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  • Tuesday, March 12, 2024 8:32 AM | Jennifer Casasanta (Administrator)

    Challenges for private practice doctors in the Rochester area are prompting some to think about leaving the field.

    It’s a move, they say, that could negatively impact the local business community who may see rising employee healthcare costs and limited choices for care as a result.

    According to a report from the American Medical Association, the number of physicians working in private practices decreased by 13 percent between 2012 and 2022.

    And the numbers continue to fall locally.

    “It’s a plight that’s getting worse,” said Lucia Castillejo, CEO of the Monroe County Medical Society.

    Challenges for primary care providers range from raising administrative burdens and low and falling payment rates to challenging and costly recruitment efforts and feelings of professional isolation.

    Douglas Bennett, MD, has been in private practice at Irondequoit Pediatrics since 2005 and has been a practicing pediatrician for over 25 years.

    In addition to the administration challenges, overhead costs and inadequate insurance reimbursements for patient care, Bennett has been dealing with the aftermath of the Change Healthcare cyberattack that prevented his office from filing any claims, impacting his cash flow and hurting the practice.

    “It’s the patients who suffer,” he said.

    Despite the challenges, Bennett prefers private practice, because it gives him increased freedom and autonomy and a greater focus on patient care.

    It can also improve patient care, added Judy Dambrose, office manager at Rochester Community Orthopaedics, noting that private practice providers often have more time to spend with patients because they aren’t pressured to meet certain daily benchmarks.

    “In private practice, the biggest goal is to take care of the patient,” Dambrose said.

    Private practices can also cost patients less. That’s because they don’t charge as much as physicians affiliated with a large healthcare organization, which have high operating costs that get passed through to patients as hospital or facility fees, she explained.

    Further complicating the matter is insurance reimbursement rates the private practitioners say are far from fair and equitable.

    The private practice providers — who negotiate reimbursement rates separately — say it has been several years since they have received a substantial increase in those reimbursement rates.

    There is also a general misconception as to where the annual increases in health insurance premiums go, Dambrose said.

    “They aren’t going to the physicians,” she said.

    With all the challenges, a 2023 MCMS Physician Survey found that Rochester area doctors are facing burnout.

    The survey — taken by 142 area doctors — found that if no changes are made to the current system, many would consider cutting back hours or leaving primary care entirely.

    Monroe County Medical Society Board President Hemant Kalia, MD, said the burnout rates for doctors in the Rochester area are higher than those seen nationally.

    Part of the reason for that is the healthcare landscape seen locally, with only two health systems in the region: Rochester Regional Health and UR Medicine, and one insurance payer, Excellus BlueCross BlueShield, that has roughly 80 percent of the market.

    Both impact the negotiating ability of private practitioners, Kalia said, and contribute to the multiple stressors on physicians.

    “Rochester is a case study in the delivery of health care,” he said, noting that other cities have more choices for insurance, which can increase competitive rates, and more private practice providers who are able to collectively bargain for better rates.

    Prior authorization is a big part of the problem, as well, he noted.

    Prior authorization — sometimes called preauthorization or precertification — is a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.

    Of the survey respondents, 92.12 percent answered that prior authorization often and sometimes delays access to necessary care which can result in poorer health results, and even death, the survey noted.

    Kalia believes it is important to get the word out about the issue in hopes it will decrease the burdens on physicians and make sure patients are getting access to care.

    In addition to increasing public awareness, the MCMS is seeking support from area legislators, noting the private practice doctors’ offices not only provide patient care they also serve as a regional economic driver, Kalia said.

    “Private practices are small businesses,” he said.

    adeckert@bridgetowermedia.com / (585) 653-4021

    CO

  • Wednesday, February 07, 2024 10:48 AM | Jennifer Casasanta (Administrator)

    Please join MSSNY for our annual Physician Advocacy Day, an educational program where physicians can hear from legislative leaders regarding key healthcare issues in New York State, and have the opportunity to pose questions to these leaders. At the conclusion of the program, physicians will join with their colleagues to encourage their senators and assembly members to support legislation that is crucial to their practice and oppose bills that place restrictions and add unreasonable burdens. This year’s event will be held in person at the Lewis Swyer Theater in The Egg (Empire State Plaza) in Albany, and will go from 7:45-11:00am. Breakfast and lunch will be served. We look forward to seeing you there! The Medical Society of the State of New York (MSSNY) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The Medical Society of the State of New York designates this live activity for a maximum of 3.0 AMA PRA Category 1 Cr

