Lehigh County Health & Medicine Fall 2022

Official Publication of The Lehigh County Medical Society

2022

LEHIGH COUNTY MEDICAL SOCIETY

P.O. Box 8, East Texas, PA 18046 610-437-2288 | lcmedsoc.org

2022 LCMS BOARD OF DIRECTORS

Rajender S. Totlani, MD

President

Oscar A. Morffi, MD Treasurer

Charles J. Scagliotti, MD, FACS Secretary

William Tuffiash

Immediate Past President

*effective February 1, 2022

CENSORS

Howard E. Hudson, Jr., MD Edward F. Guarino, MD

TRUSTEES

Wayne E. Dubov, MD Kenneth J. Toff, DO

EDITOR

David Griffiths

Executive Officer

5 IN THIS ISSUE

ON THE COVER

7 SOCIAL MEDIA AND MEDICAL INFORMATION

Dermatologists’ Tips for Identifying Accurate Information

By Elizabeth Aziz, DO, Kevin Liu, DO, Colby L. Presley, DO, Cynthia L. Bartus, MD

FEATURES

The opinions expressed in this publication are for general information only and are not intended to provide specific legal, medical or other advice or recommendations for any individuals. The placement of editorial opinions and paid advertising does not imply endorsement by the Lehigh County Medical Society.

All rights reserved. No portion of this publication may be reproduced electronically or in print without the expressed written consent of the publisher or editor.

9 PAMED CONDEMNS PA SUPREME COURT ON RESCINDING MEDICAL LIABILITY VENUE RULE

10 THE IMPORTANCE OF QUALITY IMPROVEMENT in Advancing Health Care and Controlling Costs

By Mark Wendling, MD

13 SAVING BREASTS, SAVING LIVES Take the First Step

By Patricia Maran, MD, FACOG

16 POLIO

It's Happened Again, Right Here in the US

By Carol Ferguson

18 PCFLV

Embracing the Journey with Local Pediatric Cancer Families

20 LEGISLATIVE UPDATES

23 LCMS NEWS

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Fall is at our doorsteps!

YOU CAN SMELL THE PUMPKIN SPICE IN THE AIR.

Hopefully, you have found prior issues of this magazine informative. We look forward to hearing your responses, ideas, and contributions to upcoming editions.

In this edition we are bringing you articles from a legislative report from PAMED, updates for Breast Cancer Awareness Month, a new Continuing Medical Education (CME) program our county medical society and PAMED are rolling out in 2023 for members, and social media and its effect on medicine.

October is breast cancer awareness month. Please read the article “Saving Breasts Saving Lives: Take the First Step.” This is an important topic that everyone needs to be made aware of. As someone whose family has been affected by breast cancer, it is critical to take the time to get checked or to ask someone you care about to get checked.

Most of us use some form of social media. We use it to communicate with friends and family, shop, and research things, including healthcare. Please read the article “Social Media and Medical Information: Dermatologists’ Tips for Identifying Accurate Information” for some excellent tips to better ensure that what you are reading is credible, useful information from legitimate sources.

In the article “The Importance of Quality Improvement in Advancing Health Care and Controlling Costs,” a new concept is discussed and while it is not easy, it is worth reading.

We also are re-running the piece from the Pediatric Cancer Foundation of the Lehigh Valley as we made a proofreading error in our last issue.

We hope you enjoy the magazine and find it both educational and relevant to your interests. If you wish to see past issues, they can be found at https://lcmedsoc.org/ our-publication.

As always, we hope you will enjoy reading our magazine! We will see you again in the next edition.

Social Media and Medical Information

Dermatologists’ Tips for Identifying Accurate Information

BY ELIZABETH AZIZ, DO1, KEVIN LIU, DO1 , COLBY L. PRESLEY, DO1, CYNTHIA L. BARTUS, MD1,2

1DIVISION OF DERMATOLOGY, LEHIGH VALLEY HEALTH NETWORK, ALLENTOWN, PA 2ADVANCED DERMATOLOGY ASSOCIATES, ALLENTOWN, PA

In the last 20 years, our world has become more digitally intercon nected. Now, more than ever, patients have near instantaneous access to health information at the tips of their fingers. As healthcare providers and patients alike, we must be cognizant of how medical information accessed through the internet can be both a blessing and a curse.

Social media has gripped our way of life, including a heavy influ ence on healthcare information dissemination. In the US, 72% of Americans report using at least one form of social media.1 According to the Pew Research Center, in 2021, some of the most popular social media platforms include YouTube (81%), Facebook (69%), Instagram (40%) and TikTok (21%).1 The current public uses social media as not only a way to connect with one another but to exchange current events, trends, and access health-related information. One study revealed that around 80% of dermatology patients use the internet or social media to access medical information.2 These statistics highlight how extensive the use of social media is and how much healthcare information patients consume before ever getting in the exam room.

on page 8

FEATURE Without a doubt, platforms such as Facebook, Instagram, and TikTok have made communication and dissemination of information easier than ever and many benefits have come from this. Healthcare providers can give medical advice to the population at large, or they can quickly answer specific questions that individuals may have. Alternatively, these platforms can also be used to connect patients with others who share their condition, such as cancer support groups. Here, individuals can share advice, knowledge, and experiences with one another. As the world of social media continues to evolve, the benefits of quick and easy access to medical knowledge will continue to grow.

