1. society

MEDICAL SOCIETY OF THE STATE OF NEW YORK
NEWS OF NEW YORK
Volume 70 • Number 10 • www.mssny.org
Providing Information to Assist Physicians in the State of New York
pharmacy, with limited exceptions. The
law will not require a prescriber to issue a
prescription electronically when:
•E
lectronic prescribing is not available
due to temporary technological or electronic failure
(Continued on page 6
Media Should Verify the Accuracy of Data; Understand the Context of Financial
Relationships between Physicians and Industry When Reporting on Open Payments Data
The American Medical Association (AMA)
is committed to transparency and supports the
release of data that can help improve quality of
care for patients, including information about
physician’s financial interactions with the industry which could help promote understanding
and trust and strengthen the patient-physician
relationship. For that reason, the AMA supported the Sunshine Act when it was passed by
Congress. However, because of issues with the
implementation of the law, the AMA believes
that certain safeguards are needed to ensure the
information is depicted correctly and in context
to be useful for patients and fair to physicians.
Thus, the AMA strongly encourages media
to consider the following in their coverage to
ensure data is indeed presented in an accurate
and informative way to help patients understand and interpret the information correctly.
About the Open Payments
Program
MSSNY Welcomes Integrated Medical Professionals
MSSNY is pleased to announce that
the physicians of Integrated Medical
Professionals (IMP) have entered into a
group membership. IMP is comprised of
Advanced Urology Centers of New York,
Advanced Radiation Centers of New York
and Advanced Colon & Rectal Surgery
Centers of New York. All 95 IMP physicians
from their 53 locations are now members of
MSSNY.
“It’s important for us to link arms and show
that the house of medicine is united,” said
Deepak A. Kapoor, MD, Chairman and CEO
of IMP. “It’s especially important now, given
the multitude of changes in medicine – the
ACA, Meaningful Use 2, regulatory changes,
alternative payment methods and the unre-
strained power of insurance companies.
“Physicians need to be empowered so that
we can better help our patients,” continued
Dr. Kapoor. “We need to be their voice so that
they receive high quality, affordable healthcare at the site of service of their choosing.”
A robust membership increases MSSNY’s
ability to advocate for physicians and their
patients. “As we evolve into an American
health care system that has yet to be defined,
it becomes so much more important to unite
as a profession to advocate for ourselves
and our patient population,” said Michael
Ziegelbaum, MD, an IMP physician and
President of the Nassau County Medical
Society. “That mission remains the basis of
who we are as physicians.”
Open Payments Website Debuts
September 30, 2014 marked the launch
of CMS’ open payments database, which
reports on payments made to physicians
and teaching hospitals. The database is the
product of the Physician Payments Sunshine
Act, which was included as a provision in
the Affordable Care Act. It requires pharmaceutical companies and medical device
manufacturers to report any payments made
to physicians and academic medical centers. Any item of value more than $10, or
an aggregate of $100 per year, is reportable.
Cash, stock options, travel, entertainment,
and grants are all reportable. This first public data release covers items of value given
between August 1 and December 31, 2013.
The 2015 reports will cover calendar year
2014.
November 2014
AMA Guide for Media Reporting on
“Open Payments” Data Release
Are You Ready to E-Prescribe?
Effective March 27, 2015, language
enacted into law as part of I-STOP will
require physicians and other prescribers
including nurse practitioners, midwives,
dentists, podiatrists, physician assistants
and optometrists in New York State to issue
prescriptions electronically directly to a
Lobby Day
is on
March 4, 2015
Under the Sunshine Act passed by Congress
in 2010, industry is required annually to report
financial interactions with individual physicians to the Centers for Medicare and Medicaid
Services (CMS), and this information is then to
be made public. To implement the law, CMS
developed the Open Payments program.
Are Open Payments Data
Accurate?
Patients deserve to have access to accurate
information. Publishing inaccurate data can
lead to misinterpretations, harm reputations
and cause patients to question their trust in
their physicians. It can also unfairly impact
physicians’ ability to attain or keep research
grants and other employment opportunities that
require disclosure.
AMA has strongly urged the federal government to adopt sensible measures to ensure
that the information released is accurate.
Unfortunately, the CMS’ Open Payments program has to date been plagued by significant
shortcomings that call into question the accuracy of information that will be published
on September 30th, including an inadequate
opportunity for physicians to review their individual data and technical problems with the
system’s website
• Inadequate opportunity for physician
review
For the estimated 200,000 physicians
affected by the Sunshine Act, CMS provided a
short, 45 day window to review and correct any
inaccurate data. Unfortunately, several factors
hindered participation by many of the physi-
cians impacted including:
• Conflicting and inadequate notification
to the physician community about key
implementation deadlines for the program.
CMS ignored its guidance that physicians
would be able to begin the registration process on January 1, 2014, condensing the
registration and review timeframe to just
45 days. Physicians also did not receive
timely notice when the 45 day deadline was
extended because of service interruptions
on the Open Payments website.
• A time-consuming, non-user friendly and
complicated registration process, which
physicians were required to complete in
order to review information being reported
about them. Many physicians reported
making numerous calls to the CMS
Help Desk for assistance in registering.
A 360 page guidance document that CMS
originally provided to help physicians
through the process failed to detail all the
steps involved to register with the system,
review personal reports, and seek correction of any inaccurate data.
• A beleaguered or troubled system that
has been plagued by repeated shut downs.
Many physicians expressed frustration
that the system was not working when
they attempted to use it. Some physicians who had set aside time specifically
to register and review their data while the
system was not functioning may not have
been able to schedule more time away
from their patients to accomplish the task.
Consequently, we are concerned that a
large number of physicians may not have
been able to complete the process.
• CMS concerns about the accuracy of
reported data
Concerns about accuracy have prompted
CMS to hold back 1/3 of the data reported
to the Open Payments system in the current
cycle and the agency has also expressed concern about more of the reported information.
Although the decision gives the impression that
the Agency is actively verifying the accuracy of
data submitted to Open Payments, this is unfortunately not the case.
What Does Having Financial
Relationships with Industry
Really Mean?
Publicly reporting industry payments to
individual physicians can imply, wrongly, that
such payments are always inappropriate. Some
(Continued on page 2
Inside News
Become a
MSSNYPAC
Chairman’s Club
Member...........page 2
Please send us
your correct email
address now
.......................page 4
MSSNYPAC’s
2014 - 15 candidate
endorsements
.......................page 4
Physicians
Foundation survey –
over 20,000 polled
.......................page 5
2014 MSSNYPAC Chairman’s Club Members
Mark James Adams, MD, MBA (Monroe)
Joseph H. Arguelles, MD (Clinton)
Susan Baldassari, MD (Erie)
Edward Kelly Bartels, MD (Erie)
Maria A. Basile, MD (Suffolk)
Matthew Joseph Bonanno, MD (New York)
Michael H. Brisman, MD (Nassau)
Mary Ruth Buchness, MD (New York)
Carolyn M. Castiglia, MD (Nassau)
Kenneth B. Chapman, MD (Richmond)
Inderpal S. Chhabra, MD (Queens)
Clarisse Clemons-Ferrara, MD (Kings)
Jerome Craig Cohen, MD (Broome)
Joshua M. Cohen, MD, MPH (New York)
Terese A. Copeland, MD (Saratoga)
Jose M. David, MD (Albany)
Elizabeth Dears Kent, Esq.
Senior Vice President/
Chief Legislative Counsel, MSSNY
Anthonette R. Desire, MD (Suffolk)
Ernesto A. Diaz-Ordaz, MD (Erie)
Frank G. Dowling, MD (Suffolk)
Sherman Dunn, Jr. DO, (Kings)
Janine L. Fogarty, MD (Monroe)
Arthur C. Fougner, MD (Queens)
Mark L. Fox, MD (Westchester)
Kira A. Geraci-Ciardullo, MD MPH
(Westchester)
Robert John Hughes, MD (Saratoga)
David M. Jakubowicz, MD (Bronx)
John J. Kennedy, Jr., MD (Schenectady)
Nabil K. Kiridly, MD (Suffolk)
Andrew Y. Kleinman, MD (Westchester)
George D. Kofinas, MD (Kings)
Daniel Joel Koretz, MD (Wayne)
Keith Andrew Krabill, MD (Erie)
William R. Latreille, Jr., MD (Franklin)
Thomas T. Lee, MD (Westchester)
Bonnie L. Litvack, MD (Westchester)
Thomas J. Madejski, MD, FACP (Orleans)
Joseph A. Mannino, MD (Tompkins)
Patricia Ann McLaughlin Haight, MD (New York)
Brian D. Meagher, MD (Chautauqua)
Adolph B. Meyer, MD (Kings)
Brian P. Murray, MD (Albany)
Stuart I. Orsher, MD, JD (New York)
Gregory L. Pinto, MD (Saratoga)
Paul Anthony Pipia, MD (Nassau)
David Podwall, MD (Nassau)
Thakor C. Rana, MD (Bronx)
Malcolm D. Reid, MD, MPP (New York)
Charlotte Rhee, MD (Suffolk)
Jeffrey Allen Ribner, MD (Broome)
Michael H. Rosenberg, MD (Westchester)
Charles Rothberg, MD (Suffolk)
Veronica C. Santilli, MD, MHA (Kings)
Page 2 • MSSNY’s News of New York • November 2014
Nina Feltman Sax, MD (Albany)
Robert Mark Schneider, MD (Greene)
Michael J. Schoppmann, Esq.