    With February underway, we must get as many physicians as possible to sign up for MSSNY’s Physicians Advocacy Day. There will not be a remote option for this event. Being physically present in Albany will send a direct and impactful message that Zoom cannot achieve. Physicians Advocacy Day will occur Tuesday, March 12th, 2024, at the Empire State Plaza (The Egg) in Albany from 7:45-11:00 am. Physicians will hear from the NYS Health Commissioner, the Assembly and Senate Minority Leaders, and the Chairs of the Senate and Assembly Health and Insurance Committees, followed by an informal lunch attended by legislators from your area, followed by the opportunity for legislative visits in the afternoon.

    You may be aware of the many threats we face in the Governor's proposed Budget, including requiring physicians to pay 50% of the Excess Medical Malpractice coverage cost, repealing authorization for the MSSNY’s Committee for Physicians Health (CPH) program, expanding the scope of practice for physician assistants, pharmacists, and dentists, and prohibiting physicians from bringing Medicaid Managed Care claims disputes to Independent Dispute Resolution. Enactment of any of these measures would be a disaster. In addition to State Budget issues, we will advocate for policies that address public health threats, reduce medical liability costs, remove barriers to patients accessing needed care, and reduce prior authorization and claim payment hassles.

    Please use this link to register for MSSNY’s Physicians Advocacy Day https://forms.gle/o1fg1NBa8dC8a8E6A.

     


  • Friday, January 26, 2024 8:48 AM | Jennifer Casasanta (Administrator)

    Recently, a few members of MCMS had the opportunity to speak to Will Astor at the Rochester Beacon about the "Plight of Private Practices". Check out the article below:

    The Plight of Private Practice Doctors. Hear from a few of our member physicians...https://buff.ly/42ancQZ

  • Wednesday, January 17, 2024 1:21 PM | Jennifer Casasanta (Administrator)

    American Medical Association (AMA) recently conducted a study which validated the trend of disappearing private practitioners across the country. According to the study, between 2012 and 2022, the percentage of physicians working in private practices witnessed a remarkable decline, falling from 60.1 percent to 46.7 percent. Concurrently, the percentage of physicians directly employed by or contracting with hospitals grew, reaching 9.6 percent.

    Our Rochester community has gone through an even more drastic transformation.  Area private practices are being decimated by site-of-service differential payments and cost increases shuffled by insurance companies under the guise of the “post-pandemic cost of doing business”. This is causing serious damage to Rochester’s healthcare community, including significant strain, and possible closure, of multiple independent healthcare facilities, effectively decreasing the diversity and availability of quality healthcare for members of our community.  

    While the insurance companies are still able to get approval from the Department of Financial Services to raise their premiums, our community private practices are struggling to see any corresponding meaningful change in their reimbursements.  Since 2001, the cost of operating a medical practice has increased 47%, while economy-wide inflation has risen 73%.  During this time, Medicare hospital and nursing facility updates have increased by roughly 70%, significantly outpacing physician reimbursement.  When adjusted for inflation, Medicare's rates--on which insurance company’s rates are based--have actually dropped 26 percent over the past 22 years.  Exacerbating this reimbursement gap are ballooning pandemic and post-pandemic costs of providing healthcare services, particularly soaring supply costs and labor costs: wages are up nearly 20%.  On average, private practice payroll has increased by 50% over the past 5 years in our region, and these practices are continuously losing team members to the publicly supported entities surrounding us which have access to state and federal grants and tax exemption as they are able to charge twice as much for the same care provided due to their facility fees (site-of-service differential payment system).

    The consolidation of healthcare in our region has also created a duopolistic delivery system which is not conducive to innovative, patient-centered, private practice model.

    MCMS supports preservation of patient access to cost-effective, personalized health care and independent private practices play an integral part of healthcare delivery infrastructure in our region. We need legislative action through advocacy and policy reform to support this dying art of personalized, cost-effective healthcare delivery model.


  • Thursday, January 04, 2024 3:11 PM | Jennifer Casasanta (Administrator)

    Dear Members, 

    Due to recent updates, members have reported experiencing difficulties while attempting payment of membership dues on the MSSNY website. If you have not paid your 2024 MCMS membership dues, please email Susan Bartl Conley at  SBartl-Conley@mcms.org and she will be happy to assist you with your renewal. 

