, and international scientific collaboration.
Our more than 40,000 members in 148 countries lead the charge to conquer cancer in all its forms and in every nation. Tens of thousands of people from more than 100 countries participate in our scientific meetings to exchange advances and ideas to improve patient care. Millions of cancer survivors are alive today because of the progress made possible by scientific collaboration. Progress against this disease will falter if the close-knit global community of cancer care providers is divided by policies that bar members of certain nationalities from entering the United States to conduct research, care for people with cancer, or participate in scientific and medical conferences.
American Society of Hematology
We express our deep concern about the Administration’s executive order that has denied U.S. entry to people who bring unique expertise to the practice of medicine and the conduct of cancer and biomedical research. Our nation depends on the contributions of the greatest minds from around the world to maintain the high quality of our biomedical research enterprise and health care services.
The benefits of scientific collaborations are amplified by our diversity. Limiting the exchange of ideas, practices, and data across cultures has the potential to significantly retard scientific progress and adversely affect public health. Any loss of researchers and physicians will render the United States less competitive over time, and our traditionally strong research institutions and the patients they serve will be negatively affected.
We remain deeply concerned that restricting travel will prohibit participation in scientific meetings, where cutting-edge science and treatment methods are often first introduced. These in-person meetings and other global exchanges are vitally important because they provide unparalleled opportunities for collaborations and information-sharing. Such scientific and medical meetings are absolutely essential to the conquest of cancer and blood diseases.
(Statement issued on behalf of ASH, American Association for Cancer Research, Association of American Cancer Institutes, American Society for Radiation Oncology, The American Society for Pediatric Hematology/Oncology, and LUNGevity Foundation.)
The text of the executive order can be found on the White House website.
[email protected]
On Twitter @denisefulton
Medical organizations respond to Trump’s immigration order
Organizations representing physicians and medical students have expressed their concern regarding President Trump’s executive order of Jan. 27 that curtails entry into the United States by travelers from seven Muslim-majority countries. The order also suspends for 120 days entry into the United States for all persons seeking refugee status, and it bars refugees from Syria indefinitely.
Following are direct excerpts from statements issued by medical organizations.
American Academy of Family Physicians
“We are deeply concerned that steps your Administration has taken will have a chilling effect on our nation’s physician workforce, biomedical research, and global health. It is often America’s physicians who answer the call to assist people around the world when a public health crisis occurs. Imagine a world where physicians fail to answer the call of the needy because they fear they may not be able to return to their home and families in the United States.
Many family physicians are international medical graduates (IMG), who have completed all or part of their education and training in the United States. They are professionals who dedicate their careers to the service of their patients in communities large and small, urban and rural. In fact, 20% of our membership and over 25% of family medicine residents [comprise] IMGs. The AAFP applauds and supports wholly the contributions of these individual family physicians to their patients and communities and we celebrate their diversity.
We recognize that one of your primary responsibilities as President is to ensure the safety and security of the country and its citizens. This is, without question, a daunting responsibility. But we strongly urge that the methods of doing so be examined carefully, so that the many people who can add so much to our country through immigration have the opportunity to do so, and those who are doing so already are treated with the respect and dignity they deserve.”
American Academy of Pediatrics
“The executive orders signed today are harmful to immigrant children and families throughout our country. Many of the children who will be most affected are the victims of unspeakable violence and have been exposed to trauma. Children do not immigrate, they flee. They are coming to the United States seeking safe haven in our country and they need our compassion and assistance. Broad scale expansion of family detention only exacerbates their suffering ... The AAP is non-partisan and pro-children. We urge President Trump and his administration to ensure that children and families who are fleeing violence and adversity can continue to seek refuge in our country. Immigrant children and families are an integral part of our communities and our nation, and they deserve to be cared for, treated with compassion, and celebrated. Most of all, they deserve to be healthy and safe. Pediatricians stand with the immigrant families we care for and will continue to advocate that their needs are met and prioritized.”
American Association of Medical Colleges
“The United States is facing a serious shortage of physicians. IMGs play an important role in U.S. health care, representing roughly 25% of the workforce. Current immigration pathways – including student, exchange-visitor, and employment visas – provide a balanced solution that improves health care access across the country through programs like the National Interest Waiver and the Conrad 30 J-1 Visa Waiver. In the last decade, Conrad 30 alone has directed nearly 10,000 physicians into rural and urban underserved communities. Impeding these U.S. immigration pathways jeopardizes critical access to high-quality physician care for our nation’s most vulnerable populations.
Our ability to attract top talent from around the world also enriches the research laboratories at medical schools and teaching hospitals that are working toward cures and has helped position the United States as a global leader in medical research, strengthening our economy and bolstering the public’s health. Because disease knows no geographic boundaries, it is essential to ensure that we continue to foster, rather than impede, scientific cooperation with physicians and researchers of all nationalities, as we strive to keep our country healthy.”
American College of Cardiology
“The ability to share ideas and knowledge necessary to address [the global epidemic of cardiovascular disease] is imperative. Policies that impede this free-flow of ideas will have a detrimental impact on scientific discovery, as well as the lives of patients around the world. If we are to realize a future where cardiovascular disease is no longer the number one killer of men and women worldwide we must ensure that our system of scientific exchange allows for health care professionals to learn from each other regardless of their nationality.
Additionally, IMGs, naturalized citizens, and legal residents make up a significant portion of the health care workforce in hospitals and practices across the country. More than 25% of current practicing physicians are IMGs, with cardiology ranking among the top when broken down by medical specialty. Policies that bring the immigration status of those already here into question, while also limiting the ability of others to legally train in the United States going forward, will only serve to exacerbate the already existing cardiovascular workforce shortage, especially in rural America. Such policies also threaten the care continuum of patients who rely on these providers for their medical care.”
American College of Physicians
“The executive order could deny entry or reentry to tens of thousands more persons, including medical students and physicians who are being trained in the United States and/or are delivering direct patient care. ... It also creates a precedent for barring entry of IMGs based on their religion and country of origin. ... Approximately 30% of ACP members are IMGs.”
American Gastroenterological Association
Science and illness ignore borders and political divides. That is why AGA is concerned that the recent U.S. executive order on immigration could limit scientific exchange, delay patient care and impair medical training.
AGA is committed to diversity, which we define as inclusive of race, ethnicity and national origin. Diversity within training programs and laboratories in the United States built today’s practice of gastroenterology. Scientists from around the world publish in our journals, work in our laboratories, train in our programs and present data at Digestive Disease Week. This exchange leads to better patient care, and very sick patients travel to the United States from around the world for the best digestive health care.
AGA adds our support to a growing number of medical institutions urging the administration to consider the devastating impact of the executive order on the health of the nation that will result from turning away patients, health professionals, and researchers. The recent immigration policy is clearly detrimental to America’s leadership role in advancing health care, and to the standing of the United States within the international community.
American Society of Clinical Oncology
ASCO is deeply concerned about the potential impact of the recent executive order on cancer research, patient care, and international scientific collaboration.
Our more than 40,000 members in 148 countries lead the charge to conquer cancer in all its forms and in every nation. Tens of thousands of people from more than 100 countries participate in our scientific meetings to exchange advances and ideas to improve patient care. Millions of cancer survivors are alive today because of the progress made possible by scientific collaboration. Progress against this disease will falter if the close-knit global community of cancer care providers is divided by policies that bar members of certain nationalities from entering the United States to conduct research, care for people with cancer, or participate in scientific and medical conferences.
American Society of Hematology
We express our deep concern about the Administration’s executive order that has denied U.S. entry to people who bring unique expertise to the practice of medicine and the conduct of cancer and biomedical research. Our nation depends on the contributions of the greatest minds from around the world to maintain the high quality of our biomedical research enterprise and health care services.
The benefits of scientific collaborations are amplified by our diversity. Limiting the exchange of ideas, practices, and data across cultures has the potential to significantly retard scientific progress and adversely affect public health. Any loss of researchers and physicians will render the United States less competitive over time, and our traditionally strong research institutions and the patients they serve will be negatively affected.
We remain deeply concerned that restricting travel will prohibit participation in scientific meetings, where cutting-edge science and treatment methods are often first introduced. These in-person meetings and other global exchanges are vitally important because they provide unparalleled opportunities for collaborations and information-sharing. Such scientific and medical meetings are absolutely essential to the conquest of cancer and blood diseases.
(Statement issued on behalf of ASH, American Association for Cancer Research, Association of American Cancer Institutes, American Society for Radiation Oncology, The American Society for Pediatric Hematology/Oncology, and LUNGevity Foundation.)
The text of the executive order can be found on the White House website.
Updated 2/2/17 to include the position of the American Gastroenterological Association.
[email protected]
On Twitter @denisefulton
Organizations representing physicians and medical students have expressed their concern regarding President Trump’s executive order of Jan. 27 that curtails entry into the United States by travelers from seven Muslim-majority countries. The order also suspends for 120 days entry into the United States for all persons seeking refugee status, and it bars refugees from Syria indefinitely.
Following are direct excerpts from statements issued by medical organizations.
American Academy of Family Physicians
“We are deeply concerned that steps your Administration has taken will have a chilling effect on our nation’s physician workforce, biomedical research, and global health. It is often America’s physicians who answer the call to assist people around the world when a public health crisis occurs. Imagine a world where physicians fail to answer the call of the needy because they fear they may not be able to return to their home and families in the United States.