MSSNY General Counsel
Philip Schuh, CPA,
Executive Vice President, MSSNY
Steven S. Schwalbe, MD (Queens)
Joseph R. Sellers, MD (Schoharie)
Richard Dale Semeran, MD (Onondaga)
Steven I. Sherman, MD (Kings)
Scott Alan Silverberg, MD (Nassau)
Penny Maureen Stern, MD MPH (Queens)
Zebulon Charles Taintor, MD (New York)
Edward C. Tanner, MD (Monroe)
Sam Louis Unterricht, MD (Kings)
Corliss Adam Varnum, MD (Oswego)
Salvatore Volpe, MD (Richmond)
Wayne Graham Whitmore, MD (New York)
Daniel M. Young, MD (Broome)
2014 Chairman’s Club
Corporate Supporters
Medical Liability Mutual Insurance Company
(MLMIC)
Orlin & Cohen Orthopedics (Nassau)
New York Facial Plastic Surgery Society
Brookhaven Anesthesia Associates (Suffolk)
American Society of Plastic
Surgeons Names MSSNY Member
Scot Glasberg, MD, New President
Scot Bradley Glasberg, MD, has been named president
of the American Society of Plastic Surgeons (ASPS), the
world’s largest organization of board-certified plastic surgeons. He took office at the Society’s annual scientific
meeting in Chicago and will serve for one year.
A member of MSSNY since 2001, Dr. Glasberg has
been a Delegate to MSSNY’s House of Delegates for several years. In addition to MSSNY and ASPS, Dr. Glasberg
is active within several national, regional and local medical and specialty societies. He currently serves on the
Board of Governors of the American College of Surgeons
and as Vice President of the New York State Society of
Plastic Surgeons.
Dr. Glasberg has a private practice in Manhattan and is
on the attending staff at Lenox Hill and Manhattan Eye,
Ear and Throat Hospitals.
AMA Guide on Data Release
(Continued from page 1
may be, but to be able to make an informed judgment, it is
vital to be able to set the financial information in context. Just
because a physician has a relationship with industry does not
automatically mean that his or her professional judgment has
been influenced inappropriately.
AMA strongly opposes inappropriate, unethical interactions between physicians and industry. However, relationships
with industry also drive innovation in patient care, contribute to the economic well-being of communities, and provide
significant resources for professional medical education, to
the ultimate benefit of patients. An urgent challenge for both
physicians and industry is to preserve strong, productive collaborations for the benefit of patients and the public and at
the same time take clear, effective action to avoid conflicts of
interest and relationships that would undermine trust.
Meanwhile, CMS is required by the Sunshine Act to provide context for the data released through the Open Payments
program. AMA and other stakeholders have repeatedly urged
CMS to provide this information, but the Agency has not yet
done so, even though the public release of Open Payments
data is imminent.
AMA strongly encourages members of the media to provide examples of interactions between physician and industry
in user-friendly language to help the public understand the
important role that appropriate relationships between physicians and industry has in advancing the practice of medicine.
Some examples of appropriate interactions include:
• Advancing Medical Knowledge - Research to develop new
treatments and improve patient care is costly. It takes time and
money to carry out clinical trials and get demonstrated new
therapies through the approval process and into clinical use.
Physicians in academic medical centers and other organizations receive funding from industry as investigators in clinical
research and as consultants who help design and evaluate
clinical trials or develop new medical technologies. In some
cases, industry support for multiple projects is reported under
the name of the academic dean or program director, which
can make it seem as if the individual received a large dollar
amount from industry when in fact the money financed the
cost of the clinical trial and was distributed to several endeavors actually led by other physicians.
• Advancing Physician Knowledge - Industry also supports physician education, and in some instances that will be
reported as payments to individual physicians, even if the physicians are not aware. For example, a physician may receive
an honorarium from his or her medical society for being on
the faculty of an educational program put on by the society.
If the society received a grant from industry to help support
the program, that honorarium may be reported as indirect payment from industry through the Open Payments system, even
though the physician received the honorarium directly from
the medical society and wasn’t aware of the industry support.
Continuing Medical Education courses funded by the
industry as well as visits from pharmaceutical representatives to physician offices or health care organizations to talk
about new research and treatment options can also supplement physicians’ knowledge about new advances in medicine.
Additionally, industry sometimes provides physicians with
reprints of peer-reviewed medical journal articles and medical textbooks, which likewise help physicians stay abreast of
the latest medical treatments.
November 2014 • MSSNY’s News of New York • Page 3
PRESIDENT’S COLUMN
MEDICAL SOCIETY OF THE STATE OF NEW YORK
NEWS OF NEW YORK
MSSNY is Your Source for the Latest Ebola Information
Colleagues:
While physicians may have many
different perspectives as to the chances
of an Ebola epidemic in the United
States, we need to be educating ourselves about this deadly disease now.
As we all know, our state is at the
“crossroads
of the world” and we, as
Andrew Y.
New
York
State
physicians, have a
Kleinman, MD
responsibility to be well-informed for
the benefit of our patients. MSSNY is working to keep all New York State physicians informed with the most up-to-date information,
including from the CDC and NYS Department of Health,
on the developing Ebola outbreak. As a precaution,
Governor Cuomo announced that 8 New York hospitals
have been designated as special Ebola response hospitals,
4 in New York City (Bellevue, Montefiore, Mt. Sinai and
NY-Presbyterian), as well as the North Shore-LIJ health
system, SUNY Stony Brook Medical Center, SUNY
Upstate Medical Center in Syracuse, and at the University
of Rochester Medical Center. MSSNY is here to help you. As we communicate regularly with key New York State officials, and closely monitor
the worldwide and U.S. efforts regarding efforts to contain
the outbreak, please follow us on Twitter (twitter.com/
mssnytweet) and Facebook (www.facebook.com/MSSNY)
for the latest scientific and other important information.
Continuous updates are being posted to our Twitter and
Facebook feeds when important new information arises,
which is many times per day. Medical Society
of the State of New York
Andrew Y. Kleinman, MD President
Michael Rosenberg, MD Chairman of the Board
Philip A. Schuh, CPA
Executive Vice President
COMMUNICATIONS AND
PUBLICATIONS
L. Carlos Zapata, MD, Commissioner
News of New York
Published by Medical Society of the State of New York
Vice President, Communications and Editor
Christina Cronin Southard, Editor
[email protected]
News of New York Staff
Julie Vecchione DeSimone, Assistant Editor
[email protected]
Janice Morano, Marketing Relations
[email protected]
Steven Sachs, Web Administrator
[email protected]
Susan Herbst, Page Designer
News of New York
Advertising Representatives
For general advertising information contact
Christina Cronin Southard
Phone 516-488-6100 ext 355
[email protected]
The News of New York is published monthly as the official publication of
the Medical Society of the State of New York. Information on the publication
is available from the Communications Division, Medical Society of the State
of New York, 865 Merrick Avenue, P.O. Box 9007, Westbury, NY 11590.
The acceptance of a product, service or company as an advertiser or as a
membership benefit of the Medical Society of the State of New York does not
imply endorsement and/or approval of this product, service or company by
the Medical Society of the State of New York. The Member Benefits Committee urges all our physician members to exercise good judgment when
purchasing any product or service.
Although MSSNY makes efforts to avoid clerical or printing mistakes,
errors may occur. In no event shall any liability of MSSNY for clerical or
printing mistakes exceed the charges paid by the advertiser for the advertisement, or for that portion of the advertisement in error if the primary or essential message of the advertisement has not been totally altered or substantially
rendered meaningless as a result of the error. Liability of MSSNY to the
advertiser for the failure to publish or omission of all or any portion of any
advertisement shall in no event exceed the charges paid by the advertiser for
the advertisement, or for that portion of the advertisement omitted if the primary or essential message of the advertisement has not been totally altered
or substantially rendered meaningless as a result of the omission. MSSNY
shall not be liable for any special, indirect or inconsequential damages, including lost profits, whether or not foreseeable, that may occur because of
an error in any advertisement, or any omission of a part or the whole of any
advertisement.
MEDICAL SOCIETY OF THE STATE OF NEW YORK
AT YOUR SERVICE
What Is Your Latest
Email Address?
