Author Archive

Deadline for GAFP’s Annual Research Poster Presentation Abstracts is October 12

By Sarah Bigorowski, Director of Education

The deadline to submit abstracts for GAFP’s Annual Research Poster Presentation competition is Wednesday, October 12. The presentations will take place during GAFP’s ‘Annual Family Medicine CME Weekend’ on Thursday, November 10 and Friday, November 11 at the Atlanta Marriott Northwest at Galleria, which is located at 200 Interstate North Parkway East Southeast.

GAFP’s research poster presentation competition rules and guidelines:

– Every GAFP member (students, residents, and active physicians) and pre-medical students (including those from AHEC programs) are eligible.

– Submissions can address research results, case reports, summer projects, or educational projects.

– Posters can address any topic that is related to family medicine.

– Submissions must address original and completed work that has not been published or presented at a regional or national meeting.

– Concurrent (2022) submissions to other conferences like the North American Primary Care Research Group (NAPCRG) or the Society of Teachers of Family Medicine (STFM) are encouraged.

– Medical student projects that have been presented at medical schools or during student “research days” will be accepted.

GAFP will contact the winners by email no later than Tuesday, November 1, and the winners will be asked to make a 15-minute CME presentation on their submission during GAFP’s annual meeting in Atlanta on the morning of Friday, November 11.

The best poster awards will include:

– Pre-Med Students (one $500 award)
– Medical Students (one $500 award)
– Residents (one $500 award)
– Practicing Physician/Fellow (one recognition award)

Note that if there are multiple presenters for a winning poster, they will share the award equally.

The winning posters will be published in a GAFP publication.

Click here to submit an abstract.  

Click here or contact Sarah Bigorowski at 404-321-7445 or sbigorowski@gafp.org for more additional information. 

GAFP Congress of Delegates 2022 Resolutions & Information

  By Alesa G. McArthur, Deputy Executive Vice President

GAFP Congress of Delegates

2022 Resolutions & Information

 The Georgia Academy of Family Physicians (GAFP) is encouraging its members to participate in the 54th Annual Congress of Delegates. The first meeting of the 2022 Congress of Delegates will take place via Zoom at 6 p.m. on Thursday, October 20 — with a Zoom system orientation beginning at 5:30 p.m. Every GAFP member is invited and encouraged to participate in this meeting. Please click here to register. 

1.     2022 Policies up for review from the Congress of Delegates

 Submitted by: Monica Newton, DO, Ellie Daniels, MD, and Tom Fausett, MD

Each year, GAFP’s Speaker, Vice Speaker, and the Board Chair (or their designee from the Executive Committee) will meet no later than June to review one-third of the active GAFP policies as compiled in the GAFP Policy Manual. The Policy Manual is a compilation of Congress of Delegates and Board of Directors’ approved policies.

 The group will make recommendations for each policy to be either:

  1. Archived (no longer enforced)
  2. Re-adopted (as written)
  3. Re-adopted (as edited)

 All active policies will be reviewed on a rotating basis but no later than every three years.

 The Board policies will be brought to the August Board meeting for final review and approval. The COD policies will be brought to the COD annual meeting in the Board Chair’s report, as an action item to review and approve.

A.             COD-Flag and Pledge of Allegiance

Displaying the US flag and reciting the Pledge of Allegiance

The GAFP displays the flags of the United States and the State of Georgia at the front of the room at the Congress of Delegates and the Exhibit Hall. The Pledge of Allegiance is to be recited at the opening session of the Congress of Delegates.

The Policy Review Team recommends to re-adopt the policy as written.

 B.             GAFP Mission Statement

The mission of the Georgia Academy of Family Physicians is to promote the health of the citizens of Georgia by advancing the specialty of Family Medicine through education, advocacy and service to Georgia’s family physicians.

The Policy Review Team recommends to re-adopt the policy as edited.

 C.             Legislative Lobbying for Family Medicine

The Georgia Academy of Family Physicians lobby for increased funding for Family Medicine departments and residency programs at the federal and state level.

The Policy Review Team recommends to re-adopt the policy as written.

 D.             Area of Training for Family Medicine Residents

The Georgia Academy of Family Physicians unconditionally supports the concept that family medicine residents be trained in all major disciplines of medicine, including, but not limited to, the care of pregnant women and hospitalized patients.

The Policy Review Team recommends to re-adopt the policy as written.

 E.             Healthy Lifestyle and Weight for Children and Adults

The Georgia Academy of Family Physicians both supports and encourages policies that promote a healthy lifestyle and healthy weight for both children and adults.

The Policy Review Team recommends to re-adopt the policy as written.

 F.              Hospital Operative and Non-Operative Obstetric Privileges for Family Physicians

The GAFP will support the American Academy of Family Physician’s policies and procedures as it relates to Family Physician’s obstetrics credentialing efforts. and will continue to support individual member’s credentialing efforts, and the GAFP will develop a member group to report back to the 2020 COD including but not limited to:

– Educating stakeholders at Georgia Hospital Association on the FP/OB model and training and;

– Encourage their members to recruit Family Medicine residents to provide comprehensive maternity care and offer to post jobs on the GAFP website.

The Policy Review Team recommends to re-adopt the policy as edited, as the activities listed above have already occurred or no longer needed.

 G.             Remove barriers to physician credentialing in rural and physician-shortage areas

The GAFP will support action that requires insurers and health care networks to not delay physician credentialing applications once all requirements are met. and will draft a formal statement regarding the issue of physician credentialing and its effect on patient access to care as well as how it creates a significant financial hardship for both private practices and rural hospitals that depend on this reimbursement to continue to provide health care services in their community.

The Policy Review Team recommends to re-adopt the policy as edited.