Many family physicians are international medical graduates (IMG), who have completed all or part of their education and training in the United States. They are professionals who dedicate their careers to the service of their patients in communities large and small, urban and rural. In fact, 20% of our membership and over 25% of family medicine residents [comprise] IMGs. The AAFP applauds and supports wholly the contributions of these individual family physicians to their patients and communities and we celebrate their diversity.
We recognize that one of your primary responsibilities as President is to ensure the safety and security of the country and its citizens. This is, without question, a daunting responsibility. But we strongly urge that the methods of doing so be examined carefully, so that the many people who can add so much to our country through immigration have the opportunity to do so, and those who are doing so already are treated with the respect and dignity they deserve.”
American Academy of Pediatrics
“The executive orders signed today are harmful to immigrant children and families throughout our country. Many of the children who will be most affected are the victims of unspeakable violence and have been exposed to trauma. Children do not immigrate, they flee. They are coming to the United States seeking safe haven in our country and they need our compassion and assistance. Broad scale expansion of family detention only exacerbates their suffering ... The AAP is non-partisan and pro-children. We urge President Trump and his administration to ensure that children and families who are fleeing violence and adversity can continue to seek refuge in our country. Immigrant children and families are an integral part of our communities and our nation, and they deserve to be cared for, treated with compassion, and celebrated. Most of all, they deserve to be healthy and safe. Pediatricians stand with the immigrant families we care for and will continue to advocate that their needs are met and prioritized.”
American Association of Medical Colleges
“The United States is facing a serious shortage of physicians. IMGs play an important role in U.S. health care, representing roughly 25% of the workforce. Current immigration pathways – including student, exchange-visitor, and employment visas – provide a balanced solution that improves health care access across the country through programs like the National Interest Waiver and the Conrad 30 J-1 Visa Waiver. In the last decade, Conrad 30 alone has directed nearly 10,000 physicians into rural and urban underserved communities. Impeding these U.S. immigration pathways jeopardizes critical access to high-quality physician care for our nation’s most vulnerable populations.
Our ability to attract top talent from around the world also enriches the research laboratories at medical schools and teaching hospitals that are working toward cures and has helped position the United States as a global leader in medical research, strengthening our economy and bolstering the public’s health. Because disease knows no geographic boundaries, it is essential to ensure that we continue to foster, rather than impede, scientific cooperation with physicians and researchers of all nationalities, as we strive to keep our country healthy.”
American College of Cardiology
“The ability to share ideas and knowledge necessary to address [the global epidemic of cardiovascular disease] is imperative. Policies that impede this free-flow of ideas will have a detrimental impact on scientific discovery, as well as the lives of patients around the world. If we are to realize a future where cardiovascular disease is no longer the number one killer of men and women worldwide we must ensure that our system of scientific exchange allows for health care professionals to learn from each other regardless of their nationality.
Additionally, IMGs, naturalized citizens, and legal residents make up a significant portion of the health care workforce in hospitals and practices across the country. More than 25% of current practicing physicians are IMGs, with cardiology ranking among the top when broken down by medical specialty. Policies that bring the immigration status of those already here into question, while also limiting the ability of others to legally train in the United States going forward, will only serve to exacerbate the already existing cardiovascular workforce shortage, especially in rural America. Such policies also threaten the care continuum of patients who rely on these providers for their medical care.”
American College of Physicians
“The executive order could deny entry or reentry to tens of thousands more persons, including medical students and physicians who are being trained in the United States and/or are delivering direct patient care. ... It also creates a precedent for barring entry of IMGs based on their religion and country of origin. ... Approximately 30% of ACP members are IMGs.”
American Gastroenterological Association
Science and illness ignore borders and political divides. That is why AGA is concerned that the recent U.S. executive order on immigration could limit scientific exchange, delay patient care and impair medical training.
AGA is committed to diversity, which we define as inclusive of race, ethnicity and national origin. Diversity within training programs and laboratories in the United States built today’s practice of gastroenterology. Scientists from around the world publish in our journals, work in our laboratories, train in our programs and present data at Digestive Disease Week. This exchange leads to better patient care, and very sick patients travel to the United States from around the world for the best digestive health care.
AGA adds our support to a growing number of medical institutions urging the administration to consider the devastating impact of the executive order on the health of the nation that will result from turning away patients, health professionals, and researchers. The recent immigration policy is clearly detrimental to America’s leadership role in advancing health care, and to the standing of the United States within the international community.
American Society of Clinical Oncology
ASCO is deeply concerned about the potential impact of the recent executive order on cancer research, patient care, and international scientific collaboration.
Our more than 40,000 members in 148 countries lead the charge to conquer cancer in all its forms and in every nation. Tens of thousands of people from more than 100 countries participate in our scientific meetings to exchange advances and ideas to improve patient care. Millions of cancer survivors are alive today because of the progress made possible by scientific collaboration. Progress against this disease will falter if the close-knit global community of cancer care providers is divided by policies that bar members of certain nationalities from entering the United States to conduct research, care for people with cancer, or participate in scientific and medical conferences.
American Society of Hematology
We express our deep concern about the Administration’s executive order that has denied U.S. entry to people who bring unique expertise to the practice of medicine and the conduct of cancer and biomedical research. Our nation depends on the contributions of the greatest minds from around the world to maintain the high quality of our biomedical research enterprise and health care services.
The benefits of scientific collaborations are amplified by our diversity. Limiting the exchange of ideas, practices, and data across cultures has the potential to significantly retard scientific progress and adversely affect public health. Any loss of researchers and physicians will render the United States less competitive over time, and our traditionally strong research institutions and the patients they serve will be negatively affected.
We remain deeply concerned that restricting travel will prohibit participation in scientific meetings, where cutting-edge science and treatment methods are often first introduced. These in-person meetings and other global exchanges are vitally important because they provide unparalleled opportunities for collaborations and information-sharing. Such scientific and medical meetings are absolutely essential to the conquest of cancer and blood diseases.
(Statement issued on behalf of ASH, American Association for Cancer Research, Association of American Cancer Institutes, American Society for Radiation Oncology, The American Society for Pediatric Hematology/Oncology, and LUNGevity Foundation.)
The text of the executive order can be found on the White House website.
Updated 2/2/17 to include the position of the American Gastroenterological Association.
[email protected]
On Twitter @denisefulton
Organizations representing physicians and medical students have expressed their concern regarding President Trump’s executive order of Jan. 27 that curtails entry into the United States by travelers from seven Muslim-majority countries. The order also suspends for 120 days entry into the United States for all persons seeking refugee status, and it bars refugees from Syria indefinitely.
Following are direct excerpts from statements issued by medical organizations.
American Academy of Family Physicians
“We are deeply concerned that steps your Administration has taken will have a chilling effect on our nation’s physician workforce, biomedical research, and global health. It is often America’s physicians who answer the call to assist people around the world when a public health crisis occurs. Imagine a world where physicians fail to answer the call of the needy because they fear they may not be able to return to their home and families in the United States.
Many family physicians are international medical graduates (IMG), who have completed all or part of their education and training in the United States. They are professionals who dedicate their careers to the service of their patients in communities large and small, urban and rural. In fact, 20% of our membership and over 25% of family medicine residents [comprise] IMGs. The AAFP applauds and supports wholly the contributions of these individual family physicians to their patients and communities and we celebrate their diversity.
We recognize that one of your primary responsibilities as President is to ensure the safety and security of the country and its citizens. This is, without question, a daunting responsibility. But we strongly urge that the methods of doing so be examined carefully, so that the many people who can add so much to our country through immigration have the opportunity to do so, and those who are doing so already are treated with the respect and dignity they deserve.”
American Academy of Pediatrics
“The executive orders signed today are harmful to immigrant children and families throughout our country. Many of the children who will be most affected are the victims of unspeakable violence and have been exposed to trauma. Children do not immigrate, they flee. They are coming to the United States seeking safe haven in our country and they need our compassion and assistance. Broad scale expansion of family detention only exacerbates their suffering ... The AAP is non-partisan and pro-children. We urge President Trump and his administration to ensure that children and families who are fleeing violence and adversity can continue to seek refuge in our country. Immigrant children and families are an integral part of our communities and our nation, and they deserve to be cared for, treated with compassion, and celebrated. Most of all, they deserve to be healthy and safe. Pediatricians stand with the immigrant families we care for and will continue to advocate that their needs are met and prioritized.”
American Association of Medical Colleges
“The United States is facing a serious shortage of physicians. IMGs play an important role in U.S. health care, representing roughly 25% of the workforce. Current immigration pathways – including student, exchange-visitor, and employment visas – provide a balanced solution that improves health care access across the country through programs like the National Interest Waiver and the Conrad 30 J-1 Visa Waiver. In the last decade, Conrad 30 alone has directed nearly 10,000 physicians into rural and urban underserved communities. Impeding these U.S. immigration pathways jeopardizes critical access to high-quality physician care for our nation’s most vulnerable populations.
Our ability to attract top talent from around the world also enriches the research laboratories at medical schools and teaching hospitals that are working toward cures and has helped position the United States as a global leader in medical research, strengthening our economy and bolstering the public’s health. Because disease knows no geographic boundaries, it is essential to ensure that we continue to foster, rather than impede, scientific cooperation with physicians and researchers of all nationalities, as we strive to keep our country healthy.”
