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District of Columbia
District of Columbia
Constance J. Bohon, MD, section chair
District of Columbia Junior Fellows continue to be active in our community. They will begin to participate in a student-run clinic, Bread for the City, in April. The clinic is held every Tuesday evening for indigent people in the city who have no insurance. Each week, a different specialty runs the clinic, and now there will be an ob-gyn night. Medical students interested in ob-gyn will also volunteer at the clinic. If all goes well, Junior Fellows will perform routine exams as well as procedures such as colposcopy.
Four Junior Fellows attended the ACOG Congressional Leadership Conference, The President’s Conference, March 3–5. Lauren E. Finley, MD, will attend the 2013 Annual Clinical Meeting in New Orleans in May as an Ob-Gyn Reporter.
The DC Breastfeeding Coalition held its second summit on October 26. The group includes ob-gyns, pediatricians, nurse practitioners, midwives, lactation consultants, and representatives from DC hospitals, advocacy groups, and the DC Section. The goal of the group is to increase breastfeeding in DC. Currently, 14.8% of mothers are exclusively breastfeeding at six months. The group is initiating steps to support and promote breastfeeding in DC.
The section is working with Anitra Denson, MD, MPH, perinatal coordinator for the HIV/AIDS, Hepatitis, STD, and TB Administration at the DC Department of Health, on reducing HIV infection in DC. Currently, 2.7% of the DC population is HIV positive, placing the number at an epidemic level. Heterosexual transmission is now the leading method of transmission in DC, accounting for the majority of cases among women.
With funding and sponsorship from the Alosa Foundation and Harvard Medical School, the CME program “HIV Infection and AIDS: What the Primary Care Physician Should Know about the Diagnosis and Management” was created. The program uses one-on-one education sessions in physician offices to help practitioners assess screenings, diagnostic procedures, treatments, and referral centers for HIV/AIDS. This program is pending CME approval from ACOG. We plan to promote it in DC.
The DC Section has a representative on the recently formed Adolescent Health Workgroup. Included in this group are representatives from the American Academy of Pediatrics, local advocacy groups, the DC Department of Health, and DC public schools. The group plans to assess and improve reproductive health services for adolescents in DC.
The DC Section is also working with representatives from Physicians for Reproductive Health, the DC Campaign to Prevent Teen Pregnancy, and Advocates for Youth to provide training and education to providers for intrauterine device use in adolescents.
Finally, we are also working on assessing the adequacy of the DC death certificate. There is talk of forming a maternal mortality committee in the district.
The current legislative session began in January. The only bill of interest so far is the “Patient Protection Act of 2013.” The bill would establish minimum nurse staffing ratios. It also includes whistleblower and patient protection clauses, limits mandatory overtime, establishes hospital committees, and provides funding for nursing education programs in DC. This bill is predicted to be contentious. A DC council member has introduced an alternative bill, “Nurses Safe Staffing Act.” This bill does not specify staffing ratios and is supported by the American Nurses Association, the DC Hospital Association, and some physicians.
Pamela G. Gaudry, MD, section chair
The Georgia Section works closely with the Georgia Obstetrical and Gynecological Society (GOGS) in strategic planning, outreach, legislative efforts, education, and funding events. Ruth M. Cline, MD, is president of the society and is working hard to achieve strategic goals for both our organizations.
The Georgia State Legislature passed a bill restricting abortions beyond 20 weeks’ gestation in 2012. The law provides that we must do everything to prevent fetal pain and suffering after this gestational age. If ob-gyns do not adhere to this provision, it may result in criminal prosecution and up to 10 years in jail.
GOGS held a special symposium in Atlanta to discuss this bill’s legal aspects and how ob-gyns may change their practice patterns to comply with the parameters of the law. The law was to be implemented on January 1; however, the Fulton County Superior Court granted an injunction preventing it from taking effect. The injunction is only temporary until the case can be reviewed.
We contacted the legal department at ACOG, and staff members are watching the situation closely with us. They will be there to help when needed. A similar law passed in Arizona a few years ago, and it has been on hold for more than a year.
We have a significant shortage of obstetricians in Georgia. After doing some work initially in partnership with Georgia Public Health to study the problem, we obtained a grant from the March of Dimes to evaluate the shortage. The grant, which will be carried out by the Georgia Maternal and Infant Health Research Group, is run by 13 master’s candidates from Georgia medical schools, nursing schools, and public health programs.