 H.             Support fair reimbursement maternity care services in rural areas

The GAFP will continue to support equality of payment for like services regardless of specialty and support legislation that requires insurers and health care networks to pay obstetrical physicians regardless of specialty for their maternity related services. and develop a link on their website where physicians and practices can submit information regarding issues with reimbursement of obstetrical services.

The Policy Review Team recommends to re-adopt the policy as edited, noting that it is problematic for reimbursement to be shared/compared (antitrust).  However, staff and leaders continue to work with members on specific concerns and complaints.

2.     Best Practices Implementation on Naming Disease to Reduce Stigma Resolution

Submitted by: James Mayers Jr, JD, MD

  Whereas, The World Health Organization issued best practices guidance on terms that should be avoided in disease names include geographic locations (e.g. Middle East Respiratory Syndrome, Spanish Flu, Rift Valley fever), people’s names (e.g. Creutzfeldt-Jakob disease, Chagas disease), species of animal or food (e.g. swine flu, bird flu, monkey pox), cultural, population, industry or occupational references (e.g. legionnaires), and terms that incite undue fear (e.g. unknown, fatal, epidemic) 8 May 2015, Note for Media, Geneva.

 Whereas, The WHO has announced plans to find a new name for the viral disease informally known as ‘monkeypox’ which, says the world body, is “discriminatory and stigmatizing.” https://seattlemedium.com/world-health-body-wants-new-name-for-monkeypox-virus-calling-it-     

Whereas, GAFP wishes to take a proactive approach on reducing stigmatization and discrimination in the state of Georgia that can be refined when higher level health agencies comply with best practices.

Resolve that, GAFP in accordance with WHO guidance rename Monkey pox and other viral diseases with names outside of guidance to the most specific scientific name and year of the outbreak began. For example, Orthopox (genus) 22 (2022).  

Resolve that, GAFP recommend that family physicians and Georgia Health Department use guidance compliant terminology in all communications about disease until the CDC or WHO adopt a compliant term.

Resolve that, GAFP further resolves to adopt the CDC or WHO best practices compliant term when available.

Staff Background:

AAFP has no policy related to best practices for naming diseases.

GAFP has no current policy

The WHO policy guidance was developed in 2015: https://www.who.int/news/item/08-05-2015-who-issues-best-practices-for-naming-new-human-infectious-diseases

On WHO’s website, they reference the current Monkeypox pandemic as “Monkeypox”: https://www.who.int/health-topics/monkeypox#tab=tab_1

3.     Introduction to Advocacy Initiative Resolution

Submitted by: James Mayers Jr, JD, MD

 Whereas, GAFP recognizes the importance of advocacy in its mission statement and strategic plan. GAFP Mission Statement – COD 11/11/2007. GAFP Strategic Plan 2021-2024.

 Whereas, GAFP desires that every member is exposed in residency to advocacy activities in order to encourage as much member engagement as possible.                                                                                                                

 Resolve that, GAFP sponsor and develop an annual introduction to Georgia Advocacy course where Family Medicine residents are exposed to current physician advocacy initiatives and activities in our state.

 Resolve that, GAFP may further recommend that Family Medicine residency programs provide notice and encourage course attendance to all residents.

Staff Background:

AAFP has no policy related to supporting advocacy education to family medicine residents.

GAFP has no current policy

GAFP provide education to residency programs upon request by the individual programs.  Since the pandemic, there have been member-wide (not resident specific) evening webinars on legislative advocacy (2021, 2022).  The GAFP has planned another member-wide advocacy webinar in January 2023, in conjunction with other physician colleagues within the Patient Centered Physicians Coalition of Georgia.

  1. Endorse Georgia Council on Aging Perennial Budget Issue- Increased Funding for Home and Community Based Services (HCBS) Resolution

 Submitted by: Adrienne Mims, MD, MPH – Vice Chair Georgia Council on Aging, GAFP Member, Geriatrician

Whereas: The GAFP mission statement is to promote the health of the citizens of Georgia by advancing the specialty of Family Medicine through education, advocacy, and service to family physicians in the State of Georgia; and

Whereas: The GAFP 2021-2024 Strategic Plan Item #4 – Advocacy for Family Medicine and Our Patients to Public and Private Payors charges the GAFP to advocate for our patients; and

Whereas:   As of 2021, Georgia has 3,176 actively practicing primary care physicians for a population of 10,799,566 residents – 14.7% are over age 65 (1,587,536 older adults); and

Whereas: A caregiver — sometimes called an informal caregiver — is an unpaid individual (for example, a spouse, partner, family member, friend, or neighbor) involved in assisting others with activities of daily living and/or medical tasks. Nationally, care recipients are 65% women, with an average age of 69.4.  One in 4 caregivers spends 41 hours or more per week providing care. Burden of care increases with hours of care provided. Four in 10 (40%) caregivers are in high-burden situations, 18% medium burden, and 41% low burden based on the Level of Care Index.

In Georgia, 1 in 5 adults are currently caregivers, while 1 in 7 expect to be in the next 2 years. The average age of caregivers is 49.2 years old with 26% are over 65; 59% are women. 75% of caregivers manage household tasks while over 50% assist with personal care.