However, our ease of access to information can present a double-edged sword when it comes to medical advice. In dermatology specifically, we have encountered the viral popularity of social media trends to address management for common skin concerns such as acne, eczema, and aging/wrinkles. Unfortunately, many of these trends and posts are started by paid influencers without a medical background. Unregulated medical advice, particularly that provided by un trained sources, can clearly have a negative impact on the consumers (our patients) of such information.

We provide these simple steps for patients and healthcare providers to help filter out potentially inaccurate skin care posts on social media, such as TikTok or Instagram. These steps can certainly apply to other medical specialties and health-related information found on social media.

Read the Caption.

If the social media post has a hashtag, e.g., “#ad” in their caption, the creator of the post is being transparent and informing their audience they are being paid to advertise a product. They may also create hashtags such as “#advertisement, #sponsorship, #partnership,” etc. in their captions. Be cautious of these posts as they are targeted at getting viewers to buy products and may not be providing accurate medical advice.

Check Credentials.

When viewing posts, check the profile of the creator of the post. “Influencers” will not have the certifications associated with medical professionals. For example, if a post is made by a physician, they will typically have the credentials “MD” or “DO” behind their name. Additionally, if they have “FAAD” or “FAOCD” in their title, the content creator is making you aware that they are nationally board-certified and trained dermatologists sharing skincare information. These providers are aware of the risks and benefits of providing dermatological information online.

If hesitant or questioning, don’t try it.

If it sounds either too good to be true or too strange to be true, then consult your health care provider first. In dermatology, for example, there have been a number of trends suggesting the use or application of DIY toners and serums, toothpaste, potatoes, etc., to achieve better skin. These methods are often ineffective and can cause more damage than benefit.

Dr. Google is NOT a replacement for a health care provider.

While trends continue to change, lose popularity, and new fads begin, medical knowledge only improves and increases. When it comes to skin care, your skin care professional will work with you to find the most economical and appropriate treatment

for your skin type. Money, time, and frus tration can be saved when you start with a trusted, trained source for your healthcare.

As social media continues to grow and our world becomes both more interconnected and diverse, use these steps to protect your health from promotional ads disguised as medical advice. Consult with your healthcare provider before the implementation of medical advice found through social media platforms. As healthcare providers and social media users ourselves, we must also be responsible for providing safe, accurate information on our social media platforms and adhere to professional standards if using social media in a professional setting.

REFERENCES

1. Auxier B, Anderson M. Social media use in 2021. Pew Research Center. Published April 7, 2021. https://www.pewresearch.org/ internet/2021/04/07/social-media-use-in-2021/

2. Gantenbein L, Navarini AA, Maul LV, Brandt O, Mueller SM. Internet and social media use in dermatology patients: Search behavior and impact on patient‐phy sician relationship. Dermatologic Therapy. 2020;33(6).

PAMED Condemns

PA Supreme Court on Rescinding Medical Liability Venue Rule

Message from Chair, PAMED Board of Trustees, Ed Balaban, DO, regarding the Supreme Court’s Action on Venue Shopping

In 2003, the Supreme Court of Pennsylvania adopted a rule that would allow medical malpractice cases to be filed only in the county in which the alleged malpractice occurred. Today the Supreme Court of Pennsylvania adopted amendments to the Pennsylvania Rules of Civil Procedures to rescind the 2003 rule governing venue in medical professional liability actions. This change will now expand venue to additional counties beyond the county in which the alleged malpractice occurred. The Civil Procedural Rules Committee will re-examine the 2022 rule amendments two years after the effective date of January 1, 2023.

The Pennsylvania Medical Society staunchly condemns this enormous step backwards to the days of an unstable medical liability market and a mass exodus of physicians from this Commonwealth.

After twenty years of rebuilding towards a more robust physician presence and a better liability market in Pennsylvania, the Supreme Court has, in essence, invited an unnecessary return to the “good old days” of stuffing trial lawyers’ pockets to the detriment of a steady and safe health care environment.

As we experienced in the late 1990s and 2000s, Pennsylvania will begin to see high risk specialists like orthopedists, neurosurgeons, and trauma surgeons halt procedures, OB/Gyns stop delivering babies, and our highly trained residents choosing to leave Pennsylvania to practice in states that are more welcoming to them.

The bottom line is that the court has ignored over 5,000 comments from the physicians, patients, and countless professional organiza tions across the state to the detriment of the safety and health of Pennsylvania patients.

PAMED won’t stop fighting for what is fair for patients and physicians across the state. We will look for a remedy to ensure the continuity of services, availability of high-quality healthcare, and stabilize medical liability.