    Please do so before the 10th of January to avoid laps and additional requests from MSSNY. Thank you! 

    MCMS


  • Thursday, December 21, 2023 1:52 PM | Jennifer Casasanta (Administrator)

    The pandemic has brought attention to the safety, health, and well-being of workers in healthcare. Recent efforts to address these issues include, the Office of the Surgeon General’s Addressing Health Worker Burnout,(1) an “Advisory on Building a Thriving Health Workforce,” from the National Academy of Medicine’s National Plan for Healthcare Workforce Wellbeing (2) and the  NIOSH Health Worker Mental Health Initiative (3). For today’s health workers, feeling chronically overwhelmed is commonplace. Increasing evidence of unremitting levels of high work-related stress, often beyond the control of the clinicians, can lead to severe physical and emotional harm. Such stress threatens the sustainability of the healthcare professionals workforce. Research has reported that 1/5 physicians, 1/3 advance practice providers (NP/PAs), and 2/5 nurses are planning to leave practice in the next two years due to difficult working conditions (4). In the most recent study, 44% of health workers reported an intention to look for a new job in 2022, an increase from 33% in 2018 (5).

    To improve working conditions, a Total Worker Health® approach may be particularly relevant to the healthcare sector. In healthcare, studies have found that the majority of occupational stressors causing burnout are due to systemic factors (6, 7); yet most interventions for burnout, quality, and patient safety are directed at the healthcare providers (HCP) and not at the system level (8). One challenge is that the direction of work may arise from external authorities, and communication and design of this work is often top-down.

    Workload

    The current healthcare work environment has many requirements arising from differences among local hospital systems, regulators and credentialing bodies of healthcare organizations and healthcare providers, insurers, and regulators. A recent survey of 142 physicians in Monroe County, New York; expanded upon the American Medical Association (AMA) 2021 study of physicians on the impact of prior approvals and other related workload (9). The survey found 92% of the physicians reported doing “work outside of work,” defined by the American Medical Association as electronic medical record  work outside of patient scheduled hours (10). For 88% of the respondents, this included weekends. While 57 (40%) of the physicians were glad to have access to electronic medical records at home for flexibility; 46 (81%) of the 57 cited excessive documentation as the reason they had to do this work at home.

    A key to reducing stressors is to ensure an appropriate workload. When job demands chronically outweigh the resources, burnout occurs (11). Currently, in top-down prescribed work situations, senior leadership may not be fully aware of the effort and resources, often including personal time, required to complete work. Additionally, some of the tasks that are being done may not require medical expertise, taking time away from value-added work of delivering care to patients.

    Newer research has shown the physical and emotional harm that comes from these ever-increasing, uncoordinated work expectations (12-17). The time it takes to complete mandatory trainings, administrative work for insurance payment, and respond to messages from patients, made worse with staffing shortages, contribute to the workload of healthcare providers (9). Often healthcare institutions get tasked with mandatory requirements for their operations but are not provided sufficient resources to achieve them. Cognitive (mental) workload debt accumulates when there are not sufficient brain resources to immediately finish a task or when tasks linger. As the mental workload debt accumulates, there is a tipping point past which cognitive function deteriorates (18). The total workload creates higher stress above what would be experienced for purely taking care of the patient.

    The nature of work in healthcare has also changed significantly over the last several decades, largely moving from physical work to more cognitive work. The ongoing need to master new technologies and other cognitive demands may be poorly recognized stressors as they are less quantifiable than physical demands.  This high level of cognitive work expectation without sufficient resources to achieve the work is underestimated and may not be understood to be connected to its harm to clinicians and patients (19, 20).

    The Toll of Workplace Stress

    Addressing the above issues are critical to reducing the job stress faced by healthcare providers. High chronic occupational stress and burnout creates higher risk for major depressive disorder, panic attacks, suicide, heart disease, and stroke (21,22). Chronic psychological distress may affect immunity and trigger inflammatory responses (22-24). Those with burnout may experience specific cognitive impairments, including nonverbal memory, auditory and visual attention limitations. Uncontrolled stress has been found to cause reduced key brain functions and anatomical injury. Due to a sense of calling, many years of education, and student debt, physicians often have uncontrolled stressors, demonstrated in research. It is important to create systems that offer healthcare providers adequate control and autonomy, clear communications, and psychosocially healthy working environments. A case can be made that such healthier working conditions are associated with patient safety and health, reductions in medical errors and malpractice cases, reductions in turnover, and better patient experience (20,25).