Caregivers and their care recipients are GAFP members’ patients who turn to us as their primary care practitioner for guidance and support; and

Whereas: In-home services supported by caregivers and state Home and Community Based Services (HCBS) cost a fraction of the cost of a nursing home bed; non-Medicaid HCBS averages $2145 per person annually, far less than the cost of a nursing home bed. The Non-Medicaid HCBS Program provides services that promote health and independence while supporting caregivers. HCBS programs consistently demonstrate in-home services help older Georgians age in place in their homes and communities. On average, these services can help delay premature nursing home care by 51 months. In-home services include home delivered meals, adult day care, respite care, home modification and more. The longer a person can stay at home with supports, the more it saves taxpayer dollars and supports family caregivers. There is a long waitlist for HCBS throughout Georgia; and

Whereas: The Georgia Council on Aging is a council of appointees that serve to: Advocate with and on behalf of aging Georgians and their families to improve their quality of life. Educate, advise, inform, and make recommendations concerning programs for the elderly in Georgia. Serve in an advisory capacity on aging issues to the Governor, General Assembly, Department of Human Services, and all other state agencies; and

Whereas: The Georgia Council on Aging, based on the needs of older residents, has a perennial budget issue request to the Georgia Legislature and Governor to continually increase funds for Home and Community Based Services to meet the needs of the aging population of the state; Be it therefore

Resolved that: GAFP endorses the Georgia Council on Aging Perennial Budget Issue requesting increased funding for Home and Community Based Services from the state-to eliminate waitlists for services that support Georgia family caregivers to keep loved ones aging at home.

References:

https://www.census.gov/quickfacts/GA

https://healthcareworkforce.georgia.gov/health-care-workforce-data

https://www.cdc.gov/aging/data/pdf/GEORGIA.CAREGIVING-2018.pdf

https://www.caregiver.org/resource/caregiver-statistics-demographics/

https://www.gcoa.org/our-mission

https://www.gcoa.org/2023-co-age-priorities

Staff Background:

AAFP has policy on home care: https://www.aafp.org/about/policies/all/home-health-care.html

Home health care is direct patient care, plus the management and coordination of patient care services, in a residential setting.

Family physicians have always provided home health care. Since home health care often requires continuing and comprehensive patient care in a family context, family physicians are particularly well-qualified and trained to provide home health care. Thus, the patient’s family physician should be directly involved in the initial decision to provide home health care services plus the subsequent planning, provision and management of those services. Additionally, adequate compensation for family physicians providing and managing home health care services will help ensure on-going home health care access and availability. (1986) (2020 COD)

GAFP has no current policy.

GAFP’s guidelines to select key legislative priorities is to survey the membership on a variety of health policy topics. Noting that family medicine is involved in all aspects of family care, and community health, the list that is surveyed allows for GAFP leadership (the Board under the recommendation of the Legislative Committee) to be aware of what are the most urgent priorities. Supporting increased funding for home and community-based services could be added to the list of potential topics for the GAFP to focus its advocacy efforts on which could increase the health of our patients.

  1. Auto-renewal Contract Limitations Resolution

Submitted by: Ralph Peeler, MD

Whereas, Auto-renewal (“Evergreen”) contracts are frequently and increasingly used by vendors and service providers such as insurance claim clearinghouses, sterilization services, communications providers etc. to medical practices in Georgia and the US as a means to enhance the vendor’s revenue at the expense of the medical practice (consumer) and

Whereas, such added expenses must be absorbed by the medical practice or passed on to patients, increasing the cost of health care and locking practices (consumers) into paying for services they no longer need or want, or switching to vendors with better or cheaper service and

Whereas, multiple other states including California, Oregon, and New Jersey have imposed limits on such contracts, specifying requirements for adequate written notice of renewal, require affirmative written consent to renew, simple cancellation procedures, and other disclosures and

Whereas, failure to comply with these requirements can result in the service or product being classified as an “unconditional gift” to the customer, and

Whereas, legislative action in Georgia could reduce unnecessary expense to consumers, medical practices and patients in Georgia now therefore be it

Resolve that, GAFP alert our members to the pitfalls of such contracts and GAFP through its legislative committee and lobbyists seek and support legislation in the Georgia General Assembly to impose limitations on such Auto-renewal contracts and

Resolve that, such limitations require notice and affirmative written consent to renewal of such contracts between 30 and 60 days prior to any deadline for cancellation or contract renewal and

Resolve that, all such contracts contain clear and conspicuous descriptions of the provisions for auto-renewal and any cancellation costs or penalties

Resolve that, and failure to comply with such provisions shall cause the good or service to be classified as an “unconditional gift” to the consumer.

Staff Background: 

AAFP has multiple listings on their website related to assisting employed physicians with their contract.  None of the recommendations include declining a contract with an auto-renewal clause. AAFP has no policy opposing auto-renewal contracts.

GAFP has no current policy on opposing auto-renewal contracts.

  1. Opposing and Eliminating All Types of Restrictive Covenants on the Practice of Medicine Resolution

Submitted by: Ralph Peeler, MD

Whereas, Family physicians in the United States have steadily progressed toward a majority of family physicians working as non-shareholding employees, and restrictive covenants, also called noncompete clauses, are – in states where they are legal – common components of an employed family physician’s contract, limiting their ability to practice locally should they opt to work for a different company, or for themselves, and

Whereas, in many states where restrictive covenants have been limited or eliminated, hospital systems have begun to engage in “soft” restrictive covenant proxies, such as threatening termination as a result a physician discussing with patients or publicly disclosing their departure from their employer, and such “soft” restrictive covenant proxies have become a new tacit methodology for preserving the hospital-patient relationship while severing the physician-patient relationship, and

Whereas, our American Academy of Family Physicians Congress of Delegates did resolve in 2020 to oppose restrictive covenants, and the American Medical Association did recommend to the Federal Trade Commission in 2020 to avoid federal policy with regard to physician noncompete clauses, thus leaving affected physicians of all specialties unprotected, and in 2021, President Joseph R. Biden did so instruct the Federal Trade Commission to work on eliminating non-compete clauses “and other clauses or agreements that may unfairly limit worker mobility”, and

Whereas, in 2021, a bi-partisan senate bill entitled the “Freedom to Compete Act” listed in the current Congress as S. 2375 seeks to nullify most existing non-compete clauses and prevent new covenants, and family physicians believe strongly in the primacy of the physician-patient relationship and any action that seeks to sever or otherwise deter that relationship should be considered in direct contradiction of the values of the American Academy of Family Physicians, now, therefore,