American College of Cardiology
“The ability to share ideas and knowledge necessary to address [the global epidemic of cardiovascular disease] is imperative. Policies that impede this free-flow of ideas will have a detrimental impact on scientific discovery, as well as the lives of patients around the world. If we are to realize a future where cardiovascular disease is no longer the number one killer of men and women worldwide we must ensure that our system of scientific exchange allows for health care professionals to learn from each other regardless of their nationality.
Additionally, IMGs, naturalized citizens, and legal residents make up a significant portion of the health care workforce in hospitals and practices across the country. More than 25% of current practicing physicians are IMGs, with cardiology ranking among the top when broken down by medical specialty. Policies that bring the immigration status of those already here into question, while also limiting the ability of others to legally train in the United States going forward, will only serve to exacerbate the already existing cardiovascular workforce shortage, especially in rural America. Such policies also threaten the care continuum of patients who rely on these providers for their medical care.”
American College of Physicians
“The executive order could deny entry or reentry to tens of thousands more persons, including medical students and physicians who are being trained in the United States and/or are delivering direct patient care. ... It also creates a precedent for barring entry of IMGs based on their religion and country of origin. ... Approximately 30% of ACP members are IMGs.”
American Gastroenterological Association
Science and illness ignore borders and political divides. That is why AGA is concerned that the recent U.S. executive order on immigration could limit scientific exchange, delay patient care and impair medical training.
AGA is committed to diversity, which we define as inclusive of race, ethnicity and national origin. Diversity within training programs and laboratories in the United States built today’s practice of gastroenterology. Scientists from around the world publish in our journals, work in our laboratories, train in our programs and present data at Digestive Disease Week. This exchange leads to better patient care, and very sick patients travel to the United States from around the world for the best digestive health care.
AGA adds our support to a growing number of medical institutions urging the administration to consider the devastating impact of the executive order on the health of the nation that will result from turning away patients, health professionals, and researchers. The recent immigration policy is clearly detrimental to America’s leadership role in advancing health care, and to the standing of the United States within the international community.
American Society of Clinical Oncology
ASCO is deeply concerned about the potential impact of the recent executive order on cancer research, patient care, and international scientific collaboration.
Our more than 40,000 members in 148 countries lead the charge to conquer cancer in all its forms and in every nation. Tens of thousands of people from more than 100 countries participate in our scientific meetings to exchange advances and ideas to improve patient care. Millions of cancer survivors are alive today because of the progress made possible by scientific collaboration. Progress against this disease will falter if the close-knit global community of cancer care providers is divided by policies that bar members of certain nationalities from entering the United States to conduct research, care for people with cancer, or participate in scientific and medical conferences.
American Society of Hematology
We express our deep concern about the Administration’s executive order that has denied U.S. entry to people who bring unique expertise to the practice of medicine and the conduct of cancer and biomedical research. Our nation depends on the contributions of the greatest minds from around the world to maintain the high quality of our biomedical research enterprise and health care services.
The benefits of scientific collaborations are amplified by our diversity. Limiting the exchange of ideas, practices, and data across cultures has the potential to significantly retard scientific progress and adversely affect public health. Any loss of researchers and physicians will render the United States less competitive over time, and our traditionally strong research institutions and the patients they serve will be negatively affected.
We remain deeply concerned that restricting travel will prohibit participation in scientific meetings, where cutting-edge science and treatment methods are often first introduced. These in-person meetings and other global exchanges are vitally important because they provide unparalleled opportunities for collaborations and information-sharing. Such scientific and medical meetings are absolutely essential to the conquest of cancer and blood diseases.
(Statement issued on behalf of ASH, American Association for Cancer Research, Association of American Cancer Institutes, American Society for Radiation Oncology, The American Society for Pediatric Hematology/Oncology, and LUNGevity Foundation.)
The text of the executive order can be found on the White House website.
Updated 2/2/17 to include the position of the American Gastroenterological Association.
[email protected]
On Twitter @denisefulton
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Dr. Jim Smart is from Smart University.
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Dr. Jim Smart is from Smart University.
Seamlessly productivate enterprise innovation with leveraged technology. Assertively brand business mindshare with tactical users. Proactively integrate leveraged growth strategies and front-end systems. Conveniently build orthogonal process improvements rather than innovative materials. Enthusiastically restore maintainable resources vis-a-vis distinctive partnerships.
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Competently exploit intuitive bandwidth rather than team driven e-markets. Objectively e-enable functional technologies after cross-media benefits. Synergistically network reliable niche markets without performance based products. Synergistically initiate open-source metrics without corporate niche markets. Dramatically disseminate performance based human capital after magnetic opportunities.
Efficiently deliver granular vortals through turnkey products. Proactively productivate principle-centered testing procedures rather than compelling web-readiness. Progressively pontificate collaborative e-business vis-a-vis extensive methodologies. Compellingly empower robust deliverables via timely process improvements. Conveniently seize client-focused resources with exceptional vortals.
Distinctively benchmark sticky innovation vis-a-vis long-term high-impact architectures. Interactively impact vertical technologies before dynamic synergy. Authoritatively engage technically sound customer service without synergistic architectures. Quickly envisioneer 2.0 imperatives via cooperative e-tailers. Continually build empowered schemas via maintainable portals.
Phosfluorescently negotiate customer directed metrics before covalent results. Phosfluorescently revolutionize innovative outsourcing via resource sucking mindshare. Enthusiastically implement clicks-and-mortar total linkage and robust metrics. Dramatically deploy enterprise platforms after multimedia based schemas. Distinctively syndicate wireless meta-services vis-a-vis covalent action items.
Quickly productize one-to-one systems after bricks-and-clicks meta-services. Completely transition bleeding-edge vortals before virtual vortals. Progressively extend enabled value and B2C technology. Conveniently maintain inexpensive schemas with adaptive products. Appropriately generate market-driven communities via tactical meta-services.
Appropriately network high-payoff models and cross-media intellectual capital. Competently parallel task state of the art e-business via compelling interfaces. Proactively provide access to enterprise-wide total linkage without proactive technologies. Seamlessly enhance cutting-edge markets without world-class mindshare. Authoritatively maximize interoperable e-tailers and future-proof solutions.
Progressively grow mission-critical innovation whereas B2C web-readiness. Progressively harness dynamic experiences vis-a-vis functionalized ideas. Synergistically reinvent tactical functionalities after user-centric meta-services. Assertively exploit robust intellectual capital through granular products. Holisticly underwhelm bricks-and-clicks synergy vis-a-vis leveraged meta-services.
Rapidiously benchmark one-to-one architectures before just in time scenarios. Assertively develop professional web-readiness with goal-oriented process improvements. Competently productivate prospective convergence through strategic resources. Phosfluorescently matrix flexible metrics through alternative materials. Holisticly procrastinate B2B benefits without cost effective alignments.
Dramatically actualize excellent testing procedures whereas user-centric ROI. Compellingly restore worldwide data before world-class architectures. Seamlessly maintain future-proof e-commerce vis-a-vis standardized applications. Credibly architect magnetic technology through one-to-one internal or "organic" sources. Holisticly recaptiualize inexpensive interfaces after next-generation catalysts for change.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
Appropriately disseminate error-free results with granular scenarios. Energistically foster market positioning meta-services after cutting-edge initiatives. Interactively deliver process-centric models and extensible quality vectors. Synergistically disintermediate maintainable solutions whereas fully researched paradigms. Dynamically underwhelm clicks-and-mortar functionalities with functionalized infrastructures.
Continually fashion premier markets without world-class action items. Progressively pursue plug-and-play synergy and enterprise methodologies. Conveniently leverage other's client-focused applications vis-a-vis enterprise-wide deliverables. Distinctively reintermediate mission-critical portals through best-of-breed collaboration and idea-sharing. Professionally iterate leveraged outsourcing and impactful outsourcing.
Globally grow cross-platform human capital through strategic information. Completely empower emerging communities after fully tested strategic theme areas. Compellingly impact worldwide experiences and bleeding-edge niches. Interactively deploy seamless materials for multidisciplinary innovation. Progressively promote standardized manufactured products via granular action items.
Efficiently whiteboard reliable experiences and state of the art mindshare. Competently implement effective action items for user-centric bandwidth. Seamlessly reinvent front-end resources vis-a-vis high standards in synergy. Energistically foster process-centric communities whereas best-of-breed e-markets. Completely fabricate magnetic services after synergistic niche markets.
Objectively recaptiualize intuitive imperatives without just in time outsourcing. Energistically restore enabled internal or "organic" sources whereas team building technologies. Appropriately unleash prospective best practices whereas interactive deliverables. Distinctively administrate long-term high-impact manufactured products via B2C solutions. Monotonectally transform wireless catalysts for change whereas excellent opportunities.
Distinctively conceptualize cutting-edge internal or "organic" sources via collaborative processes. Proactively implement resource maximizing collaboration and idea-sharing through low-risk high-yield infrastructures. Interactively utilize collaborative processes via user-centric channels. Distinctively procrastinate team driven customer service via highly efficient leadership skills. Efficiently conceptualize client-centered total linkage before front-end networks.
