December 2015 Issue
Happy Holidays from the NEAUA President, Dr. Thomas Kinkead

Season's greetings from the New England Section! As the holiday season is upon us and the year is coming to an end, I would like to take a few minutes to reflect on a successful year for the Section.

Dr. Tiffany and the Program Committee hosted another successful Joint Meeting with the Mid-Atlantic Section of the AUA. Professional as well as family participation was stellar, and the scientific presentations were superb. The Section has adopted two new membership categories to include our industry colleagues as well as our advanced practice provider colleagues. Details of both those categories will be shared in greater detail soon. The Board of Directors selected an excellent nominee for the AUA Research Forum in Dr. Quoc-Dien Trinh from Brigham and Women's Hospital, and the Section's slates for 2016 AUA Awards and national level representative positions are strong. The Board continues to identify ways to increase engagement of its state representatives and state urologic societies through a variety of initiatives, and our Sectional committees continue to be active in carrying out Section operational matters. In addition, the Section leadership recently elected to help fund the annual budget of UROPAC for this upcoming fiscal year. Financial support of UROPAC compliments the Section's existing health policy and socioeconomic advocacy promotion efforts. The New England Section funds the travel of our entire Board of Directors and two residents or fellows' attendance at the annual Joint Advocacy Conference, the Section subsidizes state urologic society President attendance at the annual state society meeting in Chicago, and the Section has also increased promotion of health policy and socioeconomic issues through expansion of annual meeting programming and more frequent Sectional correspondence. As I hope you can see, the Board has taken member feedback about the importance of urologic health policy and advocacy to heart and continues to invest resources to supplement activism taken on by individual urologists in our region.

In closing, I would like to thank all the New England Section members, especially the leadership, for its contributions and participation in 2015. You have all made this an outstanding year for the Section. I look forward to seeing you in Portland, Maine for the 2016 NEAUA Annual Meeting September 29-October 2, 2016. Please visit the NEAUA website for all meeting details.

Happy holidays and cheers to a prosperous 2016.

Thomas M. Kinkead, MD
President



The Blizzard of '78, Big Red and Doctor Mahoney by Dr. Kevin Loughlin

New England had already suffered through a harsh winter. On January 21, 1978 most of New England had been blanketed by twenty-one inches of snow. It was a wet, heavy snow and actually caused the collapse of the roof of the Hartford Civic Center.

By Sunday February 5th, most New Englanders were just about ready to settle back into their brumal routines. The weather forecasts on the Sunday evening news warned of a heavy storm that would arrive sometime around mid-day on Monday. It is important to remember that sophisticated meteorological technology was still in its nascent stage almost four decades ago and weather forecasts were often imprecise.

When Bostonians left for work on Monday morning, the severity of the storm was still uncertain, so no special precautions were taken by most individuals or by local and state governments. No one was advised to stay home from work and no schools were closed. Snow flurries began at about 10AM. However, by early afternoon the snow began to fall in earnest, up to two to four inches per hour in some places.

Even with some businesses releasing their employees early, the evening rush hour was a disaster. Compounding the heavy snowfall were winds that, in places, exceeded 100mph. Many people simply did not attempt to travel home, those who did, drove into what was to become known as the "storm of the century."

As conditions became more severe, Governor Dukakis declared a state of emergency and the National Guard was called up. Route 128 was hit especially hard and eventually 3,000 cars and 500 trucks were abandoned on an 8 mile stretch of the highway.

By Tuesday morning, the entire region, Massachusetts, Rhode Island and Connecticut, was shut down. The greater Boston hospitals were essentially manned by residents or staff who had been stranded the night before. The almost 12,000 fans who had attended the Beanpot Hockey Tournament the night before spent the night in the Boston Garden.

All automobile traffic was banned for the remainder of the week and attending physicians were unable to reach their hospitals for three to four days. However, one physician made his daily rounds at Carney Hospital, uninterrupted, every day for the remainder of the week. Dr. Edward Mahoney and his wife Gert had a beautiful home on Brush Hill Road in Milton. Ed was an avid horsemen and his love for riding was shared by Gert. They had a stable on their property where they kept several horses. Ed's favorite horse was "Big Red", a 17 hand American Saddle Bred chestnut. Big Red was eleven years old in 1978, in excellent condition, and still ridden regularly by Ed.