Resolve that, the Georgia Academy of Family Physicians advocate with state and federal lawmakers to support the passage of US Senate Bill 2375, the “Freedom to Compete Act” which amends the Fair Labor Standards Act of 1938 to eliminate non-compete clauses, and

Resolve that, the Georgia Academy of Family Physicians advocate with state lawmakers to ban “soft” non-compete practices, in which termination of employment may be used as a threat or punitive response to a family physician informing patients of their intent to practice outside of their current employment or publicly disclosing their intent to change practices, and advocate for the abolition by the legislature of such restrictive covenants and non-compete agreements in physician employment contracts in Georgia  and be it further

Resolved that, the Georgia Academy of Family Physicians advocate and support resolution 507 before the AAFP Congress of Delegates opposing restrictive covenants and non-compete agreements in physician contracts as against public policy, in order to better preserve the physician – patient relationship.

Staff Background:

AAFP Background and policy:

The Freedom to Compete Act (S.2375) was introduced by Senators Marco Rubio (R-FL) and Maggie Hassan (D-NH) and does not have any additional co-sponsors. The AAFP has not taken a formal position on the bill.

The AAFP’s policy on restrictive covenants states: “The AAFP believes an employment contract clause with unreasonable restrictive covenants can disrupt the patient-physician relationship. A clause that includes unreasonable geographic, time, or scope of practice constraints may limit continuity of care, access, and patient choice when the physician leaves employment in a practice.” The policy does not specifically mention “soft” non-compete practices but is general enough where it would be understood to be included.

The AAFP has not advocated specifically on the existence of “soft” non-compete practices. The Academy’s efforts have been generally focused on educating the membership. The AAFP has developed employment contracting resources to help its members navigate contracts and highlights that family physicians should review these provisions carefully to ensure the length of time, geography, and scope of practice are reasonable.

GAFP has no current policy on opposing restrictive non-compete clauses.

  1. From the Augusta University Residency Program Report

Submitted by David L. Kriegel II, MD, FAAFP

  1. Expanding existing retention benefits for Family Medicine residents to remain in practice in Georgia
  2. Improving awareness of any existing benefits above
  3. Development of a meaningful educational collaborative for Family Medicine residencies throughout the state

AAFP Policy:  Position Paper on Keeping Physicians in a Rural Practice

https://www.aafp.org/about/policies/all/rural-practice-keeping-physicians.html

Research, Collaborative – https://www.aafp.org/about/policies/all/research-collaborative.html

https://www.aafp.org/students-residents/residency-program-directors/curriculum-guidelines.html

 GAFP Policy:  The GAFP has a policy to support increased funding for family medicine residency programs.  During 2022, the Executive and Student and Residency Recruitment Committees surveyed Georgia’s Residency Director about how the GAFP can support the proposed ACGME requirements for programs to have collaborative agreements to advance education to their residents.  The final rules are still pending with the ACGME, but the Student and Resident Committee is planning to host a conference call with the program directors in October for additional feedback and information, and to host an in-person meeting of the residency directors in November to seek additional ways the chapter can support the programs and their efforts to form a collaborative.

  1. From the GAFP Board of Directors Residents’ Report

Submitted by

2022 Resident Directors and Alternates to the Board

Resident Director Samuel Nwaobi, MD

Resident Director Anthony Daniels, MD

Resident Alternate Director Nijah Burris, MD

Resident Alternate Director Sydney Koenig, MD

 Recommendations:

  • The GAFP should encourage increased opportunities for the continuous training/education of its members on chronic pain and substance use disorder screening and new treatment modalities.
  • Push for continued support for telemedicine visits to better reach our rural populations.
  • Advocate for Increased background checks and mental health screening for gun purchase
  • Improved publicity for the opportunities the GAFP provides by utilizing the influence of Program Directors.*

*GAFP staff outreached to resident directors for clarification on this fourth recommendation and the reply was:

“Thanks for the feedback. That sentence was supposed to mean that, most residents/programs get so many emails daily. We believe if the GAFP has specific resident specific programs planned, getting the Program coordinators/Program directors to help with reaching out to residents might complement the already existing emails that the GAFP sends out to residents.”

Staff Background

AAFP Policy:

Education – Pain Management/Substance Abuse

https://www.aafp.org/about/policies/all/substance-disorder-education.html

Substance Use Disorder Education for Students and Residents

To minimize the harmful effects of licit and illicit drug use on patients and communities, the AAFP believes all students and family medicine residents should receive comprehensive education on how to:

  • Use screening tools to screen for and diagnose the full, multi-faceted spectrum of substance use disorder (SUD).
  • Provide counseling and prescribe evidence-based treatment modalities for SUD.
  • Identify each patient’s medical, psychological, social, and economic complications of SUD and link them to appropriate resources.
  • Recognize the social inequities that affect patients’ capacity to understand and effectively cope with drug-related harm.
  • Implement harm reduction strategies to meet patients where they are at, affirm the patient as the primary agent of change for their drug use, and address individual and community conditions of substance use.
  • Break down the stigma often associated with patients with SUD and help build a non-judgmental and inclusive environment.
  • Advocate on behalf of patients with SUD as representatives of medical society to pertinent legislative and municipal bodies.
  • Create space for the voice of people who use drugs to be heard when developing programs and policies.
  • Follow clinical standards and utilize monitoring programs to minimize the risk of SUD when prescribing high-risk medications.