Re: After Surgery, Surprise $117,000
Medical Bill from Doctor He Didn’t Know
To the Editor:
The article mentions that New York just enacted legislation (which we supported) to address the problem of “surprise” medical bills. The new law requires disclosure by out of network physicians as to costs of
needed care and additional physicians involved, and creates a new arbitration process between insurers and physicians that removes patients from the dispute. This
should remedy the situations faced by the patients presented in the article. I encourage patients to check the fee database www.fairhealthconsumer.org for
estimates of medical procedures.
Many surprise medical bills are the result of insurance companies’ greed
through slashing what they will pay in-network physicians, creating minimal networks, and limiting coverage for out-of-network care. The law requires insurers to
offer adequate networks and out-of-network coverage options.
Andrew Y. Kleinman, MD
President, Medical Society of the State of New York
Westbury, New York, Sept. 21, 2014
mssnypaC
MSSNYPAC Endorsements
As the November 4 election nears, MSSNYPAC has been
actively engaged in vetting state and Congressional candidates.
The MSSNY Council has approved these recommendations.
MSSNY member physicians are encouraged to consider the
following candidate endorsements.
Extensions for specific services
Alliance.. ........................................................................396
Communications............................................................ 351
Computer Information Systems..................................... 361
Member Benefits/Marketing.......................................... 424
Membership Information............................................... 336
Medical, Educational & Scientific Foundation.............. 350
Office of the Executive Vice President.......................... 397
Ombudsman Claims Assistance..................................... 318
Physician Records/Credentials....................................... 367
Socio-Medical Economics............................................. 332
CANDIDATES ENDORSED BY MSSNY for NEW YORK STATE ASSEMBLY:
Michael Cusick (D, 63rd AD- Richmond County)
Deborah Glick (D, 66th AD, NY County)
Richard Gottfried (D, 75th AD, NY County)
Charles Lavine (D, 13th AD, Nassau County)
Bill Magee ( D, 121st AD, Madison, Oneida
and Otsego Counties)
Daniel Quart (D, 73rd AD, NY County)
Michele Schimel (D, 16th AD, Nassau County)
Robin Schimminger (D, 140th AD, Erie and
Niagara Counties)
albany office
Continuing Medical Education...........518-465-8085 ext.17
Public Health Committees.................518-465-8085 ext. 11
Governmental Affairs.....................................518-465-8085
Fax..................................................................518-465-0976
Other Numbers
Committee for Physicians’ Health.................800-338-1833
Dispute Resolution Agency............................516-437-8134
Kern, Augustine, Conroy & Schoppman.......516-294-5432
New York Times, September 28, 2014
Doctors, if you are receiving the MSSNY
Daily and the weekly Enews, great, we are
glad. These publications contain valuable
information about upcoming meetings,
webinars, ICD-10 news, e-prescribing,
EMR information and so much more vital
information to help our members try to keep
their heads above the regulatory waters.
If YOU are NOT receiving these publications, please be sure that we have your e-mail
address. We might have an email address
for you; but if you updated or changed that
email we might not have the most current
one on file for you. Please send us your current email listing to [email protected].
Your email address is never used, sold or
given to any other entity.
MSSNY’S WESTBURY OFFICE
Main Phone Number......................................516-488-6100
Toll Free Number...........................................800-523-4405
Main Fax Number..........................................516-488-1267
MSSNY Website......................................... www.mssny.org
If you are not already, you need to follow us on Twitter
and Facebook! (If you need help setting up an account, let
us know – please contact [email protected]). And please
“re-tweet” and “re-post” these important updates to those
physicians and other care providers who follow you.
Additional educational information is also available
from the MSSNY website, including a recently recorded
webinar (http://cme.mssny.org/) entitled “Ebola and What
Physicians Need to Know.”
We want MSSNY to be your “go to” source for information that will help you provide the best possible care for
your patients, as well as helping them to understand about
what they should, and should not, be concerned. We want
to help you separate facts from what can be unfounded
anxiety. Let’s make sure we have all the facts about how Ebola is
spread, how to identify patients who may have potentially
contracted it, and the proper protocols we should follow in
treating these patients, including proper use of protective
gear. And let me add that it is equally important to make sure
to remind our patients that there are many other infectious
diseases that are infinitely more common which can be
prevented. Tens of thousands die every year as a result of
complications from the seasonal flu. Let’s also remind our
patients of the importance of getting their flu shots.
Patients have always depended upon their physicians at
times of greatest medical need, and we need to be there for
them now more than ever.
CANDIDATES ENDORSED BY MSSNY FOR NEW YORK STATE SENATE:
Dean Skelos (R, 9th SD, Nassau County)
Kemp Hannon (R, 3rd SD, Nassau County)
Toby Ann Stavisky (D, 16th SD, Queens County)
CONGRESSIONAL CANDIDATES ENDORSED BY MSSNY:
Joseph Crowley (D- parts of Bronx and Queens Counties)
Chris Gibson (R- Broome, Columbia, Delaware, Dutchess, Greene, Montgomery, Otsego, Rensselaer, Schoharie,
Sullivan and Ulster Counties)
Tom Reed (R- Allegany, Cattaraugus, Chautauqua, Chemung, Ontario, Schuyler, Seneca, Steuben, Tompkins, Tioga and
Yates Counties)
Nan Hayworth, MD (R- candidate for New York’s 18th
Congressional District (Putnam and Westchester
Counties)
For more information concerning each of the endorsed
candidates and the reasons for the endorsement, please go to
the following link to MSSNY’s webpage: www.mssny.org/
MSSNY/ContentAreas/Election_Endorsements.aspx
(Continued on page 10)
The NEWS of NEW YORK ISSN 0028-9264, Periodical POSTAGE PAID at Westbury and other additional mailing offices. The NEWS of NEW YORK is published monthly by the
Communications Division, Medical Society of the State of New York, 865 Merrick Avenue, Westbury, NY 11590. Please address all correspondence to the Editor. POSTMASTER:
Please forward all change of address forms to the Editor, NEWS of NEW YORK, Medical Society of the State of New York, 865 Merrick Avenue, Westbury, NY 11590. Subscription,
$36.00 non-members, $18.00 members.
Page 4 • MSSNY’s News of New York • November 2014
Survey of 20,000 U.S. Physicians Shows 80% of Doctors are Over-Extended or at Full Capacity,
Demonstrating Growing Challenges for Patient Access
Biennial Research Commissioned by The Physicians Foundation Examines Physician Morale, EMR Patterns, Generational Differences,
Doctor Shortages, Medicare / Medicaid Participation Rates and More
U.S. patients are likely to face growing challenges in access
to care if shifting patterns in medical practice configurations
and physician workforce trends continue. This is one of the
key findings of a major new survey of 20,000 physicians
commissioned by The Physicians Foundation, a nonprofit
organization that seeks to advance the work of practicing
physicians and help facilitate the delivery of healthcare to
patients.
According to the research, titled “2014 Survey of America’s
Physicians: Practice Patterns and Perspectives,” 81 percent of
physicians describe themselves as either over-extended or at
full capacity, while only 19 percent indicate they have time to
see more patients. Forty-four percent of physicians surveyed
plan to take steps that would reduce patient access to their
services, including cutting back on patients seen, retiring,
working part-time, closing their practice to new patients or
seeking non-clinical jobs, leading to the potential loss of tens
of thousands of full-time-equivalents (FTEs). As the ranks of
Medicare and Medicaid patients increase - in 2011, more than
75 million baby boomers began turning 65 and qualifying for
Medicare - and millions of new patients are insured through
the Affordable Care Act, patient access to care could pose significant health delivery and policy challenges.
“America’s physician workforce is undergoing significant changes,” said Walker Ray, M.D., vice president of The
Physicians Foundation and chair of its Research Committee.
“Physicians are younger, more are working in employed
practice settings and more are leaving private practice. This
new guard of physicians report having less capacity to take
on additional patients. These trends carry significant implications for patient access to care. With more physicians retiring
and an increasing number of doctors, particularly younger
physicians, planning to switch in whole or in part to concierge
medicine, we could see a limiting effect on physician supply
and, ultimately, on the ability of the U.S. healthcare system to
properly care for millions of new patients.”
The survey, conducted online from March 2014 through
June 2014 by Merritt Hawkins for The Physicians Foundation,
is based on responses from 20,088 physicians across the U.S.
The overall margin of error (MOE) for the entire survey is
less than two percent, indicating a very low sampling error
for a survey designed to draw opinions and perspectives from
a large population.
decisions are often compromised - demonstrating a strong
potential bearing on quality of patient care.
As seen in previous survey years, a majority of physicians
(56 percent) continue to describe their morale as somewhat
to very negative However, optimism levels increased between
2014 and 2012. In 2014, 44 percent of physicians characterize themselves as somewhat or very positive about the current
state of the medical profession, compared to 32 percent in
2012.