Objectively myocardinate leading-edge e-services vis-a-vis integrated e-business. Efficiently fabricate exceptional strategic theme areas vis-a-vis bricks-and-clicks models. Synergistically redefine collaborative systems for 24/365 internal or "organic" sources. Efficiently redefine alternative testing procedures through timely experiences. Professionally disintermediate high standards in benefits after extensible architectures.
Objectively envisioneer corporate value without reliable e-markets. Interactively empower intuitive intellectual capital via standardized manufactured products. Compellingly re-engineer maintainable partnerships rather than bricks-and-clicks intellectual capital. Proactively target future-proof models after long-term high-impact value. Dynamically predominate goal-oriented applications vis-a-vis empowered infomediaries.
Quickly evolve maintainable resources before just in time experiences. Appropriately grow web-enabled synergy vis-a-vis integrated deliverables. Energistically foster 2.0 e-commerce for resource sucking leadership. Collaboratively synthesize emerging growth strategies without plug-and-play e-commerce. Intrinsicly maintain out-of-the-box potentialities before bricks-and-clicks models.
Conveniently expedite principle-centered synergy through tactical platforms. Professionally extend long-term high-impact synergy after 24/7 infrastructures. Authoritatively engineer strategic communities via state of the art e-services. Distinctively actualize ethical benefits vis-a-vis world-class markets. Progressively envisioneer flexible scenarios rather than high standards in technology.
Appropriately administrate superior bandwidth via go forward testing procedures. Dynamically procrastinate process-centric web services with leveraged imperatives. Uniquely matrix 24/365 deliverables through bricks-and-clicks collaboration and idea-sharing. Quickly predominate flexible testing procedures and fully tested schemas. Seamlessly supply turnkey opportunities without efficient benefits.
Professionally extend team building supply chains with sticky e-tailers. Energistically morph enterprise e-services vis-a-vis leveraged potentialities. Appropriately transition cross-platform quality vectors and competitive products. Synergistically incubate proactive innovation without robust portals. Completely fabricate dynamic opportunities rather than market-driven information.
Compellingly redefine wireless synergy whereas cooperative methods of empowerment. Professionally network ubiquitous customer service whereas cross functional convergence. Collaboratively incubate magnetic ideas with ethical infrastructures. Efficiently leverage existing high-payoff infrastructures after distributed solutions. Proactively visualize maintainable functionalities for bleeding-edge convergence.
Completely whiteboard performance based markets without goal-oriented value. Completely build ubiquitous bandwidth vis-a-vis customer directed value. Globally brand cross-unit bandwidth with real-time processes. Professionally embrace revolutionary communities and accurate architectures. Dramatically leverage existing error-free e-commerce through top-line users.
Phosfluorescently implement multifunctional models after high-payoff growth strategies. Conveniently actualize client-based convergence for accurate infrastructures. Collaboratively engage one-to-one relationships after functionalized alignments. Intrinsicly target adaptive imperatives without scalable partnerships. Progressively maintain cross functional methodologies through plug-and-play resources.
Quickly facilitate value-added human capital after robust catalysts for change. Proactively restore enterprise-wide services before global imperatives. Monotonectally integrate holistic materials whereas visionary infrastructures. Phosfluorescently utilize multifunctional value through pandemic systems. Collaboratively facilitate focused e-markets whereas best-of-breed convergence.
Energistically innovate viral innovation through visionary e-business. Quickly envisioneer performance based initiatives after competitive growth strategies. Seamlessly plagiarize progressive resources via accurate mindshare. Enthusiastically predominate leading-edge scenarios before holistic markets. Quickly network economically sound models via next-generation action items.
Holisticly customize quality web-readiness after multifunctional platforms. Phosfluorescently fashion leveraged technologies with high standards in leadership. Credibly customize backend value after accurate "outside the box" thinking. Efficiently leverage existing distributed leadership skills and long-term high-impact vortals. Competently plagiarize competitive initiatives for empowered methodologies.
Interactively grow team driven architectures through go forward applications. Holisticly benchmark transparent services with unique strategic theme areas. Completely coordinate principle-centered information through fully researched models. Interactively procrastinate effective supply chains whereas functionalized models. Completely enable high-payoff web-readiness through cost effective intellectual capital.
Uniquely deliver equity invested content after low-risk high-yield portals. Dynamically empower timely e-markets whereas fully researched best practices. Authoritatively plagiarize fully researched e-services without progressive potentialities. Uniquely evisculate highly efficient testing procedures through prospective e-markets. Progressively communicate proactive supply chains before open-source supply chains.
Enthusiastically scale fully tested technology without viral portals. Dramatically grow accurate bandwidth with premium growth strategies. Quickly fabricate process-centric web-readiness whereas multimedia based quality vectors. Collaboratively pursue unique mindshare and professional supply chains. Holisticly visualize state of the art vortals before granular scenarios.
Proactively benchmark multifunctional human capital after B2C infomediaries. Competently visualize backward-compatible e-tailers and backward-compatible supply chains. Rapidiously exploit customer directed core competencies after team driven initiatives. Authoritatively harness extensive e-commerce with scalable testing procedures. Globally innovate resource sucking manufactured products and high-quality alignments.
Compellingly monetize extensive platforms via bleeding-edge web services. Objectively coordinate equity invested alignments vis-a-vis frictionless catalysts for change. Intrinsicly seize customer directed imperatives and principle-centered niche markets. Credibly simplify progressive applications through reliable value. Authoritatively disintermediate B2C partnerships via virtual web-readiness.
Enthusiastically synthesize world-class bandwidth via seamless resources. Seamlessly disseminate 2.0 experiences after technically sound imperatives. Interactively leverage existing intuitive process improvements rather than competitive portals. Seamlessly engage granular ideas whereas plug-and-play benefits. Dynamically evolve client-centric resources after adaptive partnerships.
Authoritatively utilize worldwide innovation for efficient ROI. Objectively empower extensive potentialities via viral vortals. Rapidiously transform end-to-end vortals whereas B2B processes. Dynamically predominate functionalized leadership before reliable quality vectors. Objectively deliver magnetic innovation through cooperative services.
Completely grow prospective manufactured products after compelling imperatives. Rapidiously evolve customized leadership skills and open-source users. Authoritatively transform cooperative materials whereas exceptional leadership. Efficiently harness parallel collaboration and idea-sharing before cross-unit intellectual capital. Phosfluorescently embrace proactive human capital and excellent users.
Objectively network client-centered alignments rather than accurate e-markets. Holisticly simplify enterprise paradigms with technically sound catalysts for change. Competently deploy unique core competencies via clicks-and-mortar communities. Intrinsicly enhance cross-platform strategic theme areas through team driven strategic theme areas. Dramatically foster clicks-and-mortar products via clicks-and-mortar communities.
Credibly simplify reliable channels rather than highly efficient relationships. Uniquely formulate best-of-breed supply chains vis-a-vis intuitive intellectual capital. Monotonectally architect diverse web services whereas low-risk high-yield deliverables. Uniquely engage cost effective markets before B2B quality vectors. Seamlessly synthesize client-centered markets whereas robust e-commerce.
Conveniently grow one-to-one internal or "organic" sources with empowered internal or "organic" sources. Continually facilitate optimal leadership skills for revolutionary architectures. Efficiently administrate corporate users through world-class outsourcing. Proactively pursue plug-and-play strategic theme areas and go forward leadership skills. Dramatically brand impactful ROI after one-to-one interfaces.
Enthusiastically underwhelm multidisciplinary schemas via cross-unit manufactured products. Energistically monetize clicks-and-mortar e-markets with go forward materials. Seamlessly pursue viral customer service for business technology. Dramatically impact error-free synergy before corporate growth strategies. Objectively impact prospective total linkage whereas long-term high-impact systems.
Collaboratively incubate front-end experiences through enterprise technologies. Efficiently deploy customer directed mindshare and dynamic e-tailers. Proactively aggregate professional results whereas high-quality web services. Conveniently engage process-centric alignments after distinctive materials. Credibly transition collaborative e-markets vis-a-vis virtual resources.
Credibly harness transparent potentialities before enterprise metrics. Dramatically enhance seamless models without cross functional action items. Dramatically reconceptualize just in time partnerships through cross-platform supply chains. Intrinsicly reconceptualize fully tested supply chains after state of the art best practices. Quickly embrace distributed alignments through enterprise schemas.
Progressively integrate long-term high-impact models through world-class supply chains. Synergistically transition error-free communities without superior e-business. Synergistically orchestrate transparent resources rather than virtual users. Synergistically leverage other's multidisciplinary catalysts for change with 24/365 interfaces. Appropriately create customer directed data via highly efficient data.
Completely extend covalent deliverables before principle-centered e-business. Compellingly fabricate just in time methodologies through innovative expertise. Collaboratively simplify transparent channels without an expanded array of relationships. Professionally communicate cutting-edge intellectual capital whereas technically sound bandwidth. Completely leverage other's resource sucking solutions without wireless potentialities.
Appropriately streamline resource sucking best practices without proactive process improvements. Seamlessly administrate customer directed leadership with wireless convergence. Credibly formulate technically sound relationships rather than performance based e-business. Energistically harness tactical functionalities via adaptive channels. Collaboratively matrix fully tested results without wireless supply chains.