The Importance of Quality Improvement in advancing health care and controlling costs

BY MARK WENDLING, MD, EXECUTIVE DIRECTOR, VALLEY PREFERRED

“Quality is not an act; it is a habit.”

– Aristotle

Health systems around the country have been working on addressing the rising cost of health care in the United States. Few have had much success. U.S. health care spending grew 9.7 percent in 2020, reaching $4.1 trillion or $12,530 per person. As a share of the nation’s Gross Domestic Product, health spending that year accounted for 19.7 percent.(1)

The most forward-thinking physicians, ex perts, and leaders have made the connection between health care quality improvement and waste reduction toward impacting costs. This connection, however, needs to encompass a multi-faceted and continuous approach to quality to be effective. The concept, in its broadest definition comprising value-based care, has become the most logical and urgent answer as affordable access continues to spiral out of control.

THE QI SOLUTION MATURES

Historically, improving health care involved quality assurance – evaluating services and deliv ery – and quality control – basically a system that could verify whether a desired level of quality was maintained. These methods may have revealed shortcomings and indicated needed changes but failed to perform in a broader sense. They couldn’t necessarily determine effects on other parts of the organization, identify inefficiencies, or address the provider’s role in the process, all important aspects of true QI.

Fortunately, a new concept has overtaken the old. Health care organizations are now combining quality assurance with continuous quality improvement (CQI). It simply means that opportunity for improvement exists in every process on every occasion. CQI also includes the provider element: it requires a commitment to constantly improve operations, processes, and activities toward the ultimate goal of best patient care.

Something is wrong if workers do not look around each day, find things that are tedious or boring, and then rewrite the procedures. Even last month’s manual should be out of date. – Taiichi Ohno, Japanese industrial engineer, father of the Toyota production system

Organizations that take the pursuit of quality seriously and understand its connection to managing costs have initiated programs in which their own providers can participate. If a clinician sees an area that could use improve ment, he or she is able to work with a QI team to bring their solution to fruition. Some have even instituted training that enables clinicians to benefit from expert guidance while developing their QI efforts. In this way, creating a “culture of quality improvement” endorses Aristotle’s view that quality is not a single act, but a habit.

ASKING THE RIGHT QUESTIONS

One thing QI training emphasizes is not to jump to conclusions during a QI investigation. This takes some practice since physicians are expected to be authorities who “know all the answers.” “Medical school teaches you basically to recognize patterns, since there are only so many things that can cause certain symptoms,” says Grant Greenberg, MD, MHSA, MA, Chair, Department of Family Medicine, LVHN. “The contradiction is that medicine is not a definite field. There are types of problems we solve that don’t always have an obvious answer. We have to be able to take time to delve into the details, see what else is going on, and above all, ask the right questions that are directly related to the problem you’re trying to solve.”

If I had one hour to save the world, I would spend fifty-five minutes defining the problem and only five minutes finding the solution.

– Albert Einstein, German-born theoretical physicist

As QI increasingly becomes a science, there are structured models to assist. The most common QI methodologies used in health care are PDSA, six-sigma, and lean strategies.

• PDSA, or Plan-Do-Study-Act, is an iterative, four-stage problem-solving model used for improving a process or carrying out change.

• Six Sigma is a set of management tools and techniques designed to improve the capability of the business process by reducing the likelihood of error.

• Lean strategies focus on producing more with less input. Thus, it seeks to eliminate waste throughout the entire manufacturing process.

DATA IS FOUNDATIONAL TO QI

In the methods above and in all others, data is essential in being able to ask the right questions. Fortunately, data analytics has evolved as a great asset for health care QI work. It encompasses collecting, tracking, analyzing, interpreting, and acting on an organization’s data for specific measures, such as clinical quality measures. Measuring a health system’s inputs, processes, and outcomes is a proactive, systematic approach to practice-level decisions for patient care and the delivery systems that support it.

Managing all that data includes ongoing measurement and monitoring. It enables an or ganization’s QI team to identify and implement opportunities for improvements to its current care delivery systems and monitor progress as changes are applied. Managing data also helps a QI team understand how outcomes are achieved, such as improved patient satisfaction with care, staff satisfaction with working in the organization, or an organization’s costs and revenues associated with patient care.

“Without big data, you are blind and deaf like a deer wandering into the middle of a freeway.” – Geoffrey Moore, American organizational theorist, management consultant and author

As the collected data is interpreted, it becomes a reliable and insightful gauge for altering approaches, changing operations, or finding another way to do something that has proved –through data – to have less than desirable results.

FEATURE

WHEN DATA, EFFICIENCY, AND PERFORMANCE COME TOGETHER

With data, organizations now can get a bird’s eye view of their processes, from how many unnecessary lab tests are ordered to which patients have not had their annual screenings. Acting on this information through QI can affect efficiency, cost, and ultimately, value provided to the patient. At the Heart Hospital, Hamad Medical Corporation (HMC), in Doha, Qatar, two physicians identified an area that needed improvement and found a way to change it with multidisciplinary, multi-level involvement.

