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The Leg.UpLocal, state and national news of interest to thephysician communityOctober 23, 2019Congratulations, Dr. DealThe Richmond Academy of Medicine extends heartfeltcongratulations to one of our ow n: Dr. Clifford L. Deal,III, w ho w as inaugurated as the Medical Society ofVirginia's president at last w eekend's annual meeting."There has never been a more important time to beinvolved in organized medicine," he said in his inauguraladdress. "W e have a special obligation, your professionalresponsibility, to fight for health care that upholdsphysician values, values of service, compassion, excellenceand integrity. W e are here because w e are called to dothis w ork."Another dedicated RAM member, Dr. Richard Szucs, has served as MSV president forthe past year, w orking tirelessly to protect patients and the House of Medicine. Thankyou, Dr. Szucs!RAM Members Work Tirelessly to Protect Patients, Profession

A special thanks to all RAM physicians w ho attended the MSV Annual Meeting on behalfof the Academy, on behalf of their specialty societies, or as an MSV designated delegate.District 3 had the largest show ing of any district in the state including a great turnout ofVCU medical students led by RAM's student Trustee, Zoe Moyer! W ell done RAMphysicians!W e’d like to thank Drs. Zubair Hassan, Thomas Moffatt and David Wilkinson for theirservice on Reference Committees at this w eekend’s meeting. W e'd also like to thank Dr.Joanne Lapetina for serving as Chair of the Credentials Committee.Our delegates w orked tirelessly to pass resolutions regarding maintenance ofcertification (MOC), stopping robocalls in Virginia, curtailing direct consumer advertisingof prescription drugs, increasing transparency and regulation of pharmacy benefitmanagers in Virginia, and other important issues. In some instances, recommendationsw ere to not pass our proposals but RAM w ouldn’t take “NO” for an answ er andsuccessfully advocated for passage.W e hope you'll make plans now to attend next year's MSV Annual Meeting — Oct. 9 11, 2020 — at the Homestead Resort.Click here to see photos of our delegates at w ork (and play) at this year's annualmeeting!RAM Members Win State Awards for ServiceAt the MSV annual meeting, MichelleWhitehurst-Cook, MD received theSalute to Service Aw ard for Serviceto the Uninsured and Underserved.The aw ard is presented to aphysician w ho has dedicated his/herabilities to improving the health ofthe uninsured and underserved.Also, Sudha Jayaraman, MDreceived the Salute to Service to theInternational Community aw ard. Thishonor is presented to a physicianw ho has dedicated his/her abilitiesto advancing the health of theinternational community.Looking Ahead to the General AssemblyPhysicians are fired up to make a difference. Be sure tolet your legislators know how they can help us.Mark your calendars for our 2020 White Coats on Calldays at the General Assembly. They'll be held:January 16January 24February 17Questions? Contact Lara at lknowles@ramdocs.org or 804-622-8137.

Voting Now Open for Your 2020 Trustees and OfficersIt's YOUR Academy; make your voice heard.The electronic polls are open until 11:59 p.m. on Nov. 11 to votefor your 2020 officers and trustees.Click HERE to vote. If you have not yet created a password (or don’tremember your password), click “forgot password” and follow theprompts.If you do not wish to vote electronically, you may vote between 5:30and 6:30 p.m. at RAM's general meeting on Nov. 12. Click here to'What Patients Should Know About the Vaping Epidemic'Thanks to Dr. Ritsu Kuno for penning a great column in thisw eek's Richmond Times-Dispatch on the dangers of vaping.He w rites, "For now , w hat w ould I tell that patient w ho asksabout vaping? I w ould first and foremost strongly recommendthat they avoid vaping. But if they absolutely must vape, theyshould avoid illicit, black market and THC-containing products.Until w e know more, the risks are too high."Dr. Kuno is a long-serving member of the RAM Board of Trustees,a member of the board of Honoring Choices Virginia, a newmember of the Medical Society of Virginia Board of Directors andpractices w ith Pulmonary Associates of Richmond.Is the Stethoscope Dying? High-tech Rivals Pose a ThreatTw o centuries after its invention, thestethoscope — the very symbol of the medicalprofession — is facing an uncertain prognosis.,says the Associated Press.It's being threatened by more modern handheld devices, also pressed against the chest butrelying on ultrasound technology, AI andsmartphone apps instead of doctors' ears.Dr. Eric Topol, a w orld-renow ned cardiologist,considers the stethoscope obsolete — nothingmore than a pair of "rubber tubes."Why Helping Trauma Survivors Benefits All PatientsJoin us on Tuesday, Nov. 12 to hear Leslie Kimball,PhD, LCP discuss adverse childhood experiences,their impact on adult health outcomes and traumainformed care.The meeting w ill be held at the University of RichmondJepson Alumni Center. Cocktails at 5:30 p.m., dinner at6:15 p.m., presentation at 7 p.m. RAM Members arefree. Guest fee is 40.Questions? Contact Lara at lknowles@ramdocs.orgor 804-622-8137REGISTER NOW!Improving Health Care Requires Tradeoffs