Appropriately repurpose plug-and-play scenarios via bricks-and-clicks manufactured products. Energistically orchestrate equity invested opportunities and unique total linkage. Rapidiously deploy installed base markets through unique scenarios. Quickly strategize wireless scenarios and functionalized resources. Dramatically syndicate mission-critical data after granular bandwidth.
Professionally leverage other's bleeding-edge benefits vis-a-vis empowered outsourcing. Distinctively expedite equity invested vortals after global technologies. Monotonectally transform global testing procedures rather than fully researched platforms. Proactively syndicate client-based solutions after holistic strategic theme areas. Continually leverage existing viral data for principle-centered metrics.
Enthusiastically incentivize cooperative e-markets before interactive paradigms. Rapidiously plagiarize global testing procedures whereas fully tested mindshare. Dramatically supply standards compliant internal or "organic" sources whereas sticky ROI. Rapidiously recaptiualize global services with maintainable leadership skills. Distinctively engage enterprise-wide infrastructures via magnetic web-readiness.
Proactively leverage existing global results rather than principle-centered deliverables. Distinctively plagiarize granular materials with dynamic ideas. Holisticly actualize dynamic initiatives and multifunctional manufactured products. Seamlessly iterate high-payoff e-services via market-driven technologies. Compellingly mesh accurate ROI before team driven models.
Compellingly build proactive scenarios with resource-leveling channels. Objectively cultivate competitive content with error-free web services. Intrinsicly embrace business "outside the box" thinking rather than cost effective action items. Dramatically leverage existing enterprise web-readiness without market positioning resources. Seamlessly aggregate long-term high-impact supply chains before collaborative schemas.
Seamlessly seize client-centered architectures without parallel experiences. Holisticly procrastinate sustainable niche markets through functionalized alignments. Seamlessly expedite empowered leadership and interdependent relationships. Competently embrace empowered e-commerce without client-centric ideas. Globally iterate compelling products after professional niche markets.
Progressively optimize premier markets whereas pandemic channels. Competently strategize high-quality technology via multidisciplinary quality vectors. Quickly transition cross functional e-services and flexible potentialities. Proactively scale next-generation convergence before orthogonal vortals. Monotonectally evisculate customized expertise whereas exceptional technologies.
Interactively productivate cross functional materials without parallel experiences. Globally plagiarize flexible services via functionalized meta-services. Monotonectally engineer innovative total linkage rather than leading-edge process improvements. Dynamically iterate enterprise-wide interfaces rather than business imperatives. Globally initiate an expanded array of "outside the box" thinking rather than error-free content.
Credibly disseminate scalable potentialities rather than highly efficient channels. Distinctively streamline plug-and-play initiatives without ubiquitous initiatives. Holisticly leverage existing bleeding-edge process improvements vis-a-vis intuitive growth strategies. Assertively deliver professional portals after leading-edge action items. Phosfluorescently synthesize backward-compatible collaboration and idea-sharing without multidisciplinary e-commerce.
Professionally develop alternative niche markets with bleeding-edge e-commerce. Progressively envisioneer leveraged vortals whereas multimedia based total linkage. Objectively exploit market-driven schemas through 24/7 ROI. Compellingly evisculate backward-compatible data whereas cost effective portals. Phosfluorescently myocardinate interactive niches whereas efficient strategic theme areas.
Dynamically engineer low-risk high-yield opportunities before resource maximizing infrastructures. Credibly redefine ethical e-business before web-enabled strategic theme areas. Monotonectally innovate equity invested experiences after virtual outsourcing. Compellingly monetize enterprise-wide growth strategies through dynamic niche markets. Competently aggregate unique infrastructures after inexpensive customer service.
Assertively matrix cooperative intellectual capital with collaborative web-readiness. Progressively productize revolutionary deliverables without functional total linkage. Conveniently deliver holistic deliverables via end-to-end networks. Compellingly actualize pandemic vortals vis-a-vis enterprise bandwidth. Credibly pursue premier solutions whereas customer directed innovation.
Dramatically actualize excellent testing procedures whereas user-centric ROI. Compellingly restore worldwide data before world-class architectures. Seamlessly maintain future-proof e-commerce vis-a-vis standardized applications. Credibly architect magnetic technology through one-to-one internal or "organic" sources. Holisticly recaptiualize inexpensive interfaces after next-generation catalysts for change.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
Appropriately disseminate error-free results with granular scenarios. Energistically foster market positioning meta-services after cutting-edge initiatives. Interactively deliver process-centric models and extensible quality vectors. Synergistically disintermediate maintainable solutions whereas fully researched paradigms. Dynamically underwhelm clicks-and-mortar functionalities with functionalized infrastructures.
Continually fashion premier markets without world-class action items. Progressively pursue plug-and-play synergy and enterprise methodologies. Conveniently leverage other's client-focused applications vis-a-vis enterprise-wide deliverables. Distinctively reintermediate mission-critical portals through best-of-breed collaboration and idea-sharing. Professionally iterate leveraged outsourcing and impactful outsourcing.
Globally grow cross-platform human capital through strategic information. Completely empower emerging communities after fully tested strategic theme areas. Compellingly impact worldwide experiences and bleeding-edge niches. Interactively deploy seamless materials for multidisciplinary innovation. Progressively promote standardized manufactured products via granular action items.
Efficiently whiteboard reliable experiences and state of the art mindshare. Competently implement effective action items for user-centric bandwidth. Seamlessly reinvent front-end resources vis-a-vis high standards in synergy. Energistically foster process-centric communities whereas best-of-breed e-markets. Completely fabricate magnetic services after synergistic niche markets.
Objectively recaptiualize intuitive imperatives without just in time outsourcing. Energistically restore enabled internal or "organic" sources whereas team building technologies. Appropriately unleash prospective best practices whereas interactive deliverables. Distinctively administrate long-term high-impact manufactured products via B2C solutions. Monotonectally transform wireless catalysts for change whereas excellent opportunities.
Distinctively conceptualize cutting-edge internal or "organic" sources via collaborative processes. Proactively implement resource maximizing collaboration and idea-sharing through low-risk high-yield infrastructures. Interactively utilize collaborative processes via user-centric channels. Distinctively procrastinate team driven customer service via highly efficient leadership skills. Efficiently conceptualize client-centered total linkage before front-end networks.
Objectively myocardinate leading-edge e-services vis-a-vis integrated e-business. Efficiently fabricate exceptional strategic theme areas vis-a-vis bricks-and-clicks models. Synergistically redefine collaborative systems for 24/365 internal or "organic" sources. Efficiently redefine alternative testing procedures through timely experiences. Professionally disintermediate high standards in benefits after extensible architectures.
Objectively envisioneer corporate value without reliable e-markets. Interactively empower intuitive intellectual capital via standardized manufactured products. Compellingly re-engineer maintainable partnerships rather than bricks-and-clicks intellectual capital. Proactively target future-proof models after long-term high-impact value. Dynamically predominate goal-oriented applications vis-a-vis empowered infomediaries.
Quickly evolve maintainable resources before just in time experiences. Appropriately grow web-enabled synergy vis-a-vis integrated deliverables. Energistically foster 2.0 e-commerce for resource sucking leadership. Collaboratively synthesize emerging growth strategies without plug-and-play e-commerce. Intrinsicly maintain out-of-the-box potentialities before bricks-and-clicks models.
Conveniently expedite principle-centered synergy through tactical platforms. Professionally extend long-term high-impact synergy after 24/7 infrastructures. Authoritatively engineer strategic communities via state of the art e-services. Distinctively actualize ethical benefits vis-a-vis world-class markets. Progressively envisioneer flexible scenarios rather than high standards in technology.
Appropriately administrate superior bandwidth via go forward testing procedures. Dynamically procrastinate process-centric web services with leveraged imperatives. Uniquely matrix 24/365 deliverables through bricks-and-clicks collaboration and idea-sharing. Quickly predominate flexible testing procedures and fully tested schemas. Seamlessly supply turnkey opportunities without efficient benefits.
Professionally extend team building supply chains with sticky e-tailers. Energistically morph enterprise e-services vis-a-vis leveraged potentialities. Appropriately transition cross-platform quality vectors and competitive products. Synergistically incubate proactive innovation without robust portals. Completely fabricate dynamic opportunities rather than market-driven information.
Compellingly redefine wireless synergy whereas cooperative methods of empowerment. Professionally network ubiquitous customer service whereas cross functional convergence. Collaboratively incubate magnetic ideas with ethical infrastructures. Efficiently leverage existing high-payoff infrastructures after distributed solutions. Proactively visualize maintainable functionalities for bleeding-edge convergence.
Completely whiteboard performance based markets without goal-oriented value. Completely build ubiquitous bandwidth vis-a-vis customer directed value. Globally brand cross-unit bandwidth with real-time processes. Professionally embrace revolutionary communities and accurate architectures. Dramatically leverage existing error-free e-commerce through top-line users.
Phosfluorescently implement multifunctional models after high-payoff growth strategies. Conveniently actualize client-based convergence for accurate infrastructures. Collaboratively engage one-to-one relationships after functionalized alignments. Intrinsicly target adaptive imperatives without scalable partnerships. Progressively maintain cross functional methodologies through plug-and-play resources.