Poonam Gupta, MBBS, MPH, CPHQ, CMQ, a physician and head of Quality Improvement, who works with Dr. Salah Arafa, a senior consultant interventional cardiologist, says teams throughout the hospital have seen an increase in communication, cooperation, and system thinking since value and quality improvement were made a priority in 2018. “We saw great results in one of our labs where we reduced waste by decreasing the amount of rejected blood samples sent for analysis,” she says. “Using the value management system-wide lens, our frontline staffs were empowered to view and address the issue from a whole-system perspective.” Instead of teaching themselves to work around the problem and allowing the waste to grow, or having several teams tackle the issue separately, those involved banded together to effectively resolve the problem without creating unnecessary conflict with the lab.(2)

“There are many experts on how things have been done up to now. If you think something could use a little improvement, you are the expert.” – Robert Brault, author

PHYSICIANS ARE INTEGRAL TO SUCCESS

Once the data resources are in place and insights are found, the QI torch is handed to the clinicians to follow through on what they learn. It’s up to them to work with people “upstream,” before they become patients, encouraging adaptation of healthy behaviors and regular doctor visits. When illness or injuries occur, the entire system works with patients “downstream” to help them recover as effectively as possible and avoid readmissions to the hospital.

It’s data, efficiency, and performance that constitute effective QI work. Each time these elements come together in a well-thought-out QI effort, it’s another beginning of fundamental change in a health care system that is over-burdened with inefficiencies. As more organizations take on QI as a priority, the better chance we have of making health care more satisfying and affordable.

RESOURCES

1. https://www.cms.gov/Research-Statistics-Data-and-Systems/ Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsH istorical#:~:text=U.S.%20health%20care%20spending%20grew,trillion%20or%20 %2412%2C530%20per%20person

2. https://www.ihi.org/communities/blogs solving-quality-problems-and-reducing-costs-with-value-management

Melissa Draving, Personal Concierge, Owner

TAKE THE FIRST STEP

BY PATRICIA MARAN, MD, FACOG LEHIGH VALLEY HOSPITAL AND HEALTH NETWORK

As this October comes, I am reminded of Breast Cancer Awareness Month and the amazing grass roots organi zation that the Susan Komen Foundation has become. We will see pink ribbons on yogurt cap and soda bottles, pink shirts and socks on ballfields and soccer pitches.

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FEATURE

We will watch people pay tribute to their mothers, sisters, daughters, and aunts during local road races and fundraisers.

But what might not be seen behind all the publicity is the sheer volume of families affected by breast cancer. It’s not just the women of our community affected. It’s the men who will be diagnosed; the fathers left widowed raising children; the husbands who spend long hours sitting in waiting rooms hoping their wives emerge from the radiation suites and chemotherapy infusion centers. The quiet down time when all the ribbons, balloons, and fundraising starts to dissipate are the very parts of the day that feel inevitably altered once this diagnosis arrives on one’s doorstep.

As an obstetrician/gynecologist, every day, multiple times a day, I am literally examining, talking about and touching breasts. Breastfeeding, formula shortages, sore breasts from hormone changes, saggy breasts with yeast infections underneath, tight back muscles from pendulous breasts. But the conversation and exam that both patients and doctors alike fear, are chief complaints such as “I found a lump” conversations, or “the mammogram needs to be repeated” conversations.The unspoken fear lingering in the exam room is a palpable belief that if one is diagnosed with breast cancer, one will die. I would propose though that the fear of breast cancer comes from an outdated perspective that every lump or bump is cancer, and every breast cancer may require poking, prodding, cutting, chemotherapy, radiation and that breast cancer generally

kills people. And the sad reality is that this fear very often prevents people from doing the one vital step that very well may lessen the gravity of the diagnosis, and that is to get a mammogram.

The reasons are many, but over the years, the most common excuses I hear are com ments such as: “I don’t have insurance, I can’t get a mammogram.” There are multiple ways we can subsidize those community members needing preventative screening who may not have insurance.

“What’s gonna change if they find it on mammogram, I’d just get a mastectomy anyway?” While some women medically will require a mastectomy depending on the type and size of the breast cancer, the majority of breast cancers can be treated with

a lumpectomy. Scientifically, we also know that having a mastectomy does not necessarily change the need for chemotherapy, nor does it improve survival rates. With new targeted hormone therapies and chemotherapy, the options for treatment are multi-faceted.

“I DON’T HAVE TIME.”

LOOK AT YOUR CHILDREN AND GRANDCHILDREN. MAKE TIME.

“You have to die somehow, right?” Statis tically the majority of people will die of a cardiovascular event or complication from cardiovascular disease. That being said, metastatic cancer–of any kind–is not the easiest or least painful way to die.