    Measuring Workload and Wellbeing

    It is important to assess worker well-being when assessing the quality of service delivered by the organization.  Since healthcare system payments do not include metrics that are related to clinician wellbeing, or assessments of reasonableness of workload, some healthcare systems may have a disconnect between senior leadership and front-line staff. While feedback from patients on their experiences is often communicated to senior leadership, similar feedback from clinicians is often missing. Outcome metrics often include patient safety and healthcare quality measures, but not worker well-being or provider burden. To provide a more complete picture to investors, patients, employees, and the public on healthcare quality and safety sustainability, worker well-being must be measured and reported.

    Healthy Work Design and Total Worker Health

    It is important to apply healthy work design and Total Worker Health principles in healthcare. Specific promising practices include reducing administrative burden, ensuring that the workload is appropriate, and improving the psychosocial work environment. There is opportunity to better design work schedules and tasks, improve operational systems to ensure healthier working conditions, and introduce specific measures to improve worker well-being; many of these actions would also advance patient health and reduce medical errors. Improving organizational structures and reducing hierarchy and gatekeeping could facilitate healthier work (1-3, 25).

    Human Factors/Ergonomics (HFE) and macro/cognitive ergonomics is a field dedicated to jointly optimizing worker well-being and system efficiency (25). Patient safety is a product of system efficiency in a healthcare organization. One key component of this type of framework is to engage “environmental sensors” -those at the interface of the organization and its environment who directly see the organization’s effectiveness in achieving high quality and safe healthcare delivery – who can give feedback to senior leadership to make needed adjustments to be an effective organization achieving its goals (25-27). In the case of healthcare organizations, these sensors would include both patients and healthcare providers. It could be helpful to use  technology to track the time spent by healthcare providers on documentation and administrative support tasks that could be completed by assistants or administrative professionals. Electronic medical record documentation outside of patient scheduled times is an example of work outside of work that should be tracked and monitored by senior leadership, with the goal of being eliminated.

    It would be beneficial to invite healthcare providers to assess internal processes and suggest improvements, streamline data requests and workloads, and creatively look at how the tasks of frontline healthcare providers can more appropriately align with the time and resources they have. Participatory management models get those who do the work integrally involved in improving efficiency of processes and design with benefits to the organization (26-28).

    Get Involved

    There are many ways for healthcare providers and allies to take action.

    In 2017, the National Academy of Medicine launched the Action Collaborative on Clinician Well-Being and Resilience. The collaborative  recommended a systems approach, and last year, released a national plan. (2) The action plan aims to make high-level, systems change. Priority areas of the plan are directed toward leadership, policy-makers, and others who can influence the healthcare work setting. The actions to be taken by leadership are the following:

    1. Create and sustain positive work and learning environments and culture;
    2. Invest in measurement, assessment, strategies, and research;
    3. Support mental health and reduce stigma;
    4. Address compliance, regulatory, and policy barriers for daily work;
    5. Engage effective technology tools;
    6. Institutionalize well-being as a long-term value;
    7. Recruit and retain a diverse and inclusive health workforce.

    Healthcare organizations can commit to putting the national plan into action.

    Organizational leaders and employers can take trainings to better understand burnout and how to create and sustain psychosocial safety at work. New free online trainings by NIOSH include:

    Understanding and Preventing Burnout among Public Health Workers: Guidance for Public Health Leaders (cdc.gov).

    Safety Culture in Healthcare Settings | NIOSH | CDC

    In May 2023, for Mental Health Action Day, NIOSH issued a statement to call for employers to update credentialing applications to remove any overly intrusive questions about mental health. To further support and advance health worker mental health (3), in October, NIOSH launched the Impact WellBeing campaign. The project gives hospital leaders evidence-informed solutions to reduce healthcare worker burnout, sustain wellbeing, and build a system where healthcare workers thrive. It includes steps hospital leaders can take, working closely with their employees, to find long-term solutions to these challenges. Additional elements of the campaign will appear over the next year. Find out more at the resources below.