The reason for this increase could be attributed to the
changing composition of the survey respondents. Specifically,
54 percent of younger physicians (ages 45 or lower) surveyed
are optimistic about the state of medicine, versus 30 percent
of older physicians (ages 46 or higher). Female physicians are
slightly more optimistic about the current state of medicine
(49 percent) than their male counterparts (42 percent). Fifty-
one percent of employed physicians are optimistic about the
current state of the medical profession, compared to 33 percent of physicians who own their own practice.
When asked about what grade physicians would give the
Affordable Care Act (ACA), 46 percent give a D or F grade.
Younger (ages 45 or lower), employed physicians were more
inclined to give the ACA favorable marks than older (46
or higher), private practice owners. In fact, 63 percent of
younger physicians (ages 45 or lower), would give the ACA a
grade of C or above.
“The state of the physician workforce, and medicine in general, is experiencing a period of massive transition,” said Lou
Goodman, Ph.D., president of The Physicians Foundation and
CEO of the Texas Medical Association. “As such, the growing diversity of the physician workforce will reflect different
(Continued on page 10)
Physician Workforce Demographics and
Patterns - A Changing of the Guard
In comparing the physician surveys conducted by The
Physicians Foundation in 2008 and 2012, the 2014 respondents are younger, more work in employed settings (e.g.,
hospital systems), there are more females and more work in
primary care. In 2014, the average age of the respondents is
50, versus an average age of 54 in 2012. In 2014, 33 percent
of the survey respondents are female, versus only 26 percent
in 2012. Importantly, survey respondents mirror the composition of the current U.S. physician workforce - providing a
representative understanding of the diversity of attitudes and
perspectives inherent among America’s doctors.
In addition to changing workforce demographics, the survey captured significant transitions underway in physician
workforce patterns and practice settings. For instance, in
2014, only 17 percent of physicians indicate that they are in
solo practice, down from 25 percent in 2012. In 2014, only
35 percent of physicians describe themselves as independent practice owners, down from 49 percent in 2012 and 62
percent in 2008. Fifty-three percent of respondents describe
themselves as employees of a hospital or medical group, up
from 44 percent in 2012 and 38 percent in 2008. More than
two-thirds of employed physicians (68 percent) expressed
concerns relative to clinical autonomy and their ability to
make the best decisions for their patients.
Physician Morale - Outlook Improving, but
Pessimism Still Remains High
In 2012, many physicians described high levels of government regulation, malpractice liability pressures, inadequate
and inconsistent reimbursement, and eroding clinical autonomy as factors leading to discontentment. In 2014, survey
questions focused more on clinical autonomy, given the
significant patient implications. When asked about levels
of clinical autonomy and the ability to make the best decisions for patients, 69 percent of physicians indicate that their
November 2014 • MSSNY’s News of New York • Page 5
Are You Ready
ANESTHESIOLOGISTS
I-Stop, another good reason to end the practice
of medicine. No other legislation has passed the
NYS Assembly unanimously for many decades. It
criminalizes the practice of medicine. Doctors never
asked for Oxycontin. In fact, in an article from 1995,
physicians warned Oxycontin would be the most
abused medication going forward. Patients never
asked for Oxycontin; a government corrupted by
lobbying gave us Oxycontin.
Anesthesiology, Long Island
E-prescribing is very difficult for anesthesiologists,
because we write very few prescriptions and we
are not equipped to do so.
Anesthesiology, NYC area
CARDIOLOGISTS
Another way for laymen to control patients/
doctors!!!
Cardiology, NYC area
Most experienced doctors will quit practicing.
I know at least 7 doctors that have left NY in last
3-4 years. I will quit practicing even though I would
like to work for a while longer.
(Continued from page 1)
• The prescriber has a waiver granted by the New
York State Commissioner of Health
• The prescriber reasonably determines that it
would be impractical for the patient to obtain
substances prescribed by electronic prescription
in a timely manner
• The prescription will be dispensed at a pharmacy located outside New York State
The law requires electronic prescribing for all
types of medications (controlled substances and
non-controlled substances) and for syringes and
other medical devices dispensed at a pharmacy in
New York. E-prescribing for controlled substances
is currently permitted by state and federal law but it
is optional until March 27, 2015. basis. Exact quantity used per month cannot be
determined. Many patients want written prescriptions that they will fill at a future date when needed.
If all my prescriptions must be e-prescribed,
my office will be inundated by prescription refill
requests from patients when they run out of topical
medication.
Dermatology, NYC area
Cardiology, Long Island
DERMATOLOGISTS
We DO have an e-prescribing system, but we do
not use it. The reason is that it is cumbersome,
inefficient, and time consuming. We are a busy
3-doctor General Dermatology practice, writing
as many as 100 prescriptions a day. It can take 5
minutes to send a single prescription electronically
(We do NOT have EMR). This regulation will be a
disaster for our practice, and will surely tempt us to
retire early! If enacted, we will have to hire a new
and costly employee to do nothing other than send
e-prescriptions! We do not prescribe controlled
substances, and to the best of our knowledge
have never had a problem with an “error” occurring because a prescription was hand written. In
addition, I can and do check every prescription for
accuracy before I hand it to a patient. This would
be impossible if the prescriptions were being
entered separately by a dedicated employee. We
are trying had to continue to provide “old fashioned” excellent care as an independent practice.
These “mandates” are making it increasingly difficult to continue doing so.
Dermatology, NYC area
This is just another reason why doctors are no
longer happy that they became a physician.
Dermatology, NYC area
Great difficulty with Surescripts – multiple
bounce backs, software is cumbersome, difficult
for multiple scripts. Very time consuming
3 minutes vs 30 seconds.
Dermatology, NYC area
I like the idea of e-prescribing, but it should not be
forced on MDs. I am a solo practitioner and within
10 years of retirement. The cost will be tremendous. We should have some type of financial help
or better tax credit.
Dermatology, Western NY
I am considering leaving New York. I think this mandate is an outrageous burden to place on individual
practitioners.
Dermatology, Central NY
E-prescribing is a useless waste of resources and is
impersonal and rude. No scientific basis of validity
of any value apart from legibility.
Dermatology, NYC area
We should have a choice. Why is everything always
mandatory?
Dermatology, NYC area
I write most of my prescriptions rather than
e-prescribe. As a dermatologist, most of my prescriptions for topical meds and are used on a PRN
Page 6 • MSSNY’s News of New York • November 2014
E-prescribing is a problem. When a patient has
prescriptions sent and they cannot afford the med,
I waste time on the phone. Also, sometimes I give
multi scripts so the patients can get the one they
can best afford. Can’t do this with e-prescribing.
One more unfunded mandate that makes retirement more appealing every day—if only I could
afford it.
Dermatology, Long Island
EMERGENCY PHYSICIANS
I wonder if mandates like these are designed to
accommodate the needs of IT and retail pharmacy,
and not those of the patients or the health care
professionals who serve them.
Emergency Medicine, Capital District
FAMILY PRACTICE
E-prescribing should be encouraged, but not
required. Market forces will drive docs to e-prescribe when the systems in place are affordable
and better than paper (which they are not).
Family Practice, Capital District
Help, I won’t survive. This will take me too long to
do all scripts!
Family Practice, Long Island
My vendor is usually leading the charge for new
features so if they do not have e-prescribing of
controlled substances yet, I am very pessimistic
that they will be able to have it by March 2015. I
worry about all the other vendors which are not yet
set up to do this.
Family Practice, Central NY
This helps to drive the small practitioner out of
practice.
Family Practice, Southern Tier
I work in a NYS operated facility. We currently do
not have an e-record. We cover the entire State
and have yet to find an e-record that fits our needs
due to the diversity. Agency may have to apply for
waiver/is trying to apply (not done by me). Mandate
is not practice friendly and there should not be a
one size fits all solution.
Family Practice, Western NY
Some patients demand they get a paper Rx.
Family Practice, Capital District
This mandate has the ability to greatly disrupt
patient care and overburden my already overburdened office staff. This will contribute to MD
burnout and promote early retirement for many
MDs in my age cohort.
Family Practice, Central NY
to E-Prescribe?
A waiver from this mandate can be granted in
limited circumstances. To qualify for a waiver, the
prescriber must demonstrate that his or her ability to issue an electronic prescription is unduly
burdened by: (a) economic hardship; (b) technological limitations that are not reasonably within the
control of the prescriber; or (c) other exceptional
circumstance demonstrated by the prescriber. The
waiver is good for up to one year at which time the
prescriber must reapply for a continuation of the
waiver and set forth an updated statement of facts
detailing the continuing circumstances in support
of the renewal.
In September, MSSNY polled New York State
physicians about their readiness and capability to
comply with the March 27, 2015 deadline.
I have no technical ability or the equipment to
e-prescribe, except when I am at my part-time
clinic, 2 days a week where I prescribe controlled
substances.
Family Practice, Mid-Hudson Valley
I have been told that the new law would prohibit
RNs from entering a pre-determined script and
putting it into the e-prescribing software for the
physician to sign. I am told that many physicians
have their RNs perform this function for refills. The
script cannot be sent until the physician validates
it in the system. This is a tremendous time saver
for a busy practice.