“All that radiation for the mammogram, doesn’t that cause cancer, not find it?” The quality of the mammography machines we use now are far more efficient and less apt to lead to radiation exposure. On the other hand, if you do have breast cancer, rest assured radiation treatment is far more caustic than screening xrays.

“It hurts.” Truly if you are afraid of the pain, or are too anxious to go for the mammo gram, please ask your doctors for either an anxiolytic or take some pre-procedure over the counter motrin or tylenol. Also, if you are still menstruating, consider scheduling the mammogram after you have completed your menses; it does seem less painful with these simple interventions.

The basis behind all of these statements is palpable fear. Fear of the unknown often prevents people from seeking the care they need. So let me clear up some of the un known with current statistics. If women are ages 40 and above, or have any new onset symptoms such as lumps, breast discharge, or visible changes, these folks need to seek care. These days more and more patients are becoming survivors of breast cancer rather than victims to it.

The majority of these people internation ally do not have access to the screening and treatment regimes we have in the United

STATISTICS :

States. Statistically more and more patients are becoming survivors. This 42 % decline has come from marked improvements in both the way in which we treat patients, but also the understanding that breast cancer is a very broad term for the multiple types of breast lesions that may occur and the individualized way in which we can now treat them.

In the U.S, breast cancer mortality is about 40 percent higher in Black women.

This statistic is unacceptable. While scientists do not know exactly why Black women are more apt to die from breast cancer, let’s be really clear. Race matters. If the Covid pandemic has taught us nothing, it certainly has shed light on the sad reality that equity and access to medical care in our communities is not equal.

This autumn when a pink ribbon comes into view, ask the people in your life: have you gotten a mammogram this year? If the answer is no, please reach out, find a friend, make a date, call for the appointment. Maybe even plan a lunch or shopping outing. Breast cancer research and treatment is a story of hope, of advocacy, of prevention, and of medical advancements. For this, we may all offer a huge sigh of relief.

The statistics included in this article have been taken from the Susan Komen Founda tion website at https://www.komen.org and verified with article citations.

For the most up to date screening guidelines, consider checking out the website: www.nccn.org.

To consider joining this fall’s local fundraiser, sign up for our local annual walk/run in the Lehigh Valley Parkway. https://womens5kclassic.org/

Every 46 seconds, somewhere in the world, someone dies from breast cancer. That’s more than 1,876 women and men every day. Improvements in early detection and treatment contributed to a 42 percent decline in the breast cancer death rate in the U.S. between 1989-2019.

Polio

It’s happened again, right here in the US

CAROL FERGUSON FOUNDER, PA POLIO SURVIVORS NETWORK

The July announcement of a 20-yearold man from Rockland County, NY, paralyzed by the poliovirus, brings back memories of the fear, disability and death that came each summer with the polio epidemics. How can polio be happening here? We have had an injectable polio vaccine (IPV) that is 99% effective available to all children in the US since 2000. Vaccines can’t do their job if people don’t take them, and the young man from New York was not vaccinated. That’s why polio is happening again.

Initial reports indicate that his paralysis was caused by a mutation of the oral Type 2

poliovirus vaccine (OPV), a mutation that occasionally causes the vaccine to result in paralysis. The oral polio vaccines have not been given in the US since 2000, suggesting that the chain of transmission of this contagious disease began abroad. The CDC and WHO have reported the virus that infected him is genetically related to the vaccine-derived poliovirus recently found in London and Israeli sewage (like the US, they are countries that have seen the eradication of polio). The paralyzed man must have come in close contact with someone who had received the oral Type 2 polio vaccine outside the US.

As polio survivors, this case in NY is horribly sad and deeply personal. Sad because the injectable polio vaccine, the only vaccine given in the US, is 99% effective in its protection against all three types of polio. If only he had been vaccinated, the man who was paralyzed never would have become ill at all. Even sadder is that he will have to live with a disability and chances are high that he will experience and become even more disabled as a result of Polio Syndrome (PPS) – the late effects of polio – as he ages.

Why is one case of polio deeply personal? Because lack of vacci nation has added one more preventable case of polio paralysis to the WHO estimated 20 million polio survivors, 75%+ of whom will develop PPS. Survivors of this disease will always remember:

• Those who died.

• The terror that came with being so sick.

• Lonely months and years of hospitalization, surgeries and painful rehabilitation all while separated from parents and siblings.

• The frightening reality of an iron lung.

• The sorrow that came with discovering wheelchairs, leg braces and crutches were ours for life.

• The loneliness that came as we returned home, and were forced to accept that everyone around us knew that it was the home of a “cripple,” and parents kept their children away.

• The shock that has come with the reality of the long-haul effects of polio (PPS), when those of us who thought we escaped or recovered from paralysis find ourselves with new weakness, fatigue and pain as we age.

“In Our Own Words” is a page on our website that features brief stories and videos of the realities of this terrible disease.

Yes, the story of this young man’s suffering is sad and deeply personal. Even one unvaccinated person with polio is one too many. His pain is completely unnecessary. The miracle of the polio vaccines came too late for us and for the millions of others who are living with polio’s effects.