The candidates have determined that of the 82 primary care service areas outside the metro Atlanta area, 36% have no obstetrician and 16% have a severe shortage. Georgia has 10.9 ob-gyns per 100,000 residents, which falls short of the national average of 14.1 per 100,000. Population growth and provider exodus continue to exacerbate this shortage.
As expected, this problem disproportionately affects rural areas. The March of Dimes gave Georgia an “F” rating for preterm deliveries in 2010, a “D” in 2011, and another “D” in 2012. The organization informed us that we have the 10th highest infant mortality rate in the United States (8.1 deaths per 1,000 live births). Additionally, we just got news that the Burke Medical Center in rural Waynesboro is losing its only pediatrician to retirement, requiring the center to close its labor and delivery unit. This will make the county the 40th in the state without obstetric services.
Our grant work is now focusing on potential solutions to the problem. In the meantime, information cards have been sent to 178 Georgia representatives and 56 Georgia senators, displaying data specific to each legislator’s district. We have included the number of births and deliveries, information about providers, and the average annual deliveries per provider.
Gov. Nathan Deal reported to US Department of Health and Human Services Secretary Kathleen Sebelius that he will not create a health care insurance exchange program for Georgia. Consequently, beginning in 2014, Georgians will have an insurance exchange program run by the federal government as part of the Affordable Care Act. Additionally, at this time, the state does not plan to expand its Medicaid program. The ob-gyn community, along with our primary care colleagues, is campaigning for an expansion. Approximately one-fourth of women of childbearing age in Georgia are uninsured.
In February, Gov. Deal signed a bill requiring hospitals to pay 1.45% of their net patient revenue. The state will use that money to draw roughly $450 million in federal matching dollars. Without the fee, it’s likely that hospitals would have faced Medicaid reimbursement cuts of 20% or more. However, even with the fee, the program is facing a nearly $390-million budget hole.
One of the Georgia Section’s top priorities this legislative session will be to stop Medicaid budget cuts that would hurt ob-gyns and low-income women. The governor’s budget includes a 0.74% cut to ob-gyn and other non-primary care provider Medicaid fees. Continuing the already inadequate payments to ob-gyns will contribute to the decreasing number of practicing obstetricians in Georgia.
The governor’s budget also calls for savings by no longer paying for elective deliveries prior to 39 weeks. The state expects to save money by eliminating payments for these early deliveries and the high neonatal intensive care unit costs for babies born too early. However, GOGS members, ACOG Fellows, and hospitals across the state have already implemented 39-week rules and most have already met their goal. Therefore, we do not think the governor will see the savings he expects.
Georgia has one physician in its House of Representatives, Ben Watson, MD (R), an internist from Savannah. It also now has one physician in its Senate. Dean Burke, MD (R), an ob-gyn from Bainbridge, won a runoff election on February 5 for District 11 state senator.
Sandra B. Reed, MD, recently completed her tenure as president of the Medical Association of Georgia (MAG). We are proud that she has now taken the position of District IV treasurer. The MAG House of Delegates meeting was held in Savannah in October. GOGS supported resolutions to promote measures to decrease obesity and to enhance breastfeeding through licensure of lactation consultants. Additionally, MAG passed a resolution to support ob-gyns should birth control, infertility treatments, and other women’s services be threatened by future legislation.
A fully functioning maternal mortality committee for the state has been a goal of GOGS for many years. We are pleased to say, in partnership with Georgia Public Health and support from the Centers for Disease Control and Prevention, a committee has been established and training has been completed. The committee will start evaluating its first cases this month.
GOGS will sponsor a CPT coding seminar on May 3 in Macon. The GOGS annual golf tournament is scheduled for May 15 in Suwanee. Visit the GOGS website for more information on these events.
Plans for the Annual Georgia Section and GOGS Meeting in August are under way. Faculty and topics have been chosen, and we are waiting for approval of CME credits from ACOG. The meeting will be held at the Ritz-Carlton Lodge in Lake Oconee.
Georgia Junior Fellows had strong attendance at the Annual District Meeting in Charleston, SC. The section also had nine medical students attend as recipients of the John Gibbons Medical Student Award, which funded their attendance. Georgia Junior Fellows are working to make the Susan G. Komen Race for the Cure in Savannah an annual fundraiser for breast cancer research.