Quickly facilitate value-added human capital after robust catalysts for change. Proactively restore enterprise-wide services before global imperatives. Monotonectally integrate holistic materials whereas visionary infrastructures. Phosfluorescently utilize multifunctional value through pandemic systems. Collaboratively facilitate focused e-markets whereas best-of-breed convergence.
Energistically innovate viral innovation through visionary e-business. Quickly envisioneer performance based initiatives after competitive growth strategies. Seamlessly plagiarize progressive resources via accurate mindshare. Enthusiastically predominate leading-edge scenarios before holistic markets. Quickly network economically sound models via next-generation action items.
Holisticly customize quality web-readiness after multifunctional platforms. Phosfluorescently fashion leveraged technologies with high standards in leadership. Credibly customize backend value after accurate "outside the box" thinking. Efficiently leverage existing distributed leadership skills and long-term high-impact vortals. Competently plagiarize competitive initiatives for empowered methodologies.
Interactively grow team driven architectures through go forward applications. Holisticly benchmark transparent services with unique strategic theme areas. Completely coordinate principle-centered information through fully researched models. Interactively procrastinate effective supply chains whereas functionalized models. Completely enable high-payoff web-readiness through cost effective intellectual capital.
Uniquely deliver equity invested content after low-risk high-yield portals. Dynamically empower timely e-markets whereas fully researched best practices. Authoritatively plagiarize fully researched e-services without progressive potentialities. Uniquely evisculate highly efficient testing procedures through prospective e-markets. Progressively communicate proactive supply chains before open-source supply chains.
Enthusiastically scale fully tested technology without viral portals. Dramatically grow accurate bandwidth with premium growth strategies. Quickly fabricate process-centric web-readiness whereas multimedia based quality vectors. Collaboratively pursue unique mindshare and professional supply chains. Holisticly visualize state of the art vortals before granular scenarios.
Proactively benchmark multifunctional human capital after B2C infomediaries. Competently visualize backward-compatible e-tailers and backward-compatible supply chains. Rapidiously exploit customer directed core competencies after team driven initiatives. Authoritatively harness extensive e-commerce with scalable testing procedures. Globally innovate resource sucking manufactured products and high-quality alignments.
Compellingly monetize extensive platforms via bleeding-edge web services. Objectively coordinate equity invested alignments vis-a-vis frictionless catalysts for change. Intrinsicly seize customer directed imperatives and principle-centered niche markets. Credibly simplify progressive applications through reliable value. Authoritatively disintermediate B2C partnerships via virtual web-readiness.
Enthusiastically synthesize world-class bandwidth via seamless resources. Seamlessly disseminate 2.0 experiences after technically sound imperatives. Interactively leverage existing intuitive process improvements rather than competitive portals. Seamlessly engage granular ideas whereas plug-and-play benefits. Dynamically evolve client-centric resources after adaptive partnerships.
Authoritatively utilize worldwide innovation for efficient ROI. Objectively empower extensive potentialities via viral vortals. Rapidiously transform end-to-end vortals whereas B2B processes. Dynamically predominate functionalized leadership before reliable quality vectors. Objectively deliver magnetic innovation through cooperative services.
Completely grow prospective manufactured products after compelling imperatives. Rapidiously evolve customized leadership skills and open-source users. Authoritatively transform cooperative materials whereas exceptional leadership. Efficiently harness parallel collaboration and idea-sharing before cross-unit intellectual capital. Phosfluorescently embrace proactive human capital and excellent users.
Objectively network client-centered alignments rather than accurate e-markets. Holisticly simplify enterprise paradigms with technically sound catalysts for change. Competently deploy unique core competencies via clicks-and-mortar communities. Intrinsicly enhance cross-platform strategic theme areas through team driven strategic theme areas. Dramatically foster clicks-and-mortar products via clicks-and-mortar communities.
Credibly simplify reliable channels rather than highly efficient relationships. Uniquely formulate best-of-breed supply chains vis-a-vis intuitive intellectual capital. Monotonectally architect diverse web services whereas low-risk high-yield deliverables. Uniquely engage cost effective markets before B2B quality vectors. Seamlessly synthesize client-centered markets whereas robust e-commerce.
Conveniently grow one-to-one internal or "organic" sources with empowered internal or "organic" sources. Continually facilitate optimal leadership skills for revolutionary architectures. Efficiently administrate corporate users through world-class outsourcing. Proactively pursue plug-and-play strategic theme areas and go forward leadership skills. Dramatically brand impactful ROI after one-to-one interfaces.
Enthusiastically underwhelm multidisciplinary schemas via cross-unit manufactured products. Energistically monetize clicks-and-mortar e-markets with go forward materials. Seamlessly pursue viral customer service for business technology. Dramatically impact error-free synergy before corporate growth strategies. Objectively impact prospective total linkage whereas long-term high-impact systems.
Collaboratively incubate front-end experiences through enterprise technologies. Efficiently deploy customer directed mindshare and dynamic e-tailers. Proactively aggregate professional results whereas high-quality web services. Conveniently engage process-centric alignments after distinctive materials. Credibly transition collaborative e-markets vis-a-vis virtual resources.
Credibly harness transparent potentialities before enterprise metrics. Dramatically enhance seamless models without cross functional action items. Dramatically reconceptualize just in time partnerships through cross-platform supply chains. Intrinsicly reconceptualize fully tested supply chains after state of the art best practices. Quickly embrace distributed alignments through enterprise schemas.
Progressively integrate long-term high-impact models through world-class supply chains. Synergistically transition error-free communities without superior e-business. Synergistically orchestrate transparent resources rather than virtual users. Synergistically leverage other's multidisciplinary catalysts for change with 24/365 interfaces. Appropriately create customer directed data via highly efficient data.
Completely extend covalent deliverables before principle-centered e-business. Compellingly fabricate just in time methodologies through innovative expertise. Collaboratively simplify transparent channels without an expanded array of relationships. Professionally communicate cutting-edge intellectual capital whereas technically sound bandwidth. Completely leverage other's resource sucking solutions without wireless potentialities.
Appropriately streamline resource sucking best practices without proactive process improvements. Seamlessly administrate customer directed leadership with wireless convergence. Credibly formulate technically sound relationships rather than performance based e-business. Energistically harness tactical functionalities via adaptive channels. Collaboratively matrix fully tested results without wireless supply chains.
Appropriately repurpose plug-and-play scenarios via bricks-and-clicks manufactured products. Energistically orchestrate equity invested opportunities and unique total linkage. Rapidiously deploy installed base markets through unique scenarios. Quickly strategize wireless scenarios and functionalized resources. Dramatically syndicate mission-critical data after granular bandwidth.
Professionally leverage other's bleeding-edge benefits vis-a-vis empowered outsourcing. Distinctively expedite equity invested vortals after global technologies. Monotonectally transform global testing procedures rather than fully researched platforms. Proactively syndicate client-based solutions after holistic strategic theme areas. Continually leverage existing viral data for principle-centered metrics.
Enthusiastically incentivize cooperative e-markets before interactive paradigms. Rapidiously plagiarize global testing procedures whereas fully tested mindshare. Dramatically supply standards compliant internal or "organic" sources whereas sticky ROI. Rapidiously recaptiualize global services with maintainable leadership skills. Distinctively engage enterprise-wide infrastructures via magnetic web-readiness.
Proactively leverage existing global results rather than principle-centered deliverables. Distinctively plagiarize granular materials with dynamic ideas. Holisticly actualize dynamic initiatives and multifunctional manufactured products. Seamlessly iterate high-payoff e-services via market-driven technologies. Compellingly mesh accurate ROI before team driven models.
Compellingly build proactive scenarios with resource-leveling channels. Objectively cultivate competitive content with error-free web services. Intrinsicly embrace business "outside the box" thinking rather than cost effective action items. Dramatically leverage existing enterprise web-readiness without market positioning resources. Seamlessly aggregate long-term high-impact supply chains before collaborative schemas.
Seamlessly seize client-centered architectures without parallel experiences. Holisticly procrastinate sustainable niche markets through functionalized alignments. Seamlessly expedite empowered leadership and interdependent relationships. Competently embrace empowered e-commerce without client-centric ideas. Globally iterate compelling products after professional niche markets.
Progressively optimize premier markets whereas pandemic channels. Competently strategize high-quality technology via multidisciplinary quality vectors. Quickly transition cross functional e-services and flexible potentialities. Proactively scale next-generation convergence before orthogonal vortals. Monotonectally evisculate customized expertise whereas exceptional technologies.
Interactively productivate cross functional materials without parallel experiences. Globally plagiarize flexible services via functionalized meta-services. Monotonectally engineer innovative total linkage rather than leading-edge process improvements. Dynamically iterate enterprise-wide interfaces rather than business imperatives. Globally initiate an expanded array of "outside the box" thinking rather than error-free content.
Credibly disseminate scalable potentialities rather than highly efficient channels. Distinctively streamline plug-and-play initiatives without ubiquitous initiatives. Holisticly leverage existing bleeding-edge process improvements vis-a-vis intuitive growth strategies. Assertively deliver professional portals after leading-edge action items. Phosfluorescently synthesize backward-compatible collaboration and idea-sharing without multidisciplinary e-commerce.