When Ed awoke on the morning of Tuesday, February 7, 1978, he knew he wanted to make his usual rounds at Carney Hospital. Some of the drifts in his neighborhood exceeded ten feet, but Ed was undaunted. He went out to his stable, saddled up a willing Big Red, and road to the Carney amid the snow which was still coming down at a considerable rate. Both patients and staff were amazed to see him. He was the only physician who had made it into the hospital. Ed continued to ride Big Red daily for the rest of the week until the roads became passable for automobiles. Years later, Ed donated Big Red to the state police.

The link between men and horses are part of our New England lore. The Ride of Paul Revere is immortalized and known to every schoolchild throughout New England. Likewise, the Ride of Big Red, Dr. Ed Mahoney and the Blizzard of '78 should be immortalized and known by every urologist throughout New England.

Below is a picture of Dr. Mahoney on Big Red
Dr. Mahoney on Big Red



Recent AUA Board of Directors Activity Provided by Section Representative, Dr. Kevin Loughlin

View Document



Plan puts prostate cancer treatment progress at risk: An article by Dr. Kevin Koo

View Document



Resident and Fellow Travel Grants Available for the 2016 JAC, Due December 31, 2015

The 11th Annual AUA/AACU Urology Joint Advocacy Conference will take place February 28-March 1, 2016 at the Willard Intercontinental Hotel in Washington, DC. The meeting is urology's health policy "main event." The agenda features talks by members of Congress and key policy makers who will shape the regulatory future of medicine. It also affords attendees the chance to meet with members of Congress from their home state to advocate for urology's current policy initiatives. To review details of the 2015 program to get a sense of what the 2016 program will entail visit the JAC website.

The New England Section will fund the trip of 2 residents or fellows in 2016 to attend the 11th Annual JAC, as it recognizes that engagement of young urologists in urologic advocacy is important to the specialty. To apply for this funded trip, residents and fellows should submit their contact information, a 1-page essay outlining their interest in urology/healthcare policy and advocacy and how attending the 11th Annual JAC would support their interest and future aspirations at the link below. A brief letter from resident or fellow's Program Director confirming that if selected s/he will be able to attend the 2016 JAC conference in DC should also be submitted. The deadline for submissions is December 31, 2015.

SUBMIT YOUR ESSAY

After the conference, the participants will be asked to submit a 1-page summary of his/her experience at the JAC for the NEAUA website and newsletter.




AUA Leadership Program Application Deadline Extended to December 31, 2015

In 2004, the AUA and its Sections launched the AUA Leadership Program to identify urologists who have demonstrated effective leadership skills within organized medicine or the community. This program seeks applicants who are driven to tackle future roles of responsibility within the AUA. This is a call for younger AUA members to polish their leadership skills, take advantage of networking opportunities and become better acquainted with AUA programs and services. To date, 107 AUA members have participated in one of six different Leadership Program classes.

Every two years, there is a selection process for the next incoming class of program participants. To qualify, candidates must be American Board of Urology (ABU) (or equivalent) certified urologists, and 15 years or less out of training, and have demonstrated leadership skills. The candidate must have an interest in developing these skills to serve their Sections and the AUA as future volunteer leaders. They must also be Active members of the AUA and the AUA Section where they live and practice.

Benefits of the Leadership Program

  • Develop your leadership skills
  • Expand your network and accelerate your professional growth
  • Learn about the AUA's operations and sphere of influence
  • Earn the recognition and prestige that comes with being an AUA Leadership Program graduate
  • Be mentored by highly respected AUA Leaders
  • Learn about the legislative process and advocate on behalf of the specialty
  • Make significant contributions through a group project
  • Be prepared to serve as a future leader in urology

Click the following links for information about the mentors, previous Leadership Program classes, and activities and opportunities.

Apply today or find out more about program information and instructions.

If you have further questions, please contact Florence Freeman at ffreeman@AUAnet.org or 410-689-3724.



AACU Legislative and Socioeconomic Updates

The following articles are provided by the American Association of Clinical Urologists in partnership with the New England Section of the AUA. The AACU is pleased to update NEAUA members on legislative and socioeconomic issues affecting urologists. We welcome your comments and suggestions. Contact the AACU government affairs office at 847-517-1050 or info@aacuweb.org for more information. Articles by Ross E. Weber, AACU State Affairs Manager.

