CVMS Bulletin

Volume 1: Issue 3

March 2023

“The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head.” - Sir William Osler

Welcome to the third edition of the CVMS Bulletin bringing you updates on the status of healthcare in Eastern Virginia. We hope you find it interesting, informative and enjoyable. Please let us know if there is anything we can do to make it better.

Merging Medical Societies

Our last meeting of the Organization Committee on February 21, 2023 was very productive. Two representatives from the Medical Society of Virginia were able to join us and provided much insight and many suggestions that will help us tremendously. They were also able to provide excellent recommendations for us regarding legal assistance. The Committee approved the Business Plan, the Bylaws and the Articles of Incorporation that had been previously proposed. We have already connected with legal counsel (HDJ) regarding changing our name with the SCC and the IRS and preparing documentation for the merger to make it legal. Our next official Board meeting will be in approximately one month. In the meantime, we will continue to be in contact by email or phone to refine all the details. If any of you wish to provide any input as we go along, please let us know on the Contact Page.

We have also met the Chief Risk Advisor for Professional Risk, who can provide multiple resources for our new society, including education, CMEs, practice setup, HR, not to mention insurance.

We are also reaching out to other local corporate entities to create partnerships that can provide more benefits to our members. We will let you know much more as we move along.

COPN Continues to Hold Back Virginia Health Care

One of the most egregious barriers to healthcare in the Commonwealth of Virginia is the COPN mandate which requires permission from the state to expand any services to meet the demand of an ever increasing population. COPN was mandated by the Federal Government in 1973. The original purpose was primarily to control costs and supposedly to improve access to care. It was repealed in 1986 because it didn't work. Costs and access to care are worse than ever in recent history. But Virginia has kept the archaic program, which is resulting in restricting access to care, reducing quality of care, and ultimately increasing the cost of care and resulting in longer waits for patients to get the care they need. The COPN has absolutely no benefit and is harming patient care. So why is it still going on after four decades of restricting healthcare? Research now suggests that COPN caters more to the larger healthcare organizations that can afford to provide political contributions to gubernatorial and state senate candidates. The larger the political campaign contribution, and the larger the lobby, the more likely a company will receive permission for whatever it wants, which then helps to minimize the competition. Smaller organizations are at a disadvantage. As long as the money flows in the right direction, the COPN will stay and healthcare in Virginia will suffer.

On Being a Physician in Virginia

I had been called by the Emergency Room (ER) physician to see and admit one of our private patients who had come in with acute congestive heart failure. As I walked through the ER to find this patient, there were multiple gurneys lining the hallways full of patients who were not lucky enough to get a real room in the ER. This has been the usual situation for our ER for several years now, caused by 1) Shortage of beds: Patients are waiting to be admitted to a room in the hospital of which there are none open, so they have to wait 24-72 hours in the ER until a bed becomes available, and 2) Shortage of outpatient services: There is not enough access to overwhelmed outpatient clinics and primary care physicians.

After searching through the multiple hallways lined with sick people, I finally found my patient in a dark hallway separated from other patients only by a curtain. He was sitting in a chair feeling miserable, having been there already for many hours, getting up by himself to go to the bathroom every 15 minutes because he had been given a diuretic. Legs swollen twice normal size. Short of breath. No heart monitor. There was none available. His daughter was sitting next to him, worried, concerned, and frustrated, saying he would be better off at home. I checked with the nurse who said he probably would not get a bed upstairs in the hospital until tomorrow.

This is not high quality healthcare, and is a disaster waiting to happen. If it were a one time event occurring because of a community train wreck or a mass shooting, you could understand it. But it's not. This is a normal day in the ER with anywhere from 20-90 patients who need to be admitted and are waiting for a bed in the hospital. Why are there no beds available? Please read the above article on COPN.

Are Hospitalists Satisfied with their Careers?

According to a recent national survey reported in Today's Hospitalist, most hospitalists (82%) are "satisfied" or "very satisfied", but those numbers are dropping in recent years. Since 2019, 35% have dropped from "very satisfied" to "satisfied". and those who are dissatisfied have risen by 10%. Satisfaction levels drop significantly for those who see more that 18 patients a day or who work more than 12 hours a day, and for those whose salaries are in the low $300,000 range compared to those closer to $380,000. Women hospitalists tend to be less satisfied than men. Those who work for national hospitalist organizations and for university hospitals tend to be more dissatisfied.

Physician Shortage

There is a significant shortage of physicians and nurses in this country, which will get worse within the next ten years unless some changes are made. Why is that happening?

Baby Boomers are getting older and sicker.
Boomer physicians and nurses are getting older and retiring.
Rural shortages are the worst despite CMS incentives. Telehealth is helping this somewhat.
Limits on medical schools and residencies. Average medical schools only accept 7% of applicants. Federal caps on residency positions were established in 1997 and have not been raised since then. Why? Because it costs Medicare and Medicaid 11.5 billion dollars a year to train residents.
Increased shortages in some facilities cause greater workloads and more burnout, which new physicians wish to avoid, thus creating even greater shortages. Current EMR requirements increase the cognitive overload and general workload of physicians and nurses, adding to the burnout problem.

Emergency Preparedness

You never know when you might be faced with a disaster or an emergency situation that may be hazardous to life or limb. Examples are evident in the national and world news every day. Being prepared for such an event may well make the difference between life or death. Here are some things you can do to be ready ahead of time so you won't be caught off guard.

Virginia Beach Medical Society Alliance

In the pre-COVID era, the Virginia Beach Medical Society Alliance (VBMSA) was once an important fund raising arm of the Virginia Beach Medical Society (VBMS). The VBMSA is a 501(c)3 nonprofit organization founded in 1962 and operated by several physician spouses and nurses at Virginia Beach General Hospital to provide a method for local businesses to donate tax deductible dollars to the VBMS and to multiple other local charities. You may remember some golf tournaments that previously were held every spring to help with this. Unfortunately, due to the pandemic, it became inactive over the past few years. We are hoping to resurrect the Alliance to help support the new Coastal Virginia Medical Society and provide help for other charities as it has done since 2007 when it was approved for non-profit status. If you were involved in the VBMSA, and/or would like to be part of restoring this foundation, please call us at 757-816-8399, or send an email to cvms@cvmedicalsociety.com.

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We hope you enjoyed this new edition of the CVMS Bulletin. If you have any questions, concerns or comments, let us know at cvms@cvmedicalsociety.org. If you wish to provide an article or your own story to put in this newsletter, send it in. Watch the "What's New" link in the upper left Navigation Menu for updates in between the monthly newsletters. Let us know if you wish to be involved in the CVMS organization process or if you know of any resources or benefits we could potentially provide for the membership.

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