For students and family medicine residents to be competent in the knowledge, skills, and attitudes listed above, SUD must be prioritized as a core subject within undergraduate medical education (UME) and graduate medical education (GME). Didactics, case discussions, simulation, engagement with community organizations supporting people with SUD and implicit bias training can be used to teach SUD fundamental concepts and curricular topics, including but not limited to:

  • The primary a priori assumption that everyone wants to be healthy.
  • Definitions for, epidemiology of, and differences between substance use, tolerance, dependence, and substance use disorders.
  • History of drug policies in the U.S. and their impact on access to care, health inequity, and structural racism, classism, and sexism.
  • Core biological, psychological, and social frameworks of addiction and dependency.
  • Precipitants and factors that interfere with SUD treatment and referrals for services, including the impact of trauma (including adverse childhood experiences) and concurrent physical, mental, and social health conditions.
  • Intersectionality of SUD with race, gender, sexual orientation, and culture.
  • Pharmacologic and non-pharmacologic SUD treatment options, including medication-assisted treatment in combination with counseling and behavioral therapies.
  • Foundational principles central to harm reduction to reduce negative consequences associated with drug use and build respect for the rights of people who use drugs.
  • Evidence-based public health strategies to reduce harm, such as overdose prevention, syringe service programs, and safer drug use.
  • Recovery models for SUD, incorporating a holistic, supportive, and optimistic approach.
  • Person-centered care that uses non-stigmatizing language, centers on the premise that there can be difficult conversations rather than difficult patients, and incorporates motivational interviewing and shared-decision making.
  • Evidence-based screening tools for nonmedical use of prescription drugs, prescription drug monitoring programs, and patient-centered clinical practices that consider all treatment options, monitor risks, and safely discontinue high-risk medications.

To successfully train and produce knowledgeable and skilled physicians in preventing, screening, diagnosing, and treating SUD, UME and GME faculty must be equipped and supported. Leaders at UME and GME institutions should ensure core faculty are appropriately trained to 1) teach and role model the knowledge, skills, and attitudes they are attempting to impart to their learners surrounding SUD assessment and management, 2) tailor the SUD curriculum to meet the needs of the communities they serve and specific practice settings implicated at a local level, 3) facilitate dialogue that explores values and cultural norms related to drug use and drug-related stigma, and 4) stay current in the comprehensive approaches used for SUD diagnosis and management as they evolve. (April 2022 BOD)

And https://www.aafp.org/about/policies/all/substance-use-disorders.html

All members:

Opioids, for example,

Concurrent with the increased use of opioid analgesics for pain control has been an explosive growth in the rate of abuse, misuse and overdose of these prescription medications. The AAFP recognizes the vital role that family physicians and other primary care clinicians have in the proper provision of pain management services including prescribing opioid analgesics. The AAFP supports the training of family physicians regarding the proper assessment, referral and treatment of chronic pain patients in an effort to lessen the diversion, misuse of opioid pain relievers. The AAFP also supports further research into evidence-based guidelines for the treatment of chronic pain syndromes, implementation of prescription drug monitoring programs nationwide and greater physician input into pain management regulation and legislation. Please see the AAFP position paper, “Chronic Pain Management and Opioid Misuse, A Public Health Concern” for further information.

GAFP Policy: Biannually, GAFP conducts a needs assessment survey among all members to find out what educational topics members want to receive. In addition, GAFP utilizes outside resources, including the AAFP needs assessment results, industry information and other appropriate resources, which is all shared with the GAFP Education and Research Committee for use in determining educational topics of need and interest to members.

Telemedicine – https://www.aafp.org/about/policies/all/telehealth-telemedicine.html

Payment models should support the patient’s freedom of choice in the form of service preferred (i.e., copays should not force patients to a specific modality). Value-based payment models must also support telehealth services by addressing the service’s role in patient attribution, ensuring risk scoring (i.e., HCC scoring) is enabled during such visits, and that quality measures support care delivered via telehealth visits. Additionally, payment models should support the physician’s ability to direct the patient toward the appropriate service modality (i.e., provide adequate reimbursement) in accordance with the current standard of care. The AAFP believes current reimbursement policies warrant increased standardization among payers, especially in regard to eligible originating and distant sites, and use of asynchronous store-and-forward technology. The current unneeded variability in policies among payers leads to administrative complexity and burden for physicians and patients. Some telemedicine visits require the same level of work by the physician and incur the same level of liability as in-person visits; therefore, those telemedicine services should be reimbursed at parity with the corresponding in-person visit. 

GAFP Policy: GAFP has a long standing (successful) legislative history of seeking Georgia Medicaid payment parity with Medicare (focusing on most commonly utilized primary care codes). GAFP supports policy changes (via AAFP Congress of Delegates – 2016) and Medical Association of Georgia’s House of Delegates (2022) to seek advocacy against direct-to-consumer telehealth services that undercuts the medical home.

Mental health screening/background checks for gun purchase:

AAFP policy in place, full position paper located here: 

https://www.aafp.org/about/policies/all/gun-violence.html

Except from the position paper:

Family physicians can further address gun violence in their practices and communities by following these office- and community-based steps.

Office-based:

o   Patients who screen positive should undergo additional assessment that considers severity of depression and comorbid psychological problems, alternate diagnoses, and medical conditions. Patients with depression should be treated with antidepressant medication and/or psychotherapy.

o   The presence of guns in the home increases the risk that a woman will die due to an IPV-related homicide eight-fold.9

Community-based:

  • Know the rates of gun violence in your area to better understand the impact on your community (http://www.gunviolencearchive.org/charts-and-maps)6
  • Participate in programs that address violence in your community.
  • Communicate with your local, state, and federal officials about gun violence as a public health concern. These conversations should specifically address:

o   Funding research to identify effective measures to increase the safety of firearms;
o   Gun safety legislation;
o   Strict enforcement of current gun laws;
o   Constitutionally-appropriate restrictions on the manufacture and sale, for civilian use, of large-capacity magazines and firearms; and
o   Appropriate funding for mental health services.

GAFP does not have a current separate policy.