    Webpage: Healthcare Worker Wellbeing | NIOSH | CDC

    Campaign Webpage: Impact Wellbeing | NIOSH | CDC

    Fact sheet: Making the System Work for Healthcare Workers | NIOSH | CDC

    Joint statement with Dr. Lorna Breen Heroes’ Foundation: Statement on Removing Intrusive Mental Health Questions from Hospital Credentialing Applications from the Dr. Lorna Breen Heroes’ Foundation and the National Institute for Occupational Safety and Health (cdc.gov)

     

    Michael R Privitera, MD, MS, Professor Emeritus of Psychiatry, University of Rochester Medical Center; Past Medical Director, Medical Faculty and Clinician Wellness Program, 2015-2022

    Chia-Chia Chang, MPH, MBA, is a Public Health Analyst in the Office for Total Worker Health.

    L. Casey Chosewood, MD, MPH, is Director of the NIOSH Office for Total Worker Health.

     

    References

    1. Addressing Healthcare Worker Burnout. The U.S. Surgeon General’s Advisory on Building a Thriving Health Workforce (2022).https://www.hhs.gov/sites/default/files/health-worker-wellbeing-advisory.pdf
    2. National Academy of Medicine’s National Plan for Healthcare Workforce Wellbeing (2022). https://nam.edu/initiatives/clinician-resilience-and-well-being/national-plan-for-health-workforce-well-being/
    3. Healthcare Workers: Work Stress & Mental Health | NIOSH | CDC
    4. Sinsky, C.A., Brown, R.L., Stillman, M.J. and Linzer, M. (2021) COVID-Related Stress and Work Intentions in a Sample of US Health Care Workers. Mayo Clinic Proceedings : Innovations , Quality & Outcomes, 5, 1165-1173. https://doi.org/10.1016/j.mayocpiqo.2021.08.007
    1. Nigam JA, Barker RM, Cunningham TR, Swanson NG, Chosewood LC. Vital Signs: Health Worker–Perceived Working Conditions and Symptoms of Poor Mental Health — Quality of Worklife Survey,  United States, 2018–2022. MMWR Morb Mortal Wkly Rep 2023;72:1197–1205. DOI:   http://dx.doi.org/10.15585/mmwr.mm7244e1
    2. Panagioti, M., Panagopoulou, E., et al . (2017) Controlled Interventions to Reduce Burnout in Physicians: A Systematic Review and Meta-Analysis. JAMA Internal Medicine, 177, 195-205. https://doi.org/10.1001/jamainternmed.2016.7674
    3. West, C.P., Dyrbye, L.N., Erwin, P.J. and Shanafelt, T.D. (2016) Interventions to Prevent and Reduce Physician Burnout: A Systematic Review and Meta-Analysis. The Lancet , 388, 2272-2281. https://doi.org/10.1016/S0140-6736(16)31279-X
    4. Sinsky, C.A. and Privitera, M.R. (2018) Creating a “Manageable Cockpit” for Clinicians:A Shared Responsibility. JAMA Internal Medicine , 178, 741-742. https://doi.org/10.1001/jamainternmed.2018.0575
    1. Monroe County Medical Society 2023 Survey of physician Workload: https://mcms.org/resources/Documents/Physician%20Wellness%20Survey%20Results%202023.pdf
    1. Reilly M, Wolf M. Reducing pajama time and work outside of work (WOW) August 17, 2022. AMA Podcast. https://www.ama-assn.org/practice-management/physician-health/reducing-pajama-time-and-work-outside-work-wow
    2. Demerouti, E., Bakker, A.B., Nachreiner, F. and Schaufeli, W.B. (2001) The Job-Resources Model of Burnout. Journal of Applied Psychology, 86, 499-512.https://doi.org/10.1037/0021-9010.86.3.499
    1. Savic, I. (2015) Structural Changes of the Brain in Relation to Occupational Stress. Cerebral Cortex , 25, 1554-1564. https://doi.org/10.1093/cercor/bht348
    2.  Michel, A. (2016) Burnout and the Brain. Association for Psychological Science.       http://www.psychologicalscience.org/index.php/publications/observer/2016/february-16/burnout-and-the-brain.html
    3. Alkadhi, K. (2013) Brain Physiology and Pathophysiology under Mental Stress. International Scholarly Research Notices , 2013, Article ID: 806104. https://doi.org/10.1155/2013/806104
    4. Arnsten AFT. The Biology of being Frazzled. Science. 12 June 1998. 280 (5370): 1711-1712.
    1. Golkar, A., et al . (2014) The Influence of Work Related Chronic Stress on the Regulation of Emotion and Functional Connectivity in the Brain. PLOS ONE, 9, e104550. https://doi.org/10.1371/journal.pone.0104550
    2. Ridout, K.K., Ridout, S.J., et al . (2019) Physician-Training Stress and Accelerated Cellular Aging. Biological Psychiatry , 86, 725-730. https://doi.org/10.1016/j.biopsych.2019.04.030
    1. K Tara Smith Ph.D. of HFE Solutions in the United Kingdom (2021) Personal Communication 10-14-21.
    1. Arnsten, A.F.T. and Shanafelt, T. (2021) Physician Distress and Burnout: The Neurobiological Perspective. Mayo Clinic Proceedings , 96, 763-769. https://doi.org/10.1016/j.mayocp.2020.12.027
    1. Privitera, M.R. and MacNamee, K. (2021) Integrating Patient Safety and Clinician Wellbeing. Physician Leadership Journal , 5/6, 39-46.
    2. Wurm W, Vogel K, Holl A, Ebner C, Bayer D, Mörkl S, et al. (2016) Depression-Burnout Overlap in Physicians. PLoS ONE 11(3): e0149913. doi:10.1371/journal.pone.0149913
    3. Sapolsky RM Stress and the brain: individual variability and the inverted-U. Nature Neuroscience. Volume 18 (10) October 2015 ( 1344-46)
    4. Calcia MA, Bonsall DR, et al. Stress and neuroinflammation: a systematic review of the effects of stress on microglia and the implications for mental illness. Psychopharmacology (2016) 233:1637–1650 DOI 10.1007/s00213-016-4218-9
    5. Salim S. Oxidative stress: a potential link between emotional wellbeing and immune response Current Opinion in Pharmacology 2016, 29:70–76
    6. Privitera, M.R. (2022) Promoting Clinician Well-Being and Patient Safety Using Human Factors Science: Reducing Unnecessary Occupational Stress. Health, 14, 1334-1356. https://doi.org/10.4236/health.2022.1412095
    7. Pasmore, W.A. (1988) Designing Effective Organizations: The Sociotechnical Systems Perspective. John Wiley & Sons, New York.
    8. Pasmore, W., Winby, S., Mohrman, S.A. and Vanasse, R. (2019) Reflections: Sociotechnical Systems Design and Organization Change. Journal of Change Management 19, 67-85. https://doi.org/10.1080/14697017.2018.1553761
    9. Ashton M. Getting rid of stupid stuff. N Engl J Med. 2018;379(19):1789-1791. doi:10.1056/NEJMp1809698
    Posted onDecember 19, 2023 by Michael R Privitera, MD, MS; Chia-Chia Chang, MPH, MBA; L. Casey Chosewood, MD, MPH