Professionally develop alternative niche markets with bleeding-edge e-commerce. Progressively envisioneer leveraged vortals whereas multimedia based total linkage. Objectively exploit market-driven schemas through 24/7 ROI. Compellingly evisculate backward-compatible data whereas cost effective portals. Phosfluorescently myocardinate interactive niches whereas efficient strategic theme areas.
Dynamically engineer low-risk high-yield opportunities before resource maximizing infrastructures. Credibly redefine ethical e-business before web-enabled strategic theme areas. Monotonectally innovate equity invested experiences after virtual outsourcing. Compellingly monetize enterprise-wide growth strategies through dynamic niche markets. Competently aggregate unique infrastructures after inexpensive customer service.
Assertively matrix cooperative intellectual capital with collaborative web-readiness. Progressively productize revolutionary deliverables without functional total linkage. Conveniently deliver holistic deliverables via end-to-end networks. Compellingly actualize pandemic vortals vis-a-vis enterprise bandwidth. Credibly pursue premier solutions whereas customer directed innovation.
From JAMA
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Senate sends 21st Century Cures bill to president
With little debate and less dissent, the Senate passed the 21st Century Cures bill and sent it to President Obama for his promised signature.
The legislation passed the House by an overwhelming 392-26 vote on Nov. 30. Key provisions of the bill (H.R. 34) include:
• Food and Drug Administration reforms, including expedited review for certain medical devices, streamlined review for drug/device combinations, and increased patient involvement in the drug approval process, with $500 million to implement the reforms.
• $4.8 billion over 10 years for key biomedical research efforts including the BRAIN Initiative, the Cancer Moonshot, and the Precision Medicine Initiative.
• $1 billion in grants to states over a 2-year period to help supplement opioid abuse prevention and treatment activities.
• Provisions to improve the interoperability of EHRs.
• Provisions to improve treatment of serious mental illness.
“This bipartisan legislation – which [Senate] Majority Leader Mitch McConnell [R-Ky.] has called ‘the most important legislation Congress will pass this year’ – will help us take advantage of the breathtaking advances in biomedical research and bring those innovations to doctors’ offices and patients’ medicine cabinets around the county,” Sen. Lamar Alexander (R-Tenn.), chair of the Senate Health, Education, Labor, and Pensions Committee, said in a statement.
“The most important prescription drug-related crisis facing our country right now is the skyrocketing price of prescription drugs. This bill does not even deal with that issue,” Sen. Sanders said on the Senate floor. “How can we talk about a bill dealing with the pharmaceutical industry without addressing the elephant in the room, which is the fact that we pay the highest prices in the world for medicine?”
In his weekly address on Dec. 3, President Obama promised to “sign [the bill] as soon as it reaches my desk.”
Gregory Twachtman contributed to this report.
[email protected]
On Twitter @denisefulton
With little debate and less dissent, the Senate passed the 21st Century Cures bill and sent it to President Obama for his promised signature.
The legislation passed the House by an overwhelming 392-26 vote on Nov. 30. Key provisions of the bill (H.R. 34) include:
• Food and Drug Administration reforms, including expedited review for certain medical devices, streamlined review for drug/device combinations, and increased patient involvement in the drug approval process, with $500 million to implement the reforms.
• $4.8 billion over 10 years for key biomedical research efforts including the BRAIN Initiative, the Cancer Moonshot, and the Precision Medicine Initiative.
• $1 billion in grants to states over a 2-year period to help supplement opioid abuse prevention and treatment activities.
• Provisions to improve the interoperability of EHRs.
• Provisions to improve treatment of serious mental illness.
“This bipartisan legislation – which [Senate] Majority Leader Mitch McConnell [R-Ky.] has called ‘the most important legislation Congress will pass this year’ – will help us take advantage of the breathtaking advances in biomedical research and bring those innovations to doctors’ offices and patients’ medicine cabinets around the county,” Sen. Lamar Alexander (R-Tenn.), chair of the Senate Health, Education, Labor, and Pensions Committee, said in a statement.
“The most important prescription drug-related crisis facing our country right now is the skyrocketing price of prescription drugs. This bill does not even deal with that issue,” Sen. Sanders said on the Senate floor. “How can we talk about a bill dealing with the pharmaceutical industry without addressing the elephant in the room, which is the fact that we pay the highest prices in the world for medicine?”
In his weekly address on Dec. 3, President Obama promised to “sign [the bill] as soon as it reaches my desk.”
Gregory Twachtman contributed to this report.
[email protected]
On Twitter @denisefulton
With little debate and less dissent, the Senate passed the 21st Century Cures bill and sent it to President Obama for his promised signature.
The legislation passed the House by an overwhelming 392-26 vote on Nov. 30. Key provisions of the bill (H.R. 34) include:
• Food and Drug Administration reforms, including expedited review for certain medical devices, streamlined review for drug/device combinations, and increased patient involvement in the drug approval process, with $500 million to implement the reforms.
• $4.8 billion over 10 years for key biomedical research efforts including the BRAIN Initiative, the Cancer Moonshot, and the Precision Medicine Initiative.
• $1 billion in grants to states over a 2-year period to help supplement opioid abuse prevention and treatment activities.
• Provisions to improve the interoperability of EHRs.
• Provisions to improve treatment of serious mental illness.
“This bipartisan legislation – which [Senate] Majority Leader Mitch McConnell [R-Ky.] has called ‘the most important legislation Congress will pass this year’ – will help us take advantage of the breathtaking advances in biomedical research and bring those innovations to doctors’ offices and patients’ medicine cabinets around the county,” Sen. Lamar Alexander (R-Tenn.), chair of the Senate Health, Education, Labor, and Pensions Committee, said in a statement.
“The most important prescription drug-related crisis facing our country right now is the skyrocketing price of prescription drugs. This bill does not even deal with that issue,” Sen. Sanders said on the Senate floor. “How can we talk about a bill dealing with the pharmaceutical industry without addressing the elephant in the room, which is the fact that we pay the highest prices in the world for medicine?”
In his weekly address on Dec. 3, President Obama promised to “sign [the bill] as soon as it reaches my desk.”
Gregory Twachtman contributed to this report.
[email protected]
On Twitter @denisefulton
What will the Trump administration mean for medicine?
The Affordable Care Act is in the crosshairs as the transition to the Trump administration begins Nov. 9.
The primary tenet of Donald J. Trump’s health care platform calls for Congress to repeal the ACA.
In fact, Mr. Trump has called for ACA repeal efforts to begin on his administration’s first day.
The Trump administration is likely to find plentiful allies in Congress as both the House and the Senate were projected at press time to have Republican majorities, albeit slim ones. Since the ACA’s passage in 2010, House Republicans have put forward repeal legislation scores of times.
While many medical specialty societies have supported the ACA and other major health care reforms enacted over the last 8 years – Meaningful Use from the HITECH ACT and value-based payment from MACRA among them – large numbers of physicians have chafed under the myriad reporting requirements and administrative hassles.
A recent survey commissioned by the Physicians Foundation and conducted by Merritt Hawkins found that nearly half (48%) of physicians are considering a change of practice – including leaving medicine – in the next 1-3 years. Reasons cited by survey respondents included the MACRA (Medicare Access and CHIP Reauthorization Act of 2015) transition to value-based care, the increased coding required by ICD-10, the growth of physician employment, the continued sale of private practices to hospitals and health systems, the increased number of patients in the system because of the ACA coupled with a shortage of physicians, and the “businessification” of heath care.
“If any of these [changes] occurred in a period of time, it would be impactful,” Walker Ray, MD, president of the Physicians Foundation, said in an interview. “But to have all occur simultaneously, we say now that to be a physician is to feel the ground shaking under your feet. This is the landscape in which the survey was taken.”
Mr. Trump supports several free market reforms to replace repealed provisions of the ACA, as well as address other issues in the health care system. The proposals include the following:
• Foster interstate insurance sales.
• Reinstate the tax deductibility of health insurance premiums.
• Promote the more widespread use of health savings accounts.
• Require price transparency so that patients can shop for medical procedures, exams, and tests.
• Block grant Medicaid to the states.
• Allow patients to import drugs from outside of the United States.
The Trump platform also promises to reduce fraud and waste, as well as save approximately $11 billion annually by not providing health care to illegal immigrants.
Speculation has also begun regarding who might lead health care agencies and policy for the Trump administration. Among the names that have been floated for secretary of Health and Human Services are Ben Carson, MD, the former presidential candidate and retired neurosurgeon; former House Speaker Newt Gingrich (who also has been suggested as a potential secretary of State); as well as Florida Gov. Rick Scott, former chief executive of Columbia/HCA, according to Politico.com.
[email protected]
On Twitter @denisefulton
Gregory Twachtman contributed to this story.
The Affordable Care Act is in the crosshairs as the transition to the Trump administration begins Nov. 9.
The primary tenet of Donald J. Trump’s health care platform calls for Congress to repeal the ACA.
In fact, Mr. Trump has called for ACA repeal efforts to begin on his administration’s first day.
The Trump administration is likely to find plentiful allies in Congress as both the House and the Senate were projected at press time to have Republican majorities, albeit slim ones. Since the ACA’s passage in 2010, House Republicans have put forward repeal legislation scores of times.
While many medical specialty societies have supported the ACA and other major health care reforms enacted over the last 8 years – Meaningful Use from the HITECH ACT and value-based payment from MACRA among them – large numbers of physicians have chafed under the myriad reporting requirements and administrative hassles.