We celebrate Rotary International’s focus on disease prevention and the Global Polio Eradication Initiative for their determined efforts to rid the world of polio and educate parents about the gift of modern vaccines.

In spite of these determined eradication efforts overseas, polio is happening in the US.

Please help your patients make the choice to vaccinate. No one needs to suffer from the effects of polio, ever again.

The foreign origin of the poliovirus that paralyzed the unvac cinated man in New York is a painful reminder that polio (and many vaccine preventable diseases) are only a plane ride away.

Embracing the Journey with Local Pediatric Cancer Families

The Pediatric Cancer Foundation of the Lehigh Valley (PCFLV) is a local non-profit providing free and unique programming and services to local kids with cancer and their families. Established in 2003 by a local cancer Mom, PCFLV’s mission is to embrace the pediatric cancer journey alongside children and their families, moving forward as a community with love, hope and smiles. PCFLV supports at diagnosis, encourages during treatment, empowers in survivorship, and, in the event that a child passes away, they comfort throughout bereavement.

Run by a small staff of three full-time employees and one part-time employee, PCFLV serves any family who lives within a 50-mile radius of the PCFLV office. About 50 percent of those families are treated at Lehigh Valley Reilly Children’s Hospital, while the other 50 percent receive treatment at Children’s Hospital of Philadelphia and St. Christopher’s Hospital in Philadelphia.

“We help any family in our geographical radius, regardless of where they receive treatment,” explains Michelle Zenie, the Executive Director of PCFLV and also a cancer mom. Zenie’s son was diagnosed with leukemia at age 3. “PCFLV’s mission is to provide assistance and opportunities for local pediatric cancer families. We help with the here and now needs of these families.”

PCFLV programs include: a college/trade school scholarship program that provides cancer warriors with a one-time, $3,000 scholarship; a bill-paying fund through Lehigh Valley Reilly Children’s Hospital to assist with mortgage/rent payments or any other major bill; a Birthday Club, where each warrior and their siblings receive a birthday card and gift card each year until they reach the age of 18; Camp Smile, a one-week free day-camp for warriors and their siblings that includes art, theater, sports, swimming and more; a one-time house cleaning service for when an immune-compromised child comes home from the hospital; various events for kids, teens, moms and dads to allow the families to have some respite and also get to know other local families; twice-monthly Chemo Circus, where a PCFLV staffer visits the local oncology clinic and makes crafts with the kids, hands out toys, and provides lunch; monthly support groups for caregivers and bereaved

parents; tickets to various sporting and enter tainment events within the Lehigh Valley; a gift card program that distributes thousands of dollars’ worth of gas, grocery store, EZ Pass and hospital cafeteria gift cards each year; an Adopt-A-Family Holiday Program that distributes gift cards for Holiday gifts; monthly Caregiver Coffee, where a PCFLV staffer takes coffee and goodies to the local oncology clinic for staff and parents; a $1,000 end-of-life stipend when a child passes away; End of Treatment gifts for warriors when they complete their treatment; and much more.

These programs are designed to help local pediatric cancer families financially, socially and emotionally. To create a support community and network is a big part of the mission of PCFLV.

“We love that we are able to connect our families and we love to see when they form bonds with each other,” said Zenie. “No one but another pediatric parent or warrior really knows what this journey is all about. Having someone who is walking your same path to lean on is monumentally helpful.”

PCFLV is able to fund these amazing programs due to individual and corporate donations and also fundraising events. PCFLV hosts three main fundraising events each year: the Luau On The Links Golf Outing, the Ready, Set, GOLD 8k Run/5k Walk, and the Hearts of Gold Gala. The Hearts of Gold Gala and Luau On The Links take place in the spring, and the Ready, Set, GOLD Run/ Walk is a September event. You can go to pcflv.org to find the registration link.

September is Pediatric Cancer Awareness Month, and each September PCFLV hosts a campaign called 30 Days, 30 Stories.® This campaign introduces supporters each day to a local warrior. These are kids who are in treatment or in survivorship, and also high lights kids who have passed away. A photo accompanies each story, which is written either by the child, a parent or sometimes a grandparent.These heart-warming and impactful stories give just a glimpse into the life of a pediatric cancer warrior and family. This series can be found on the PCFLV website (pcflv.org) and also on PCFLV’s social media platforms (Facebook, Twitter, Instagram, LinkedIn).

There are numerous ways for individuals and companies to get involved with PCFLV. They can make a monetary donation, they can sponsor an event, they can volunteer as an individual or group at a fundraising event, or they can even host their own fundraising event.

“We have so many opportunities for the community to jump in and get involved in our mission,” explained Tracy Stauffer, the Marketing, Community Relations and De velopment Coordinator for PCFLV. Stauffer is also a cancer mom. Her daughter was diagnosed at age 1 with brain and spinal cancer. “If anyone is interested in learning specifics on how to make a difference in the lives of our local warriors, they can call the PCFLV office at 484-221-9294.”