Resident member communication:

GAFP policy: 

GAFP outreaches to resident members via electronic communications in the same way and rate as other membership categories.  In addition, in 2022, GAFP has begun outreaching via social media.

GAFP welcomes and looks for other modalities to outreach to resident members and other membership categories.

  1. From the GAFP Board of Directors Students’ Report

 Submitted by:

Brejon Childers | Morehouse SOM | Voting Director

John Chancellor | Emory University SOM | Voting Director Karimah Rokins | Morehouse SOM | Voting Director

Prince Adu Amoako | American University of Antigua College of Medicine | Alternate Nneka Onyejekwe | American University of Integrative Sciences SOM | Alternate

Rachel Gerald | Augusta University/ University of Georgia Medical Partnership aka Medical College of Georgia-Athens | Alternate

Recommendations

-GAFP Residency Fair was an exciting event and helped students to connect with residency programs in the state of Georgia. We recommend the GAFP continue Family Medicine events for students (virtual and in-person), e.g., Virtual Family Medicine Student summit, in-person GAFP Residency Fair, and other events (e.g., social engagements, medical mentorship). These events will increase student membership and networking opportunities for both students and residents.

-We recommend GAFP to allow medical students to apply for Committee and Board of Directors positions, and to attend Board of Director meetings along with other District Directors and Physician Members of the Board of Directors.

– We recommend the GAFP continue to provide and expand scholarship opportunities for students to participate in the AAFP National Conference for Medical Students and Residents. This would increase the diversity of participants by lessening financial barriers to attendance.

Staff Background:

AAFP Policy: https://www.aafp.org/about/policies/all/studentchoice-familymedicine.html

Student Choice of Family Medicine, Incentives for Increasing

A robust family medicine workforce is critical to ensure that the American public has equitable access to appropriate and effective primary care. The AAFP recognizes the multifaceted and complex factors leading to specialty choice. Therefore, the AAFP calls on entities including, but not limited to medical schools, health systems, local and federal government, health care payers, nonprofit organizations, and private industries to develop and support programs and incentives that encourage student career choice of family medicine. These programs and incentives could be financial, educational, institutional, or political in nature.

The Four Pillars for Primary Care Physician Workforce Reform serves as a blueprint to identify the components needed to ensure sufficient growth in the number of primary care physicians (defined as family physicians, general internists, and general pediatricians). This model is used to organize the list below of program characteristics and initiatives known to increase student choice of family medicine into four pillars of pipeline, process of medical education, practice transformation, and payment.

GAFP Policy:

Continue GAFP Student Meeting – Current Policy

Allow Student and Residents to Serve in Leadership Positions (Board/Committee) – Current Policy

Support Scholarships to AAFP National Conference – GAFP Current Policy to promote AAFP travel scholarships to students and residents, and to support travel for up to four medical student and resident leaders to participate in the National Conference Congress.

Dr. Maria Bramhall addresses dangers of tobacco/vaping at Gainesville middle school

By Abbey Carr, Statewide Manager, Tar Wars Education

The middle school assembly room at Lakeview Academy in Gainesville was buzzing with energy as Maria Bramhall, M.D., a medical resident in the family medicine program at Northeast Georgia Medical Center (NGMC), showed students a vape advertisement on the screen. The students grew quiet as Dr. Bramhall explained the false claims that the advertisement depicted and warned students of the negative health effects and consequences of tobacco, nicotine and vape use, in stark contrast to the healthy image displayed.

Dr. Bramhall presented this important anti-vaping message to over 120 middle school students at the school on September 21 and 22. The Georgia Healthy Family Alliance ‘Tar Wars’ team coordinated the effort with Lakeview Academy School Counselor Liz Moore, NGMC Family Medicine Residency Program Director Monica Newton, M.D., and Dr. Bramhall.

GHFA Board and Statewide Tar Wars Manager Abbey Carr says, “The Tar Wars would like to express its sincere thanks to Dr. Bramhall for taking time out of her busy schedule to make these presentations to these young people, and we are optimistic that the information she shared will make them think twice before they try tobacco, nicotine or vape products.”

Want to help us stop Georgia students from vaping before they start? Plug-in to our ‘Tar Wars’ education initiative! Contact Abbey Carr at acarr@gafp.org or click here to sign up for our weekly program orientation.

Dr. Maria Bramhall addressing students at Lakeview Academy in Gainesville

Medicaid Banner Message: Telehealth and Telemedicine

Dear Provider Community,

In accordance with the Georgia Telehealth Act, enrolled providers may render medically necessary covered services, when appropriate, with Telehealth or Telemedicine. The provisions below apply to in-state providers and out-of-state providers.

Licensing and Credentialing Requirements for Providers Rendering Services via Telehealth or Telemedicine

All enrolled providers, rendering services using Telemedicine or Telehealth must possess the required credentials and be legally allowed to practice within the state of Georgia. All enrolled providers must be credentialed by DCH’s Centralized Credentialing Verification Organization (CVO) or through a delegated credentialing arrangement with a Care Management Organization (CMO).

All individual practitioners must possess the appropriate Georgia license (this includes a Telemedicine License, Temporary License or Emergency Practice Permit), permit, certificate, approval, registration, or other form of permission issued by an entity other than the Department of Community Health (DCH), which form of permission is required by law. All enrolled individual practitioners must act within the scope of his or her practice as defined by federal and state laws, rules, and regulations.

Telemedicine/Telehealth services shall be subject to utilization review and auditing requirements.

Providers must maintain documentation of all services provided by Telemedicine/Telehealth in accordance with DCH policy.

Admitting Hospital Privileges

In-state physicians providing services using Telemedicine/Telehealth must have admitting privileges at a Georgia hospital or an arrangement with a local physician who has admitting privileges.