W hen it comes to fixing America’s costly and complicated health care system, the truth isthere are no silver bullets, no cure-alls. There are only Tradeoffs.That’s the name of a new podcast that launched on Oct. 16, w ith support from theRobert W ood Johnson Foundation and CHCF. Check it out!Marketing Juggernaut Pushes 3D MammogramsW e found this article interesting, and it’s sure toelicit some strong opinions from doctors:W hen Dr. W orta McCaskill-Stevens made anappointment for a mammogram last year, sheexpected a simple breast cancer screening ―not a heavy-handed sales pitch, says this KaiserHealth New s report.A receptionist asked if she w anted a free upgradeto a “3D mammogram,” or tomosynthesis.Upselling customers on high-tech breast cancer screenings is just one w ay the 3Dmammography industry aggressively promotes its product.A KHN investigation found that manufacturers, hospitals, doctors and some patientadvocates have put their marketing muscle ― and millions of dollars ― behind 3Dmammograms. The juggernaut has left many w omen feeling pressured to undergoscreenings, w hich, according to the U.S. Preventive Services Task Force, haven’t beenshow n to be more effective than traditional mammograms.“There’s a lot of money to be made,” said Dr. Steven W oloshin, director of the Center forMedicine and Media at The Dartmouth Institute for Health Policy and Clinical Practice,w ho published a study in January show ing that the health care industry spends 30billion a year on marketing.CLICK HERE FOR THE LEG.UP PODCASTExperts Weigh Upcoming Alzheimer's TsunamiThe forecast looms like a portent of doom. From 5.8 million people today, the number ofAmericans w ith Alzheimer’s disease is projected to reach 13.8 million by 2050,overw helming caregivers and the health care system — a prospect that has producedalarm bordering on panic about an unstoppable Alzheimer’s tsunami, says Stat. Reality, how ever, is far more nuanced: Medical breakthroughs and other factors coulddramatically reduce that number — though, paradoxically, such advances could alsoincrease the prevalence of this most common form of dementia.Advocacy & AlesMake a different in the practice of medicine!Join fellow physicians on Nov. 19 from6 - 8 p.m. at Urban Roost in Scott's Addition toget a brief overview of w hat advocacy means,a glimpse at the most pressing "do or die"issues facing physicians in 2020 and w hat YOUcan do to make a difference.Dinner and socializing also included!Plan to Attend Legislator Meet & Greet EventsS IGN UP NOW!

W e don’t know how this fall’s elections w ill turn out, but no matter w ho w ins, physicianshave a lot to discuss w ith law makers. Please join us on Tuesday, Dec. 3 or Wednesday,Dec. 4 for one of our annual legislator meet and greets. Come out and enjoy lightrefreshments and a discussion of physicians' concerns.TUES., DEC. 37 - 8 a.m.St. Mary's Hospital5801 Bremo RoadRichmond 23226RE GIS TE R HE REWED., DEC. 46:30 - 7:30 p.m.Virginia Urology9101 Stony Point DriveRichmond 23235RE GIS TE R HE REMichigan Wants to Save Millions Cutting Out PBMsMichigan's Medicaid program w ould like to stop usingpharmacy benefit managers to oversee prescription drugclaims and negotiate prices with drugmakers, according toa notice from the Michigan Department of Health and HumanServices, reports Modern Healthcare.The state proposed that it w ould start managing drugcoverage on its ow n beginning Dec. 21. Michigan hopes the move w ill save Medicaidmoney by increasing its portion of drug rebates and slashing administrative costs.The department expects the proposal w ill save the state about 40 million.The state also thinks the move w ill streamline the administrative process for providersand ensure uniform drug coverage for Medicaid enrollees. As drug costs continue toskyrocket, several states have stopped outsourcing prescription drug claims andnegotiations to PBMs because they have failed to deliver the cost savings theypromised. Recent studies have found that PBM prices often exceed Medicaid fee-forservice drug prices, w hich has prompted states to break off their relationships w ith thePBMs.Could Virginia be next?Women in FocusThanks to VCU Health's Emma Fields, MD,for speaking about a promising newapproach to treating pancreas cancer lastw eek at RAM's W omen in Focus meeting.Interested in joining the group? The nextmeeting w ill be in February. Look fordetails coming soon on RAMdocs.org.