LEGISLATIVE UPDATES Summer Recess

For those engaged in the daily grind of the legislative process, summer has finally arrived with the passage of a $39.8B state budget. In the days leading up to the June 30 budget deadline—and a few days afterwards—we saw activity on an unusually large number of legislative proposals on which PAMED has been actively engaged. A number of them made it across the finish line and to the Governor’s desk, while a few could still see passage when the General Assembly returns in the fall.

Suffice it to say legislative activity has been somewhat contentious over the past few months as lawmakers positioned themselves politically for either the recent primary election or the upcoming election this fall. While PAMED’s government affairs staff is always sensitive to the “politics” that drives the development of public policy, we do our best to limit our focus on the impact legislation has on physicians and the patients they treat.

While the list below reflects the entirety of legislation that has been “active” since the current legislative session began in January of 2021, there are several items that deserve special recognition.

Prior authorization reform (SB 225) has been a priority issue for PAMED and our 40+ member coalition of physician orga nizations and patient advocacy groups for over six years. Earlier this session, Senator Kristin Phillips-Hill introduced SB 225, and has since been championing the effort to achieve senate passage before this year’s summer recess.

Over the past 6 months, various coa lition partners met countless times with senate staff and representatives of the insurance industry to hammer out language that could pass the senate. These meetings were often contentious, as one might expect, with the industry pushing back on nearly every provision of the original bill. Again, PAMED remained focused on how prior auth impacts patient care. Happily, her efforts, along with the efforts of key staff and our coalition partners, resulted in the unanimous approval of SB 225 by the full senate on June 29th. The bill now moves to the House Insurance Committee for consideration.

In the past, legislative activity during fall sessions has been robust as lawmakers work to wrap up their business before the end of the year. This year may prove different as there are only twelve legislative session days currently scheduled with rumors that a few additional days may be cut. With that in mind, PAMED will be aggressively

pushing for the House of Representatives to approve SB 225 before they break for the November election…which will ostensibly end the legislative session.

When it comes to legislation addressing scope of practice, PAMED has always viewed patient safety as our number one concern… not as competition against our non-physician colleagues. As a result of the COVID-19 waivers that granted pharmacists with expanded authority to provide COVID-19 vaccines, pharmacists began efforts in early January to further expand their role into the realm of childhood immunizations, seeking the authority to provide this service to their “customers” over the age of 5. Working in concert with the PA Academy of Family Physicians (PAFP) and the PA Chapter of the American College of Pediatrics (PA-ACP), that effort was stopped before it even became part of a legislative proposal.

Though the child vaccine issue was side lined, PAMED along with PAFP and PA-ACP did agree to allow pharmacists to provide seasonal flu and COVID-19 vaccines to individuals aged 5 and above. This “compromise” should serve to keep the issue of child vaccines off the table for the foreseeable future.

Speaking of the future, PAMED was successful during the recent budget process in securing additional funding for the state’s Primary Care Loan Repayment Program. This program provides loan forgiveness, presently up to $80,000, for physicians who choose to practice in a rural or underserved community for two years. PAMED secured an additional $2.5M to bring the program’s total allocation to $7M. This is the first time in more than a decade that the legislature has increased this line item.

PAMED was also engaged in advocating for the passage of HB 2660, a legislative resolution that would have been the first step in potentially amending Pennsylvania’s constitution to place the question of judicial “venue” in the hands of the legislature instead of the state Supreme Court.

Unfortunately, efforts by PAMED, the Hospital Association, and a number of business groups, all of which are members of the Pennsylvania Coalition for Civil Justice Reform (PCCJR), were unsuccess ful. Though the bill only won committee approval in the House of Representatives, it was successful in getting the issue before the legislature. PAMED will continue to work within the framework of PCCJR to ensure that Pennsylvania’s legal climate is improved.

At this point, the state Supreme Court has not taken any formal action to change venue thresholds.

However, we continue to keep our ear to the ground in the event a potential change is once again made public.

PAMED encourages all physicians to engage in the legislative process by getting to know your individual representatives in Harrisburg. Nothing is more important than developing a trusting relationship with lawmakers so that your concerns are heard and respected.

The following are legislative initiatives that either made it to the Governor’s desk thus far this year or are still “in play” between now and the November General election.

SB 818

Amends the Health Care Facilities Act to allow ambulatory surgical facilities to per form certain permitted surgical procedures without seeking a waiver/exception from the Department of Health. The bill creates an updated waiver/exception process for surgical procedures not on the 2022 CMS ASC-CPL list or otherwise prohibited by state regulation. Signed by the Governor as Act 87 of 2022

HB 1421

Provides additional funding for the Primary Care Loan Repayment Program. Raises funding from $4.5 million to $7 million Signed by the Governor as Act 54 of 2022

LEGISLATIVE UPDATES

HB 1563

Amends the Pennsylvania Drug and Alcohol Abuse Control Act (DAACA). This legislation brings DAACA into alignment with HIPAA to create a consistent and easily understandable standard and revises outdated regulations. The bill also pro vides consistency between statutory and regulatory language.