Family Practice, Central NY
I am semi-retired. I don’t think e-prescribing
should be mandatory to everybody.
Family Practice, Lower Hudson Valley
I believe e-prescribing should be an optional
program. Physicians should not be forced to
e-prescribe. I believe e-prescribing introduces
much opportunity for things to go wrong, and
errors to be made. It is excessively time consuming, and ought not be required of already
overburdened physicians. I would like to see
new legislation introduced and passed making
e-prescribing optional, or the least delayed for a
few years.
Family Practice, Long Island
Recently retired, I write a few prescriptions in my
volunteer work at a homeless shelter. It would not
be possible to e-prescribe.
Family Practice, Western NY
How does one accommodate this rule, when writing so few Rxs?
Family Practice, NYC area
Retired MDs are unable to prescribe after 3-2715. Why should they continue with registration?
Family Practice, Western, NY
I volunteer in a free clinic. I doubt they can afford
equipment needed for e-prescribing.
Family Practice, Central NY
Physicians who write very few scripts should be
exempt from the e-prescribing law.
Family Practice, Long Island
GASTROENTEROLOGISTS
The majority of pharmacies in NYC are not yet
set up to receive e-RX of controlled substances –
only Duane Reade and Walgreens accept them.
Gastroenterology, NYC area
I think paper Rx should still be allowed for
non-controlled substances, regardless of the circumstance. I agree that all controlled substances
should be electronic.
Gastroenterology, Mid-Hudson Valley
I have found all instances in which computers
have been used to carry out previously manual
record-keeping functions to be unbearable
burdens. The EMRs – for example – are slow,
complex to use, and incredibly time-consuming.
In the same vein I suspect electronic prescribing
will turn a 1 minute process into something much
longer and more tedious.
Gastroenterology, NYC area
SURGEONS
The law will increase the time per patient that I
cannot absorb.
General Surgery, NYC area
Another unfortunate incursion into my practice.
I’ve been in practice for forty years. I keep my
scripts locked up. I have never had a script stolen.
I have limited practice and do not wish to incur
the expense involved in this change. Plus, old
people don’t like change.
General Surgery, Central NY
DISGRACEFUL. Stuff like this will drive me out of
New York.
General Surgery, Long Island
INTERNAL MEDICINE
E-prescribing for controlled substances
ABSOLUTELY has to link with the EMR software
so that the prescriber does not have to input
the patient’s name, sex and DOB for controlled
substances and ISTOP. There should be a simple
click from the EMR to ISTOP to research prior
controlled prescriptions.
Internal Medicine, North Country
What if a patient hasn’t decided which pharmacy
to use? Shouldn’t a patient be permitted to shop
for the best price? What is the rational for this
system? Don’t the bureaucrats have anything
better to do?
Internal Medicine, Long Island
Affordability is a major concern for small solo
practices. Each new regulatory requirement
threatens to push me and other physicians into
retirement. Monthly charges for most EPCS
software appears to be close to $200/month. As it
is, a full-featured EMR system is well beyond my
reach.
Internal Medicine, NYC area
We can’t wait, will avoid a lot of phone calls
and patients coming in to pick up a written
prescription.
Internal Medicine, Southern Tier
eRx of controlled substances is a good thing
which MSSNY should encourage with educational
programs and zero resistance.
Internal Medicine, Lower Hudson Valley
Vendors need to email physicians with the status
and steps we need to do to make this work.
Internal Medicine, Long Island
This is a nightmare. Many of my patients use a
variety of different pharmacies and mail order
services, change pharmacies, and want written
prescriptions. They often don’t know which prescriptions go to mail order and which do not.
Internal Medicine, NYC area
I practice at several locations under contract.
They have only fledgling plans, or no plans, for
a comprehensive EHR. At two of these places,
the nurses write the (many) on-going prescriptions and I review and sign them. A stand-alone
eRx system would pose substantial problems for
work-flow.
Internal Medicine, Western New York
E-prescribing should be free and optional.
Internal Medicine, NYC area
I am concerned that E-Prescribing controlled substances will greatly increase time and complexity
to prescribe medications and will only increase
outside monitoring of prescribing practices to the
detriment of practitioner.
Internal Medicine, Capital District
I will give up all practice if not able to
prescribe.
Internal Medicine, Long Island
Computer technology has only slowed
down our practice. Currently overwhelmed with volume of patients and
paper work. E-prescribing will just slow
us down more. We will likely hold off till
we can’t anymore.
Internal Medicine, NYC area
I have a limited practice and cost of
software and charges for intermediary is
too much vs. insurance reimbursement.
I would rather stop caring for my patient
population. I have no idea where they will
go, but thousands will be displaced from
the 100 or so physicians who will quit.
Internal Medicine, Long Island
I am in solo practice and think EMR and
e-prescribing are unnecessary for my
practice and may lead to breaches in
patient privacy.
Internal Medicine, NYC area
I have tried Rxing with Allscripts--it takes
much too long to Rx; I find it impossibly
cumbersome and time consuming.
Internal Medicine, NYC area
There needs to be a plan for low medication prescribers.
Internal Medicine, NYC area
May force me to retire.
Neurology, NYC area
If this is what the legislature wants, this is
what the people of NY will get. The legislature, both state and federal is far too
powerful in regards to physicians. Easy
for them, all lawyers. How many tests
annually do they take? Think about it,
please. They need us doctors when they
get sick, and have no compunction about
it. I went into medicine to treat human
beings, not follow mandates of idiots.
Neurology, NYC area
OB-GYNs
E-prescribing is very impractical, with
risks and inconvenience to all that far
outweigh the benefits envisioned by the
elites/politicians.
OB-GYN, NYC area
E-prescribing takes more time than writing prescriptions, delays office hours,
increases patient office appointment
waiting times and thus increases patient
dissatisfaction. E-prescribing requires the
use of electronic equipment which is not
always available, removes the capabilities of retired physicians to write Rxs if
they have no equipment at home and
often generates phone calls from patients
whose Rxs don’t “go through,” electronically. All this is a step backwards.
OB-GYN, Long Island
NEUROLOGISTS
ONCOLOGISTS
This is a hardship; now that there is
ISTOP, scripts are being checked already.
Patients want to leave the office with
their script to take to the pharmacy of
their choice, which can change over
time. Doctors cannot continue to be
burdened by increased time constraints
and financial outlays while managed care
reimbursement rates do not go up at all
despite increased practice expenses.
MSSNY needs to pressure insurers to
fairly reimburse the good doctors of this
state (i.e. GHI rates of 47 dollars for an
office visit are barely above Medicaid
rates). It is quicker to write a script than
to have to enter data into a system on
every patient for scripts.
I am not in active practice - I am consulting. I continue to write prescriptions for
a few colleagues and old patients who
do not need active medical attention. No
reason to have access to e-prescribing
for this. I resent a mandate that will limit
my ability to continue to function as a
physician.
Neurology, Long Island
Death by 1000 fees: $400/yr. to eRX
(even on a “free” system) especially if you
want to prescribe controlled substances.
Clearinghouses for billing. Cuts for not
having EHR. It goes on and on. This
government clearly does not want to have
doctors.
Neurology, Long Island
Oncology, NYC area
My ability to e-prescribe will mean that
the hospital buy a program tied in to our
present technology. Unfortunately our
present technology needs updating. This
update is expensive and the hospital is
unable financially to provide it at this time.
Oncology, Southern Tier
The need for biometrics or an ID token
will make this difficult. I am an oncologist
and necessarily prescribe narcotics for
cancer pain.
Oncology, Capital District
OPTHALMOLOGISTS
How do patients shop for the best price
from the pharmacy, when they have to
pick their pharmacy at the time the Rx is
(Continued on page 8)
November 2014 • MSSNY’s News of New York • Page 7
Are You Ready to E-Prescribe?
(Continued from page 7)
PEDIATRICIANS
written? This is good for pharmacy but bad
for patients.
The last time I tried to e-prescribe a controlled substance w/ Allscripts a message
was returned that NYS did not allow it. I have
registered w/ NYS for e-prescribing controlled substances, but I have not contacted
Allscripts or tried again.
Ophthalmology, Lower Hudson Valley
E-Rx is time consuming and cumbersome. I
would rather use good old fashioned pad and
pen.
Pediatric Care, Western NY
Ophthalmology, Mid-Hudson Valley
Anticipate significant time (and therefore
practice expense) for staff to utilize Rx
software. Also extra demand on my time to
supervise staff so as to avoid staff error (as
opposed to my just writing Rx).
Ophthalmology, NYC area
I think there will be numerous errors!
Accidently hit the wrong key and the wrong
medication results. Pharmacists tell me that
the instructions they receive electronically
often don’t make sense!
Ophthalmology, NYC area
I used iPrescribe for a while. It is massively
inconvenient. I’m switching to Allscripts out
of necessity, but it’s still like typing with mittens on. Just more government control of
medicine. I’m glad retirement is within sight.