    CategoriesHealthcareMental HealthStressTotal Worker HealthWell-being


  • Friday, November 17, 2023 8:18 AM | Jennifer Casasanta (Administrator)

    Published 11/17/23 on Channel 10, by Eriketa Cost:

    On Wednesday, Rochester Regional Health said several physicians resigned to start a retainer-based concierge medicine practice.

    The office remains open for business, as RRH works to replace the physicians with other employees in the network. In the statement, RRH says all physicians at the Linden location will continue to see patients through the end of the year.

    “We remain true to our mission to provide high-quality, affordable, and accessible care to our patients and the community. During this transition phase, there will be no interruption to anyone seeking care at the Linden Medical Group practice. Our staff is actively contacting all patients to assist them in transitioning to other providers within our 400-member network,” the statement read.

    News10NBC has been talking to some other doctors throughout the region, who are leaving the practice to go to concierge medicine. Many are unable to speak out, due to non-disparagement agreements in their contracts.

    Head of Monroe County Medical Society Hemant Kalia said the current state of healthcare is contributing to unsustainable rates of burnout. For example, the emergence of two giants, UR Medicine and RRH controlling the market, and the administrative burden that comes with that.

    Another contributing factor, he said, is the disparity of reimbursement between private practices and employed physician groups. Kalia said in a recent survey with members of the medical society, more than 50% percent of respondents said they were burned out.

    As for why some are choosing concierge medicine? Kalia said there’s probably no specific reason. Concierge medicine is when patients pay a premium, perhaps in the form of annual fees, for increased access to providers and care.

    “The main point, the main emphasis is, our physicians are struggling and they’re crying for help,” said Kalia. “We can certainly talk about other innovative models of delivering care, concierge medicine is one of them, but if we don’t address the route cause of the problem, we will continue to see physicians moving out of our region.”

    It has patients like Joe Gonzalez wondering, what’s next?