Out of state physicians providing services via Telehealth must have an arrangement with a local physician who has admitting privileges or a local hospitalist.

Prescribing Medications Via Telehealth

Providers may prescribe medications with Telemedicine/Telehealth. All prescribers, whether in-state or out-of-state, must have and use his or her unique Drug Enforcement Administration (DEA) registration number to authorize controlled substance prescriptions. DEA regulations require practitioners to obtain a separate DEA registration in each state in which he or she prescribes controlled substances.

Accordingly, out of state practitioners, must obtain a Georgia DEA registration number if prescribing controlled substances to Georgia Medicaid and PeachCare for Kids members who are located within the state of Georgia. Out-of-state practitioners who do not prescribe controlled substances to Georgia Medicaid and PeachCare for Kids members within the state of Georgia are not required to have a Georgia DEA registration number.

Ordering, Prescribing, and Referring (OPR) Requirements for Telehealth Services:

1. The physician or non-physician practitioner who wrote the order, prescription or referral must be enrolled in Medicaid as either a participating Medicaid provider or as an OPR provider and his or her NPI number must be included on the claim.

2. The provider’s NPI number must be for an individual physician or non-physician practitioner (not an organizational NPI).

3. The physician or non-physician practitioner must be of a specialty type that is eligible to order, prescribe, or refer.

For addition information pertaining to OPR requirements, please click the following link: OPR FAQ.

Monkeypox Updates from Georgia DPH

The Georgia Department of Public Health has updated its slide deck that includes information for clinicians regarding Monkeypox, including updated case rates and some changes that are related to vaccination and TPOXX. Click here for DPH’s updated slide deck on Monkeypox.

Resource: For Your Aging Patients – What Services Are They Eligible?

By the Atlanta Regional Commission (ARC) – Area Agency on Aging

Eligibility, Process & Cost

For what services am I eligible?

The services available to you depend on many different factors, including your age, where you live, and your assets and income. Based on these requirements, some services may not be available to you, or may be available to you for a cost.

It can be difficult to determine whether you are eligible for a service on your own. If you live in the Atlanta region, you can give us a call and our skilled counselors will answer your eligibility questions at no cost. Empowerline serves the City of Atlanta as well as Cherokee County, Clayton County, Cobb County, DeKalb County, Douglas County, Fayette County, Fulton County, Gwinnett County, Henry County, and Rockdale County. If you don’t live in the Atlanta region, you can find an agency to help you on n4a.org.

Where do I start?

The process is a little different for each service, but there are typically three steps:

Step 1. Contact Empowerline

We can help you understand the right services for your situation and how to access the support you need. You can reach one of our trained counselors and ask for help for yourself or a loved one. Our counselors are trained experts, certified by the Alliance of Information and Referral Systems.

Just pick up the phone or click on our live chat feature. Before you connect, be prepared to share the date of birth and any goals, symptoms, conditions, or obstacles for yourself or the person for whom you are calling. If you would like to access services paid for by public funds, the counselor may ask you for information regarding the income and available resources of the older person or individual with disabilities who need access to services.

You are in safe hands. Our systems are secure and your information will be kept entirely confidential – our counselors comply with federal privacy rules. We will not share any of your information without your permission.

Step 2. We will connect you

Together, we will determine the resources and services that best fit your needs. If you are able to pay privately, we will provide you with information on how to contact service providers to meet your goals and needs.

If you need assistance paying for services, we will schedule a 30 to 45-minute screening to make sure you are eligible. For the screening, be prepared to share information on your financial situation, any existing insurance policies, and your day-to-day activities for which you need assistance.

There is often high demand for publicly funded services. Because of this, even if you are eligible to receive no-cost or reduced-cost assistance, you may be placed on a needs-based waiting list – but we won’t forget about you. If you are on the waitlist for a long time, we will check back in to reassess your situation and determine whether you need to be moved higher on the list. You can also contact us at any time to let us know if your situation has changed.

Step 3. Receive assistance

If you are paying privately, you can usually contact a service provider immediately to get services started.

If you need no-cost or reduced-cost assistance, when funding becomes available to assist you, we will give you a call within one week. A representative (called a “case manager”) will visit you to conduct a final face-to-face assessment, work with you to determine the exact services you need and then work to get services started so you can begin to receive the help you need. Your case manager can continue to keep tabs on you – as your or your care partner’s needs change, we will follow up to see if there is any additional support we can identify for your situation.

How much do the services cost and how do I pay for them?

It costs nothing to contact Empowerline and explore your options. The costs of services depend on which services you need and your financial situation. Support can be funded by your own income or savings, by public funds, by an insurance company, by veterans benefits or other publicly funded programs, or by your caregivers. You have three cost options to receive long-term solutions:

No cost – If you meet low-income requirements, you may be able to receive all the help you need at no cost.

Cost-shared – If you do not meet low-income requirements but still cannot afford the full cost of a service, you may be able to receive the help you need at a reduced cost.

Full cost – If you are able to pay for the full cost of a service, we can provide you with information regarding how to access a service and the necessary payment methods.

Call our phone line to speak with a skilled counselor who can help you identify the best solution to fit your financial needs, or read more on how to manage paying for your care.

This article was originally published by ARC’s Empowerline. To learn more, visit https://www.empowerline.org/.

This information is brought to you by a RRF Foundation on Aging grant received by the Georgia Academy of Family Physicians and the Atlanta Regional Commission (ARC) – Agency on Aging.

GAFP to Offer Virtual KSAs on Diabetes & Care of Children in October

By Sarah Bigorowski, Director of Education

The Georgia Academy of Family Physicians is hosting two virtual Knowledge Self-Assessments (KSAs) in October to help you meet your CME & ABFM requirements from the comfort and convenience of your home! Don’t miss this chance to earn up to 16 AAFP Prescribed credits and at least 10 ABFM certification points.