Ophthalmology, Central NY
Some patients insist on a hard copy as they
don’t know which pharmacy they will use.
Sometimes cost is an issue. How are they
supposed to shop around with mandated
e-prescribing? It also takes much more time,
clicking and typing away, to e-prescribe.
Ophthalmology, NYC area
Many patients are unable to specify the location or phone number of their pharmacy. This
makes it impossible to send an eRx. NYS
should mandate that all citizens know the
address and/or phone number of their preferred pharmacy - I have better things to do
than show them maps on Google or search
for a pharmacy convenient to them.
Ophthalmology, NYC area
I want to continue to have the ability to prescribe using a written format even though the
vast majority of my prescribing is electronic.
Ophthalmology, NYC area
ORTHOPEDIC SURGEONS
Using Allscripts standalone. This will not be
able to handle narcotics. I will need to step
up to a pay for product with Allscripts.
Orthopedic Surgery, Southern Tier
I think E-prescribing controlled substances
is a great idea...what took so long? I hope it
becomes an effective way to eliminate inappropriate prescribers.
Orthopedic Surgery, Western NY
I don’t know where and how to obtain software for electronic prescribing.
Orthopedic Surgery, NYC area
I am retired from active patient-care practice. I only do non-patient related activities
but write an occasional prescription. I have
been told that without reimbursement for
patient care and for the few prescriptions I
write that I do not have to do anything about
e-prescribing.
Orthopedic Surgery, NYC area
Congratulations DOH, you have successfully
forced me to completely retire from active
practice. At this point, my practice is mainly
IMEs, but I maintain a small office practice
(no surgery) and write about 8-10 prescriptions per month. I will have to quit that since
I cannot afford the cost of equipment for
e-prescribing.
Orthopedic Surgery, Central NY
There are >10 pharmacies in a 4 block radius
of our office. Patients and caregivers don’t
know which one they go too, they barely have
the name and address let alone the code /
address I’d have to use to e-prescribe. Also
if it is not in stock, pediatric patients have
to shop around. I think this penalizes small
businesses and small pharmacies and limits
parent’s choices and convenience. As peds,
we are usually prescribing ‘emergency’ meds/
antibiotics not chronic ‘90day’ supplies.
Pediatric Care
I have borrowed from my personal savings to
keep the practice open this year due to such
poor insurance company reimbursement
rates; coming up with funds to meet this
unfunded mandate is just not an option.
Pediatric Care, Lower Hudson Valley
More time is clearly needed to get this right.
My vendor is clear that the system does not
currently work well.
Pediatric Care, Mid-Hudson Valley
Politicians are quick to make rules for others
that cost increased dollars without appropriate remuneration. They should get their own
house in order first.
Pediatric Care, NYC area
This is an awful idea; we are still exploring
purchasing an EMR. This mandate may force
us to buy a system that we are not comfortable with just to meet the deadline. I am very
upset about the ISTOP system, and this is
just another administrative burden. Why is NY
doing this when other states are not? Please
fight the legislature and extend the deadline!
Pediatric Care, Lower Hudson Valley
The cost created by E-Rx is not reasonable
when cost/benefit to the patient is considered. No study I am familiar with shows this
to be the solution or a major part of the solution to patient compliance, drug errors, over
dosage, dispensing mistakes or expediency.
At a time of great stress financially to the consumer and physician, additional unwarranted
costs should be avoided.
Pediatric Care, NYC area
I am concerned about the learning experience
of the new software, the cost of the software
and the fact that I am a solo practitioner with
plans to retire within the next three years.
Pediatric Care, NYC area
How will this affect residency programs? Are
there any plans for residency training? The
residents don’t have prescribing capability
through our EMR. Also, how will residents
learn how to write prescriptions if they are
unable to do so?
Pediatric Care, NYC area
PLASTIC SURGEONS
I have no intention of spending thousands of
dollars to e-prescribe when I write less than
40 prescriptions a year
Plastic Surgery, NYC area
Another unfunded, burdensome mandate
with no proof of success!
Plastic Surgery, Lower Hudson Valley
Takes more time to e-prescribe. Patients
need to know the exact pharmacy that they
are going too. What happens if the medica-
Page 8 • MSSNY’s News of New York • November 2014
tion isn’t available at the emailed pharmacy?
With a Rx written, a patient can go to several
pharmacies based on drug availability and
cost!
physician’s patient’s records or a pharmacy’s
records? Another brilliant idea from the
government, another big contract for private
companies. Shameful.
Plastic Surgery, NYC area
PSYCHIATRISTS
Though I have several jobs, my private
practice is so small that purchase/time spent
learning, etc. would be so expensive, and I
would have to retire.
Psychiatry, Western NY
Too much hassle; will probably discontinue
prescribing any medications at all.
Psychiatry NYC area
E-prescribing would be a great burden on
me as I am not computer comfortable. It is a
source of anxiety.
Psychiatry, Long Island
I find ISTOP and this new requirement
intrusive. I don’t keep a computer (aside from
a smartphone) in my office to avoid diluting
empathic contact, and do my computing at
night at home, including ISTOP. E-prescribing
will cost me money for another computer and
it is not secure and will be cumbersome.
Psychiatry, Long Island
E-prescribing has been great and has simplified my practice, especially being able to
e-prescribe controlled medications. Now,
if we could only get the pharmacies to stop
harassing us about “auto refills” and renewals
of prescriptions without office appointments.
Psychiatry, NYC area
I am concerned about pharmacies which
don’t stock many controlled drugs:
Suboxone, Amphetamines, and the outcome
of the prescription.
Psychiatry, Lower Hudson Valley
I am very concerned about internet security.
I have a locked internet account at my office
but am not sure how to be sure that it is
secure. If I got hacked and my prescribing
info was released, I do not want to be liable.
I heard there are thousands if not millions of
health records that have been hacked and
can be bought online. Not to be paranoid but
how secure can I be and do I need to be?
Psychiatry, NYC area
Psychiatry NYC area
I am essentially retired, don’t treat patients,
and will only very rarely write a prescription for someone who had been a long term
patient. Ethically I would be uncomfortable
with that.
Psychiatry, Long Island
More nonsense to intrude on doctor patient
relationship, devaluing honesty of physician.
Psychiatry NYC area
I can’t wait until we can e-prescribe all
prescriptions. I wish our vendor would hurry
up and get credentialed, since there is no
need to wait until 3/27/15 as it is legal now to
e-prescribe controlled substances. Of course,
I do not know how many pharmacies in my
area are yet accepting them as I have been
unable to try this.
Psychiatry, Mid-Hudson Valley
I began e-prescribing one year ago and
investigated e-prescribing controlled
substances. The regulations required three
physicians and I am a solo practitioner in
private practice.
How could anyone prescribe to a pharmacy
not knowing if the pharmacy has the medication in stock, particularly on a new patient?
Psychiatry, Long Island
I am 78 years old, and I greatly enjoy my
work with patients. However, after trying
e-prescribing I find it a hassle, and I am
aware of increasing governmental demands
re: e-prescibing, as well as other aspects
of practice, to a degree that I feel I may be
forced to retire before I’d wish to do so. I’ve
been refusing new Medicare patients for the
last two years, and I feel I should probably
withdraw from that program, although I feel
bad about discontinuing with those patients.
Psychiatry, Long Island
The e-prescribing has led to more errors with
the pharmacy than written prescriptions.
Psychiatry, Central NY
This is sure to cause utter chaos. Everyone
I know who e-prescribes says they then get
email calls and faxes from the pharmacy.
Enormously inefficient.
Psychiatry, NYC area
Psychiatry, Long Island
There is always the potential for error
with electronic data, as well as breach of
confidentiality.
Psychiatry, Long Island
From what I have been told, NY and/or
the DEA require a complicated system for
prescribing of controlled substances which is
highly unfortunate as the current e-prescribing of non-controlled substances is much
more secure than any paper scripts.
Psychiatry, Long Island
I don’t understand the state’s goal in mandating e-prescribing rather than making it
optional. I believe that for my patients, getting
the physical written prescription directly
from me is part of the therapeutic process.
I want them to remain central in the loop. I
have the relationship with them. They have
the relationship with the pharmacist and
the responsibility of getting the Rx to the
pharmacist.
Psychiatry, Long Island
Another burden on the solo practitioner
physician. What is the purpose of it when
we hear every day about stolen personal
data from banks, stores, etc. Why wouldn’t
a hacker steal personal information from a
I would like to obtain e-prescribing software
without having to purchase an entire EMR.
And I am within one year of retirement.
Psychiatry, Lower Hudson Valley
RADIOLOGISTS
NOT happy about this-BIG hassle!
Radiology, Mid-Hudson Valley
Routine prescriptions should be allowed by
telephone, directly to the pharmacy.
Radiology, Western NY
I would like to see a waiver possibility for
e-prescribing for retired physicians who prescribe less than 50 prescriptions per year.