    Gonzalez said he was shocked to learn in a letter, that his doctor Dr. Jeffrey Vuillequez is no longer practicing there. He said he and his wife would like to continue seeing him, even if means going somewhere else.

    He has an appointment coming up in February, and he’s not sure if he’ll get to connect with him before then. He said the office couldn’t provide a specific end-date. Gonzalez said he called the office to ask some questions, including if he could still be a patient in the future. He says a woman replied, it’s possible he won’t be, if there’s not enough staff. According to the letter Gonzalez got in his MyCare inbox, the office said it will continue to operate with other nurses and staff.

    “You really want to be sure that you have somebody you can see if you are sick. They didn’t even give any advice like, if you’re sick after this date go to the hospital,” said Gonzalez. “Starting over with a new doctor, might happen someday. This was a little bit of a surprise and not much warning.”

    “This seems like a mass exodus from the practice,” he said. “I understand there is probably a bunch of legal things going on behind the scenes, things they can and can’t say,” he said.

    RRH says if you’re a patient at the Linden location, you can still call the office with questions, and make an appointment.

    https://www.whec.com/top-news/some-physicians-switching-to-concierge-medicine/

  • Thursday, October 05, 2023 12:12 PM | Jennifer Casasanta (Administrator)

    Good morning 7th District & MCMS Members:

    I hope this email finds you well. I am reaching out to discuss a crucial matter that requires our collective attention and immediate action.

    As you are aware, the Wrongful Death Bill (aka “Grieving Families Act”) is currently under consideration, and its potential implications for our medical community are concerning. We are asking the Governor to veto this legislation (A.6698) because it would harm patient access to care in our communities by significantly increasing damages awardable in wrongful death actions. If signed into law, this could increase already exorbitantly high physician and hospital liability costs by over 40%. In order to effectively oppose this bill, we will need to join forces with MSSNY to greatly strengthen our efforts.

    To that end, a comprehensive strategy, was created, that includes mobilizing our physicians to reach out to the Governor's office through phone calls. MSSNY has provided us with a well-crafted one-page talking points sheet for our physicians to utilize during their conversations (it is attached). This will ensure that you are equipped with the necessary information to express your concerns effectively.

    Furthermore, a schedule was prepared that assigns specific days for each district to make their calls. This approach aims to maximize our impact by creating a coordinated and sustained effort across the state.

    To fully leverage our partnership, we are asking all physicians, and practice leadership, within every county to actively participate in this advocacy campaign. When you make your calls, it would be immensely valuable if they could also inform the MCMS about the experience by emailing Joanne Rau at jrau@mcms.org. This feedback will enable us to gauge the overall response and make any necessary adjustments to our strategy.

    In summary, here are the key action steps:

    • Make Calls: Physicians, and medical practice leadership, should call the Governor's office on their designated day – 7th District (MCMS) will begin on 10/17/2023 then on 11/7/2023. Call Schedule Here!
    • Utilize the one-page talking points sheet during the conversation. Talking Points Sheet Here!
    • Document your experience and share with your 7th District Leadership: Lucia Castillejo at lcastillejo@mcms.org or Joanne Rau at jrau@mcms.org.

    By working together, we can make a substantial impact on this issue and protect the interests of our medical community. MSSNY Leadership is incredibly appreciative for our help in this crucial endeavor.

    Thank you for your attention and your commitment to ensuring the best possible outcomes for our physicians and patients alike.

    Be Well,

    Lucia Castillejo, MS

    Chief Executive Officer (CEO), Monroe County Medical Society

    200 Canal View Blvd. – Suite 202

    Rochester, NY 14623

    Office: 585-473-7573


  • Monday, August 14, 2023 4:05 PM | Jennifer Casasanta (Administrator)

    This morning, August 14, 2023, MCMS and our physician members had breakfast with Senators Samra Brouk and Jeremy Cooney to discuss community health care concerns. Check out our photos of the morning here! 

  • Monday, August 14, 2023 3:29 PM | Jennifer Casasanta (Administrator)

    On Saturday, August 12, 2023, MCMS had its first Member Appreciation BBQ since 2019. Members enjoyed the afternoon at Durand Eastman Park with lunch provided by Sticky Lips BBQ. The event was sponsored by our friends at MLMIC, Sellers Insurance, Merrill Lynch and Alliance Advisory Group. Check out the photos here! https://www.mcms.org/page-1075611

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