Urologists take action on worrisome definitions of "quality"
To measure patients' subjective experience, public and private payers, as well as clinically focused physician groups, are scurrying to define "quality." There is some urgency to this effort because the law that repealed the Medicare sustainable growth rate formula requires physician payments to be largely based on quality as of January 2019. If defining quality is left only to payers, there is cause for alarm. Two recent proposals from CMS stray far from the Institute of Medicine's definition of quality: "the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge."

Urologists fight measure penalizing docs who order PSA
A recent proposed clinical quality measure titled "Non-Recommended PSA-Based Screening" has drawn concern and opposition from the AUA, the American Medical Association, individual urologists, and other physicians. The quality measure, developed by Mathematica Policy Research for CMS, comes on the heels of two newly published studies noting declines in PSA screening since the USPSTF 2012 grade D recommendation against screening. The measure "discourages PSA screening in all men over age 18, regardless of age or risk factors," according to a Nov. 18 article in the AUA's Policy & Advocacy Brief.

Urologists take aim at prior auth, work force at state advocacy conference
Leaders of more than 30 organizations representing urologists and scores more attendees came away from the 2015 AACU state advocacy conference with a better understanding of the complicated socioeconomic issues facing the profession and a resolve to not stand idly by as public policies impacting their patients and practice are developed in Washington and state houses across the country. The event, now in its eighth year, brought together representatives of state, regional and subspecialty groups, many of which do not traditionally engage in political advocacy. After nearly every session, conference goers turned to one another to explain how the subject specifically affected them, or that the newfound insight would be of great value to colleagues back home.

State lawmakers pushing telemedicine coverage in 2016
State legislation is heavily contributing to the expected reimbursement/coverage uptick in 2016, as more states consider legislation requiring coverage for telemedicine and in-person visits alike. To date, 29 states and Washington D.C. have enacted legislation ensuring that private insurers offer reimbursement for telemedicine at equivalent levels with in-person services, provided the care is deemed medically necessary. Many of the laws enacted in 2015 will take effect in January 2016.

Related: State licensure issues challenging telemedicine borders; Compact aims to help doctors practice across state lines
http://www.healthcaredive.com/news/state-licensure-issues-challenging-telemedicine-borders/408177/
http://articles.philly.com/2015-11-04/news/67990356_1_license-medical-boards-federation

How proposed payer mergers impact state insurance markets?
With recent news of the proposed Aetna/Humana, Anthem/Cigna, and Centene/Health Net mergers, a number of stakeholders have raised questions about consolidation's impact on the competitiveness of health care markets. For these proposed deals, we estimated the degree of payer consolidation post-merger across the 50 states and the District of Columbia. If the mergers are finalized, Georgia, Connecticut, and Colorado could potentially experience 40 percent or higher increases in commercial insurance concentration...Understanding payer concentration trends and potential future scenarios will inform policy and decision makers as they discuss the implications of consolidation and competition within the United States health care system.

Insurance commissioners aim at ACA narrow networks

Insurance commissioners propose more narrow-network controls

"Defensive Medicine" could lead to fewer malpractice claims

No conclusive evidence defensive medicine works

CT: Hospital funding battle increasingly bitter

CT: Critics seek hard look at hospital market power

MA: Moves to strengthen HPC and expand telemedicine

MA: Former candidate for governor Don Berwick to join Mass. Health Policy Commission

ME: Senator King convenes roundtable on telemedicine

ME: Maine welcomes telemedicine with new guidelines

NH: Medicaid expansion, drug abuse biggest issues facing NH lawmakers

RI: Debate on "freestanding" ERs hits R.I.

VT: Vermont improvises to attract physicians



Upcoming Meetings

February 2016

Maine Urological Association 2016 Annual Meeting

February 6-7, 2016
Sugarloaf Conference Center & Resort, Carrabassett Valley, Maine
View program and register



AUA Interactive State Legislation Map

The AUA tracks state legislation that could impact the practice of urology in your region. View which bills the AUA is monitoring by visiting the interactive state legislation map.