Radiology, Central NY
I think MSSNY or NYS Dept. of Health should
issue specific instructions to low prescribing
MDs as to how to obtain a waiver from the
e-prescribing mandate.
Radiology, Capital District
VASCULAR SURGEONS
Although ADS is listed as having capability
with a contractor, they have told us several
times they cannot do controlled meds.
Vascular Surgery, Long Island
CMS Reopens Submission Period for the Meaningful-Use Hardship Exception
Eligible professionals are required to
demonstrate meaningful use of Certified
Electronic Health Record Technology
(CEHRT) or obtain a waiver for failure to
demonstrate meaningful use. Failure to comply with one of these requirements will result
in a 2015 Medicare payment adjustment,
which will reduce Medicare reimbursements
by 1% for 2015. A reduction in payment will
continue each year until the reduction reaches
5% if the eligible professional continues to
fail to meet one of the requirements. CMS
has announced it will reopen the submission period for the meaningful use hardship
exception applications. The reopened submission period is for eligible professionals
who have been unable to fully implement
2014 Edition CEHRT due to delays in 2014
Edition CEHRT availability and were unable
to attest by October 1, 2014. Eligible professionals will now have until November 30,
2014 to submit a hardship exception application. The new application may be found on
the CMS website at http://ow.ly/CFVhb.
• Second, the identity proofing process as
defined in the federal requirement must be
completed;
• Third, a two-factor authentication as
defined in the federal requirements must be
obtained;
• Fourth, the DEA certified EPCS software must be registered with the Bureau
of Narcotic Enforcement of the NYS
Department of Health.
There are many electronic prescribing vendors (eRx vendors), but not all eRx vendors
meet all the federal security requirements for
EPCS. It is strongly recommended that you
require the eRx vendor to provide proof that
it meets all federal security requirements
for EPCS. According to the DEA, an appli-
cation provider must either hire a qualified
third party to audit the application or have
the application reviewed and certified by
an approved certification body. The auditor
or certification body should issue a report
that states whether the application complies
with DEA’s requirements and whether there
are any limitations on its use for controlled
substance prescriptions. The application provider must provide a copy of the report to
the healthcare professionals who use or are
considering use of the electronic prescription application to allow them to determine
whether the application is compliant with
DEA’s requirements. The DEA website provides a list of certifying organizations whose
certification processes have been approved by
the DEA: http://ow.ly/CFXMV.
According to a recent report of the Medical
Society of the State of New York (MSSNY),
MSSNY plans to interview eRx vendors for
possible selection and offering as a MSSNY
membership benefit. Please note that beginning on March 27, 2015, you will be required
to issue electronic prescriptions. Public
Health Law §281.
The Bureau of Narcotic Enforcement has
issued FAQs for EPCS, which is available at:
http://ow.ly/CFY6b.
For more information on the above
items, contact Kern Augustine Conroy &
Schoppmann, P.C. at 1-800-445-0954 or via
email at [email protected].
National Practitioner Data Bank
Fees Reduced
The National Practitioner Data Bank
(“NPDB”) collects information on all payments made on behalf of physicians in
connection with medical liability settlements or judgments, as well as adverse peer
review actions against licenses, clinical privileges and professional society memberships
of physicians and other practitioners. The
information is considered confidential and
released only to eligible entities or to individual practitioners who perform self-queries.
Some employers require that physicians
annually submit self-query reports as a condition of employment. Effective October 1,
2014, the National Practitioner Data Bank
has decreased its fees for queries. The new
fee for continuous and one-time queries
is $3.00 and the new fee for self-queries is
$5.00. You may find further instructions on
performing self-queries on the NPDB website: http://ow.ly/CFVyH.
New York Electronic
Prescribing Vendors
Effective March 27, 2015, a NY law
(Public Health Law §281) will go into effect
that will require physicians and other healthcare professionals (excluding prescriptions
issued by veterinarians) to issue prescriptions
electronically directly to a pharmacy, with
limited exceptions. In order to electronically
prescribe controlled substances (EPCS) in
schedules II through V, you must take the following additional steps:
• First, the software must meet all the federal security requirements for EPCS, which
can be found on the Drug Enforcement
Agency’s (DEA) web page http://ow.ly/
CFXuJ (Note that federal security requirements include a third party audit or DEA
certification of the software);
November 2014 • MSSNY’s News of New York • Page 9
ALLIANCE
AMA Alliance Northeast Regional
Leadership Conference a Success in Syracuse
AMA Alliance members attending NE Regional meeting visit Stickley Showroom
Survey of 20,000 U.S. Physicians
(Continued from page 5)
perspectives and sentiments surrounding the
state of medicine. While I am troubled that a
majority of physicians are pessimistic about
the state of medicine, I am heartened by the
fact that 71 percent of physicians would still
choose to be a physician if they had to do it
over, while nearly 80 percent describe patient
relationships as the most satisfying factor
about practicing medicine.”
Electronic Medical Records
and Additional Findings
Eighty-five percent of physicians surveyed
indicate that they have implemented electronic medical records (EMR). Yet, only 24
percent say that EMR systems have improved
efficiency and only 32 percent indicate that
it has improved quality of care. Nearly half
of respondents (47 percent) noted that EMR
systems detract from patient interaction.
Additional survey findings include:
• Thirty-nine percent of physicians indicate
that they will accelerate their retirement
plans due to changes in the healthcare
system
• Twenty-six percent of physicians now
participate in an Accountable Care
Organization (ACO), though only 13 percent believe ACOs will enhance quality
and decrease costs
• Fifty percent of physicians indicate
implementation of ICD-10 will cause
severe administrative problems in their
practices
• Physicians spend 20 percent of their time
on non-clinical paperwork
• On average, physicians surveyed said 49
percent of their patients are enrolled in
Medicare or Medicaid
• Yet 24 percent of physicians surveyed
either do not see Medicare patients or
limit the number Medicare patients they
see
• Thirty-eight percent of physicians either
do not see Medicaid patients or limit the
number of Medicaid Patients they see
• Physicians surveyed said they work an
average of 53 hours per week and see
approximately 20 patients per day
“The more than 20,000 physicians who
participated in this survey also submitted
more than 13,000 written comments - demonstrating the eagerness of doctors to voice
their perspectives on the critical issues
impacting America’s patients and healthcare
system,” said Tim Norbeck, CEO of The
Physicians Foundation. “With more than one
million data points derived from this survey,
our hope is that policy makers, healthcare
influencers, media and other stakeholders
will use the findings as a valuable resource to
better understand the underlying challenges
facing our healthcare system, and formulate
effective policies that will advance the health
and interests of our patients.”
Save the Date:
MSSNY STATE LOBBY Day
is March 4, 2015
Page 10 • MSSNY’s News of New York • November 2014
The sun shined brightly all weekend, which highlighted the beauty of
Syracuse – its streets of colorful maple
trees, the expansive campus of Syracuse
University, the Rose Garden, the Carrier
Dome, SUNY Upstate Medical campus,
nearby historic communities, and the
undulating hills laden with a bountiful fall
harvest of apples, grapes, squash, corn
and pumpkins.
AMAA members attended from Ohio,
Maryland, Massachusetts, New York and
Pennsylvania.
The AMSSNY planning committee
consisted of Joan Cincotta (Onondaga),
Stephanie
Cospito
(Schenectady),
Julia Nosovitch (Onondaga), Lynn
Pyke (Onondaga), and Kate Singh
(Schenectady). AMSSNY Executive
Director, Kathleen Rohrer worked hard
to offer an excellent balanced program
enjoyed by all.
Educational Programs
The educational elements included a
leadership segment by Michael Saccocio,
Executive Director of City Mission of
Schenectady and a legislative update by
Barbara Ellman and Donna Baver Rovito.
Barbara is Associate Director for policy
for MSSNY as well as a Lobbyist for 60
Senate and Assembly members of the
New York State Legislature and Donna
is a trained journalist and broadcast professional who has spoken about medical
liability and health care reform for almost
20 years. She is also the editor of the new
Physician Family, an AMAA online publication (www.physicianfamilymedia.org),
that includes a weekly blog. The topic of
sports concussions was addressed by Dr.
Claudine Ward, Medical Director of the
Concussion Program at SUNY Upstate
Department of Physical Medicine and
Rehabilitation and Cheryl Stier, RN,
Co-Chair of NY State AMAA Health
Promotions and past Co-President of
AMSSNY. Dr. Robert Paeglow of Albany
spoke to us about “The Medical Marriage.”
Julie Newman, AMAA President-Elect
spoke on Mentorship, and Donna Rovito
spoke on managing social media.
Off-site tours included the Stickley
Museum in Fayetteville, the Matilda
Joslyn Gage House, a station in the
Underground Railroad and the home of
women’s rights worker, Matilda Joslyn
Gage, and lunch with tour and wine tasting at the new Owera Winery located
near Cazenovia Lake. A Chinese auction
was held to raise grant funds through the
new AMAA Alliance Health Education
Initiative, the NY State Physicians Home,
the AMAA Grassroots Honor Fund, and
the Belle Tanenhaus Leadership Fund.