Signed by the Governor as Act 33 of 2022 (Note: HB 1561, now Act 32, was a companion bill that amended the Mental Health Procedures Act.)

HB 2419

Allows psychiatrists, and other mental health providers, to provide telehealth services. Signed by the Governor as Act 76 of 2022

HB 2604

Allows name badges to have the health system a healthcare provider works for on the badge. Previously name badges had to be specific to the location the provider was working, becoming an issue for providers who work in multiple locations.

Signed by the Governor as Act 79 of 2022

HB 2679

Amends the Pharmacy Act to allow pharmacists, and supervised pharmacy interns, to administer influenza and COVID-19 vaccines to children ages five and older.

Signed by the Governor as Act 80 of 2022

SB 106

A Joint Resolution proposing five separate and distinct amendments to the PA Constitution.

1. Establishes that the PA Constitution does not grant any right to abortion or taxpayer funding for an abortion.

2. Allows the General Assembly to disapprove regulations by its own vote with no signature by the Governor required.

3. Eliminates separate election for Lieutenant Governor. Allows the gubernatorial candidate to select his own running mate.

4. Requires all voters, whether in person or not, to present a government-issued form of identification prior to voting.

5. Requires the General Assembly to provide by statute for the auditing of elections and election results.

Current Status—Passed the General Assembly on July 8, 2022. Identical language must pass again next session and then the ballot questions can be presented to the voters at the next statewide election, possibly as early as the 2023 Primary Election.

SB 225

Amends the Insurance Company Law of 1921 to standardize and streamline the practices of prior authorization.

Current Status—Unanimously passed the Senate on June 29, 2022. Referred to House Insurance Committee.

SB 317

Provides health care practitioners the authority to prescribe or personally furnish antibiotics to treat sexually transmitted infec tions, without having examined the individual for whom the drug is intended, in accordance with the Expedited Partner Therapy (EPT) in the Management of Sexually Transmitted Diseases guidance document issued by the United States Center for Disease Control(CDC).

Current Status—Unanimously passed the Senate in April 2022. Reported out of House Health Committee on April 26 but no further movement.

HB 1280

Amends the Patient Test Results Information Act. Provides for certain exclusions, and definitions within the Patient Test Results Information Act.

Current Status—Waiting Consideration from the Senate Health and Human Services Committee.

HB 1393

Amends the Controlled Substance, Drug, Device and Cosmetic Act to legalize the use of drug testing products like fentanyl test strips for personal use.

Current Status—Passed the House on June 20, 2022. Referred to Senate Judiciary Committee but no further movement.

HB 2660

Proposed Constitutional amendment that would put the current Venue Rule into the Pennsylvania Constitution.

Current Status—Referred to House Rules.

LCMS NEWS

NEW MEMBERS

Steve Patrick Bibu, MD

Michael Chiou, MD

John Dubois DelBianco, MD

Jack Grossman, DO

Michael David Kaplan, MD

Bright Kim, MD

Ryan Lee McClintock, MD, FACEP

Kanwardeep Singh Sethi, MD

Saran Taj Singh

Kyle Brant Tio

Reema M. Vaze, MD

RE-INSTATED MEMBERS

Kimberly Lynn Fugok, DO

Thong Phuoc Le, MD

Jennifer Christine Rovella, DO

Christine Georgine Saad, MD

Shamsuddin Shaik, MD

Hina Kashyap Trivedi, DO

Starting in 2023, the County Medical Societies and PAMED will provide free accredited CME courses for our members, both virtually and in person.

The County CME Collaboration Initiative (CCCI) will offer monthly education, fostered by County Medical Societies and supported by PAMED, that will provide free CME courses with open dialogue, ideas from new and diverse speakers, and content from across Pennsylvania. Each month, an in-person or virtual educational event will be facilitated by one of our sister counties or PAMED and uploaded to PAMED’s online learning platform for all members to view.

In the coming months counties will be able to promote a library of instant edu cational content for our members to utilize. We hope this will help alleviate the financial burdens and time restrictions facing all our members, but also help attract new members.

If you would be interested in suggesting topics for CME programs, or any aspect of planning, speaking, etc., please email our office at info@lcmedsoc.org.

St. Luke’s Pediatric Specialty Center

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When it comes to your child, you only want the best from the team you TRUST. At St. Luke’s, our entire team of pediatricians and pediatric specialists are skilled in diagnosing, treating and managing infant, childhood and adolescent conditions.

St. Luke’s growing pediatric services offer easy access to care at the new St. Luke’s Pediatric Specialty Center, the region’s only free-standing facility dedicated entirely to caring for kids.

The care you trust... for kids. Now more than ever.

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For a full list of specialties, visit sluhn.org/pediatrics.

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