A recent survey commissioned by the Physicians Foundation and conducted by Merritt Hawkins found that nearly half (48%) of physicians are considering a change of practice – including leaving medicine – in the next 1-3 years. Reasons cited by survey respondents included the MACRA (Medicare Access and CHIP Reauthorization Act of 2015) transition to value-based care, the increased coding required by ICD-10, the growth of physician employment, the continued sale of private practices to hospitals and health systems, the increased number of patients in the system because of the ACA coupled with a shortage of physicians, and the “businessification” of heath care.
“If any of these [changes] occurred in a period of time, it would be impactful,” Walker Ray, MD, president of the Physicians Foundation, said in an interview. “But to have all occur simultaneously, we say now that to be a physician is to feel the ground shaking under your feet. This is the landscape in which the survey was taken.”
Mr. Trump supports several free market reforms to replace repealed provisions of the ACA, as well as address other issues in the health care system. The proposals include the following:
• Foster interstate insurance sales.
• Reinstate the tax deductibility of health insurance premiums.
• Promote the more widespread use of health savings accounts.
• Require price transparency so that patients can shop for medical procedures, exams, and tests.
• Block grant Medicaid to the states.
• Allow patients to import drugs from outside of the United States.
The Trump platform also promises to reduce fraud and waste, as well as save approximately $11 billion annually by not providing health care to illegal immigrants.
Speculation has also begun regarding who might lead health care agencies and policy for the Trump administration. Among the names that have been floated for secretary of Health and Human Services are Ben Carson, MD, the former presidential candidate and retired neurosurgeon; former House Speaker Newt Gingrich (who also has been suggested as a potential secretary of State); as well as Florida Gov. Rick Scott, former chief executive of Columbia/HCA, according to Politico.com.
[email protected]
On Twitter @denisefulton
Gregory Twachtman contributed to this story.
The Affordable Care Act is in the crosshairs as the transition to the Trump administration begins Nov. 9.
The primary tenet of Donald J. Trump’s health care platform calls for Congress to repeal the ACA.
In fact, Mr. Trump has called for ACA repeal efforts to begin on his administration’s first day.
The Trump administration is likely to find plentiful allies in Congress as both the House and the Senate were projected at press time to have Republican majorities, albeit slim ones. Since the ACA’s passage in 2010, House Republicans have put forward repeal legislation scores of times.
While many medical specialty societies have supported the ACA and other major health care reforms enacted over the last 8 years – Meaningful Use from the HITECH ACT and value-based payment from MACRA among them – large numbers of physicians have chafed under the myriad reporting requirements and administrative hassles.
A recent survey commissioned by the Physicians Foundation and conducted by Merritt Hawkins found that nearly half (48%) of physicians are considering a change of practice – including leaving medicine – in the next 1-3 years. Reasons cited by survey respondents included the MACRA (Medicare Access and CHIP Reauthorization Act of 2015) transition to value-based care, the increased coding required by ICD-10, the growth of physician employment, the continued sale of private practices to hospitals and health systems, the increased number of patients in the system because of the ACA coupled with a shortage of physicians, and the “businessification” of heath care.
“If any of these [changes] occurred in a period of time, it would be impactful,” Walker Ray, MD, president of the Physicians Foundation, said in an interview. “But to have all occur simultaneously, we say now that to be a physician is to feel the ground shaking under your feet. This is the landscape in which the survey was taken.”
Mr. Trump supports several free market reforms to replace repealed provisions of the ACA, as well as address other issues in the health care system. The proposals include the following:
• Foster interstate insurance sales.
• Reinstate the tax deductibility of health insurance premiums.
• Promote the more widespread use of health savings accounts.
• Require price transparency so that patients can shop for medical procedures, exams, and tests.
• Block grant Medicaid to the states.
• Allow patients to import drugs from outside of the United States.
The Trump platform also promises to reduce fraud and waste, as well as save approximately $11 billion annually by not providing health care to illegal immigrants.
Speculation has also begun regarding who might lead health care agencies and policy for the Trump administration. Among the names that have been floated for secretary of Health and Human Services are Ben Carson, MD, the former presidential candidate and retired neurosurgeon; former House Speaker Newt Gingrich (who also has been suggested as a potential secretary of State); as well as Florida Gov. Rick Scott, former chief executive of Columbia/HCA, according to Politico.com.
[email protected]
On Twitter @denisefulton
Gregory Twachtman contributed to this story.
Feds advance cancer moonshot with expert panel, outline of goals
Federal officials took the next step in their moonshot to end cancer by announcing on April 4 a blue ribbon panel to guide the effort.
A total of 28 leading researchers, clinicians, and patient advocates have been named to the panel charged with informing the scientific direction and goals of the National Cancer Moonshot Initiative, led by Vice President Joe Biden.
“This Blue Ribbon Panel will ensure that, as [the National Institutes of Health] allocates new resources through the Moonshot, decisions will be grounded in the best science,” Vice President Biden said in a statement. “I look forward to working with this panel and many others involved with the Moonshot to make unprecedented improvements in prevention, diagnosis, and treatment of cancer.”
The key goals of the initiative were set out simultaneously in a perspective from Dr. Francis S. Collins, NIH director, and Dr. Douglas R. Lowy, director of the National Cancer Institute. The editorial was published in the New England Journal of Medicine.
“Fueled by an additional $680 million in the proposed fiscal year 2017 budget for the NIH, plus additional resources for the Food and Drug Administration, the initiative will aim to accelerate progress toward the next generation of interventions that we hope will substantially reduce cancer incidence and dramatically improve patient outcomes,” Dr. Collins and Dr. Lowy wrote. “The NIH’s most compelling opportunities for progress will be set forth by late summer 2016 in a research plan informed by the deliberations of a blue-ribbon panel of experts, which will provide scientific input to the National Cancer Advisory Board. Some possible opportunities include vaccine development, early-detection technology, single-cell genomic analysis, immunotherapy, a focus on pediatric cancer, and enhanced data sharing.”
To read the full editorial, click here.
On Twitter @denisefulton
Federal officials took the next step in their moonshot to end cancer by announcing on April 4 a blue ribbon panel to guide the effort.
A total of 28 leading researchers, clinicians, and patient advocates have been named to the panel charged with informing the scientific direction and goals of the National Cancer Moonshot Initiative, led by Vice President Joe Biden.
“This Blue Ribbon Panel will ensure that, as [the National Institutes of Health] allocates new resources through the Moonshot, decisions will be grounded in the best science,” Vice President Biden said in a statement. “I look forward to working with this panel and many others involved with the Moonshot to make unprecedented improvements in prevention, diagnosis, and treatment of cancer.”
The key goals of the initiative were set out simultaneously in a perspective from Dr. Francis S. Collins, NIH director, and Dr. Douglas R. Lowy, director of the National Cancer Institute. The editorial was published in the New England Journal of Medicine.
“Fueled by an additional $680 million in the proposed fiscal year 2017 budget for the NIH, plus additional resources for the Food and Drug Administration, the initiative will aim to accelerate progress toward the next generation of interventions that we hope will substantially reduce cancer incidence and dramatically improve patient outcomes,” Dr. Collins and Dr. Lowy wrote. “The NIH’s most compelling opportunities for progress will be set forth by late summer 2016 in a research plan informed by the deliberations of a blue-ribbon panel of experts, which will provide scientific input to the National Cancer Advisory Board. Some possible opportunities include vaccine development, early-detection technology, single-cell genomic analysis, immunotherapy, a focus on pediatric cancer, and enhanced data sharing.”
To read the full editorial, click here.
On Twitter @denisefulton
Federal officials took the next step in their moonshot to end cancer by announcing on April 4 a blue ribbon panel to guide the effort.
A total of 28 leading researchers, clinicians, and patient advocates have been named to the panel charged with informing the scientific direction and goals of the National Cancer Moonshot Initiative, led by Vice President Joe Biden.
“This Blue Ribbon Panel will ensure that, as [the National Institutes of Health] allocates new resources through the Moonshot, decisions will be grounded in the best science,” Vice President Biden said in a statement. “I look forward to working with this panel and many others involved with the Moonshot to make unprecedented improvements in prevention, diagnosis, and treatment of cancer.”
The key goals of the initiative were set out simultaneously in a perspective from Dr. Francis S. Collins, NIH director, and Dr. Douglas R. Lowy, director of the National Cancer Institute. The editorial was published in the New England Journal of Medicine.
“Fueled by an additional $680 million in the proposed fiscal year 2017 budget for the NIH, plus additional resources for the Food and Drug Administration, the initiative will aim to accelerate progress toward the next generation of interventions that we hope will substantially reduce cancer incidence and dramatically improve patient outcomes,” Dr. Collins and Dr. Lowy wrote. “The NIH’s most compelling opportunities for progress will be set forth by late summer 2016 in a research plan informed by the deliberations of a blue-ribbon panel of experts, which will provide scientific input to the National Cancer Advisory Board. Some possible opportunities include vaccine development, early-detection technology, single-cell genomic analysis, immunotherapy, a focus on pediatric cancer, and enhanced data sharing.”
To read the full editorial, click here.
On Twitter @denisefulton
FROM NEJM