The AMSSNY Fall meeting was held
on Sunday afternoon.
Please save the date for MSSNY Lobby
Day March 4 in Albany and for the
AMSSNY Annual Meeting April 30- May
1 in Saratoga Springs.
mssnypaC
MSSNYPAC Endorsements
(Continued from page 4)
Unlike other organizations, MSSNY
has endorsed very few candidates, and has
reserved such distinction for only those
individuals, regardless of political affiliation, who have demonstrated themselves
to be “champions” of issues to preserve the
ability of our patients to continue to receive
needed and timely physician care. The list
was developed and approved by MSSNY’s
State Candidate Evaluation Committee,
chaired by Westchester county neurosurgeon Dr. Thomas Lee, and MSSNY’s
Federal Candidate Evaluation Committee,
chaired by Staten Island Internist Dr.
Vincent Calamia, with input from the
MSSNYPAC Executive Committee. In addition to consideration of these
endorsements, there are a number of
ways physicians can help elect friends of
medicine. They can work on campaigns
themselves walking their neighborhoods
with the candidates, holding “get to know”
you events at their home, and making calls
of their behalf. Physicians can also make
contributions directly to the campaign
committee of their favorite politician.
Most importantly, physicians can and
should join MSSNYPAC. It is through
MSSNYPAC that the collective strength
of organized medicine can be found.
MSSNYPAC is strong but it can become
infinitely stronger if your friends and colleagues join.
This is a particularly critical time of year
given the countless requests MSSNYPAC
has received from the hundreds of candidates across the state of New York. Go to
the link below to join or to increase the
level of your MSSNYPAC contribution.
Please go to MSSNYPAC’s website to
make your contribution now! http://bit.
ly/1oB2wv7
Business Associate Agreement Update Reminder
Warning on Campaign Donations?
Members of the American Cancer Society’s New York branch are
mulling a move that could put more pressure on lawmakers to forgo
tobacco money, which has continued to flow into state and local
committees for Republicans and Democrats.
“Just as there are warning labels on cigarettes, there should be
warning labels when you see (campaign) donations that this could
be dangerous to public health,” remarked Michael Burgess,
government relations director at The American Cancer Society Cancer
Action Network of NY & NJ.
He said that the group’s counterpart in California has already launched
a campaign asking legislators there to swear off tobacco money.
Times Union (9/22)
MSSNY MSS to Participate in St. Jude’s “Give Thanks Walk”
A great way to spend the day – support cancer research and catch up with
your colleagues! The annual St. Jude’s “Give Thanks Walk” will take
place on November 22 in two locations:
Shopping Town Mall
3649 Erie Blvd East Syracuse, NY 13214
8:00 am registration, 9:00 am walk
The walk will be held indoors, no need to
worry about the cold!
Upstate Medical School Students register:
http://walk.stjude.org/
upstatenymedschools For questions contact:
Jennifer Taylor at [email protected]
Camden Plaza Park
Downtown Brooklyn, New York, NY 11201
9:00 am registration, 10:00 am walk
Downstate Medical School Students register:
http://walk.stjude.org/mssnydownstate
For questions contact:
Sunita Sridhar at
[email protected]
You can also sponsor your own team for the walk by
clicking register on the link at: http://tinyurl.com/q48gyqp
Can’t make the “Give Thanks Walk” this year? You can still show your
support! Contact Jennifer Taylor ([email protected]) or Sunita Sridhar
([email protected] ) to make a donation.
MSSNY wants to highlight your charitable events! Please send information
to Julie Vecchione at [email protected] or call: 516-488-6100 ext. 340.
OBITUARIES
BRIGANDI, Angelo R.; Rochester NY. Died August 10, 2014, age 79.
Monroe County Medical Society.
EWING, Kenneth A.; Port Washington NY. Died September 01, 2014, age 77.
Nassau County Medical Society.
GRUBER, Ellis; Rochester NY. Died August 18, 2014, age 90. Monroe
County Medical Society.
JAMESON, Gerardus Smith; Schenectady NY. Died August 18, 2014, age
80. Medical Society County of Schenectady.
NYITRAY, Marko; Bakersfield CA. Died August 18, 2014, age 81. Nassau
County Medical Society.
RUDANSKY, Sheldon; Cedarhurst NY. Died September 01, 2014, age 91.
Nassau County Medical Society.
WADSWORTH, John Murray; Buffalo NY. Died September 14, 2014, age
77. Erie County Medical Society.
WILLER, Justin A.; Brooklyn NY. Died September 01, 2014, age 50. Nassau
County Medical Society.
Correction: Dr. Necati Keskin was incorrectly listed in the October News
of New York’s obituaries. According to the physician who called MSSNY,
Dr. Keskin (Nassau County), age 93, is alive and well and living in Istanbul,
Turkey.
Question: My Business Associates are starting to
send me updated agreements, but our old agreements
have not expired yet. Is a new agreement necessary?
Answer: Yes. A Covered Entity, such as a practitioner
or medical practice, is required to enter into Business
Associate Agreements with all Business Associates
(“BA”). The HITECH/Omnibus Rule expanded the
definition BA to include any entity that, on behalf
of a Covered Entity, creates, receives, maintains or
transmits protected health information (“PHI”) for a
HIPAA-regulated function or activity.
The definition also includes a subcontractor of a
BA, which is a person or entity that creates, receives,
maintains or transmits PHI on behalf of a BA. In
other words, those (other than a workforce member)
to whom your BA delegates a function, activity, or
service involving PHI. As a Covered Entity, you do
not have to enter into a BA Agreement directly with
these subcontractors, but your BAs must do so and
you must require your BAs to do so.
The HITECH/Omnibus Rule also set forth new
requirements for BA Agreements. If you have not
updated your existing BA Agreements after January
25, 2013, you will be required to do so by September
23, 2014. The BA Agreement must require the BA to
comply with the new Security Rule and applicable
provisions of the Privacy Rule. It should further
require the BA to have BA Agreements with all
Subcontractors, and it should avoid characterizing your BA as your agent (so you do not create an
impression that you have assumed liability for the
acts of your BA). That means not having authority
(either on paper or in practice) to control the BA’s
conduct nor to provide interim directions to the BA
regarding its performance. The BA Agreement also
must require your BA to report to you within a short
timeframe any security incident of which it becomes
aware, including breaches of unsecured PHI.
A sample BA Agreement is available on DrLaw.
com. Additional contract provisions may be beneficial to a Covered Entity depending on the nature of
the relationship and the underlying service provided
by the BA. You should seek legal counsel to determine
what additional protections may be warranted in a
particular BA Agreement.
If you have any questions, please contact our
Managing Partner, Michael J. Schoppmann, Esq at
1-800-445-0954 or via email at MSchoppmann@
DrLaw.com.
CLASSIFIED ADVERTISING
MSSNY’S CLASSIFIED HAS GONE GLOBAL
Classified ads can be accessed on MSSNY’s website at
www.mssny.org. Click classifieds.
DECEMber 2014 ISSUE CLOSES November 12
$150 per ad; $200 with Photo
PHYSICIANS’ SEARCH SERVICES • ALLIED MEDICAL PLACEMENTS • LOCUM TENENS • practice valuation
practice brokerage • practice consulting • Real estate
for help, information or to place your ad, call 516-488-6100 x355 • Fax 516-488-2188
SUblease of Office Space
7800 SF Medical/Professional Building by owner (MD).
Completely new, available for sale or lease.
State Road 25A in Port Jefferson Station.
Walk to St. Charles/Mather Hospitals. Short drive to SBUH.
Call for info 631-476-9100.
Upper West Side
SEEKING SUBLEASE OF MEDICAL SPACE
Neurosurgical practice seeking sublease of
one/two exam room(s), one consult office and
shared reception. One day per week.
No surgical procedures.
Upper West Side of Manhattan, in vicinity of
66th St and 10th Ave/Amsterdam Ave.
Please contact: [email protected]
516.314.3290
Place Your Classified Ad In News Of New York!
Leasing or Selling Space? Selling your practice or equipment? All Ads $150; $200 with Photo
Call 516-488-6100, ext 355
business showcase
Medical Review Officer Training
(Special CME Programs)
Come learn the technical, legal, business procedures
and guidance to act as a certified Medical Review
Officer for drug free workplace testing. (Urine, Hair,
Sweat, Oral Fluid and Alcohol Testing)
Basic Comprehensive MRO Training
including Certification Exam (Friday–Sunday)
Washington, DC September 26–28, 2014
Las Vegas, NV December 12–14, 2014
Advanced – Certified only
(Saturday–Sunday)
Washington, DC September 27–28, 2014
800-489-1839
www.aamro.com
November 2014 • MSSNY’s News of New York • Page 11