Diabetes
Saturday, October 22, 10:00 a.m.-2:00 p.m.

Care of Children
Saturday, October 29, 10:00 a.m.-2:00 p.m.

Click here to register for these courses and to get more information about GAFP’s slate of ABFM topics – keeping in mind that the deadline to register for these courses is the Thursday before the event is scheduled to be held.

KSAs are used to help identify knowledge gaps and enhance your clinical knowledge to provide high-quality care. Participants are encouraged to visit ABFM’s website at https://www.theabfm.org/ to verify that they are eligible for KSA credit.

Excitement Grows for Upcoming 75th Anniversary Celebration & Annual Family Medicine CME Weekend!

By Sarah Bigorowski, Director of Education

GAFP’s Annual Family Medicine CME Weekend is just six weeks away. We’ll be celebrating 75 years of accomplishments and advancements that have strengthened the practice of family medicine. Join us in Atlanta on November 10-12 to network with your peers, participate in valuable CME activities, and discover the latest products and services in the GAFP Social & Information Hub (also known as the Hub)!

Our annual meeting will kick off on the morning of Thursday, November 11 with a CME activity and the Social & Information Hub. The CME activities will include 1) an overview on the Georgia Department of Public Health’s children’s medical services, autism screenings, and home visiting programs and 2) a ‘Summer of Thrive’ debrief that will feature participants sharing the lessons they have learned to enhance their practice environments and optimizing their coding processes. The day will end with a welcome reception in the Hub – a great time to celebrate and connect with your peers and industry partners.

The Friday program will feature brief presentations from the top three research poster finalists and member interest group conversations on rural and hospital medicine, independent practice, obstetrics and more. On that Friday evening, we will welcome incoming GAFP President Sharon Rabinovitz, M.D., and we will honor this year’s GAFP award recipients with a night of dancing and friendship during the Diamond Jubilee President’s Celebration and Awards Dinner.

And don’t forget to spend time discovering new partners and technologies that bolster family medicine and boost productivity in the Hub.

Our annual meeting will conclude on Saturday, November 12 with a wrap up of CME topics as well tending to important work of GAFP’s Congress of Delegates. The Annual Family Medicine CME Weekend will offer up to 20 AMA PRA Category 1 Credits™. The deadline to register for the meeting is Sunday, October 30. Click here to register for a room at the Atlanta Marriott Northwest at Galleria until October 26 or until GAFP’s block of rooms is full. Don’t delay, click here to register for the GAFP Annual Family Medicine CME Weekend today!

GAFP offering THRIVE Coding & Reimbursement Improvement Bootcamp

By Sarah Bigorowski, Director of Education

The Georgia Academy of Family Physicians will offer a THRIVE coding and reimbursement bootcamp during its Annual Family Medicine Weekend in Atlanta on November 10-11. GAFP’s THRIVE bootcamps are intensive and innovative CME-approved practice transformation projects that focus on helping family medicine practices increase reimbursement and improve the health of their patients by identifying under-used codes and procedures.

The bootcamp qualifies as an American Board of Family Medicine (ABFM) Performance Improvement Activity, which means participants can earn up to 20 points towards their 50-point activity requirement.

Participants will attend half-day workshops on performance improvement and coding and documentation on November 10 and 11. They will also complete a rapid cycle improvement project. The sessions will be led by practice transformation experts Stephen Mayfield, DHA, MBA, MBB, and Bob Addleton, EdD, and longtime GAFP partner and coding expert Steve Adams. Together, a Master Black Belt and a master coder will guide participants through a change process that will enhance their practice’s efficiency, improve health outcomes, and increase practice revenue.

Once a participant completes and is accepted into the bootcamp in November, GAFP will reimburse their practice for up to $1,050 to offset travel and registration costs.

Interested practices must complete a brief application by the end of the day on October 12. Applicants will be notified of the results of their application no later than October 20.

Click here for more details on GAFP’s annual meeting and contact Bob Addleton at bobaddleton@outlook.com with questions related to the bootcamp.

GAFP to Honor Dr. Macy McNair with ‘2022 Resident of Year’ Award

By Ali Bohannon, Manager of Membership and Operations

The Georgia Academy of Family Physicians will honor Morehouse School of Medicine family medicine resident Macy McNair, M.D., with its ‘2022 Resident of the Year Award’ during the organization’s annual meeting in November.

“In addition to her steadfast pursuit of excellence in teaching our future doctors, Dr. McNair stands out for her tireless drive to understand and address health equity and disparities,” says President Susana Ajoy Alfonso, M.D., FAAFP. “Dr. McNair is a deserving recipient of this award given her steadfast commitment to family medicine and research and empathy for the underserved.”

Dr. Alfonso also notes that, “Dr. McNair plays several key roles at MSM’s student-run HEAL Clinic, including volunteer physician, mentor, and preceptor. She has also participated in numerous health fairs – including being one of the first residents to volunteer for a series of food distribution and COVID-19 education and screening events in the under-resourced Pittsburgh community of Atlanta during the early part of the pandemic – and a school supply drive for metro Atlanta elementary and middle schools.”

And Dr. Alfonso applauds Dr. McNair for “taking the initiative to provide health education to the community through panel discussions at health fairs that have addressed common chronic diseases like heart disease and stroke.”

Dr. McNair is a resident member of the Georgia Healthy Family Alliance Board of Trustees, and she formerly served as a student member of GAFP’s Board of Directors.

In addition to an undergraduate degree from Armstrong State University in Savannah, Dr. McNair has a medical degree from the Morehouse School of Medicine.

While she was in medical school, Dr. McNair received MSM’s ‘Leonard Tow Humanism in Medicine Award’ and earned a top three finish in MSM’s ‘Graduate Medical Education 5th Annual Resident Teaching Competition.’