Mark S. Seigel, MD, section chair
The Maryland General Assembly convened on January 9. It is anticipated that transportation funding and gun control legislation will be the most hotly debated issues, but much of the agenda has yet to be determined.
During the last legislative session, a bill was introduced that would have allowed certified professional midwives to attend home births without insurance, backup, or any formal training beyond a high school diploma or equivalent. The legislation also requested approval to provide care for newborn infants for the first six weeks of life. The proponents of the legislation shifted their focus to a forum on the rights of women to have home births and the relative unavailability of that service in Maryland.
Despite a vigorous attempt by proponents to pass this legislation, it only resulted in a summer study focus group by stakeholders, which led to a report with no agreed-upon recommendations. There has not yet been legislation relative to midwives introduced this session, but it’s likely there will be.
Bills that outline reporting requirements for child abuse and neglect and substance-exposed infants at the time of delivery have been introduced. Additionally, a bill to mandate hepatitis B testing has been reintroduced.
With respect to federal health care implementation, Maryland has implemented a structure that will continue to ensure a broad set of benefits, including comprehensive maternal and child health coverage.
The section held its Annual Emil Novak Conference in November in Baltimore. The meeting’s lectures focused on medical liability, emotional intelligence, work-life balance, and assessing cost-effectiveness in ob-gyn.
We are currently planning for the Annual David A. Nagey Resident Research Day, which will be held on April 12. This popular conference gives residents a chance to create research projects and present them in a public forum attended by other residents, attendings, and program chairs. Awards are given for the best papers.
The Maryland Section recently sponsored a “Be an Ob-Gyn Night” at Johns Hopkins Hospital in Baltimore. Area medical students were invited to a simulator event where different stations gave an introduction to the variety of endeavors that ob-gyns perform. There were many stations illustrating labor and delivery, ultrasound assessment, and gynecologic surgery. I was happy to teach at the knot-tying station. The enthusiasm of the medical students was impressive!
Maryland Section Junior Fellows have established three primary goals:
- To educate medical students about what ob-gyn has to offer and encourage resident research and national conference attendance
- To keep Junior Fellows informed of legislative issues pertinent to the ob-gyn field and to promote resident advocacy and understanding of the politics of medicine
- To organize a women’s health-related service activity targeting Baltimore youth
Additionally, they hope to hold regular social events to promote inter-residency relationships and to build an even stronger cohort of Maryland residents and Junior Fellows.
Brenda S. Peacock, MD, section chair
There is no new legislative activity to report with North Carolina’s new governor and legislators just starting to lay out their agendas. We have a Republican governor for the first time in more than 20 years, former Charlotte mayor Pat McCrory. The General Assembly is two-thirds Republican. It is our state’s first Republican majority in the executive branch and the General Assembly since 1870.
Thanks to the legal department at ACOG, the North Carolina Section and the North Carolina Obstetrical and Gynecological Society (NCOGS) now have a contract. The society has been acting on behalf and in the interest of the section, including hosting an annual meeting and organizing lobbying efforts. The contract was implemented January 1.
Section and society leaders held an interim meeting in late October, in conjunction with the North Carolina Medical Society Annual Meeting. We look forward to the 2013 Annual North Carolina Section Meeting, which will be held at the Grove Park Inn in Asheville in April. We anticipate more than 100 registrants. John M. Thorp Jr, MD, remains program chair. We have an excellent scientific program in place, with resident papers for competition from all but two of the state’s teaching hospitals.
Haywood L. Brown, MD, District IV chair, is also now NCOGS president. We continue to work on increasing section member involvement in the society for those who are not members of both organizations.
The North Carolina Medicaid pregnancy medical home program received a grant for an additional data analyst. At last report, more than 85% of practicing ob-gyns in the state were participating in the program. Kathryn Menard, MD, MPH, will report on the program’s progress at our section meeting in April.
For many years, the North Carolina Medical Society has sponsored “White Coat Wednesdays” for physicians to meet with state legislators in Raleigh on issues pertinent to their specialty and others. May 1 has been designated “Ob-Gyn White Coat Wednesday.” On this day, we will meet at the North Carolina Medical Society office for a briefing, speak with state legislators, and attend legislative committee meetings and sessions. Please save this date.
Two North Carolina Fellows and one Junior Fellow attended the ACOG Congressional Leadership Conference, The President’s Conference, March 3–5. The lobbyist for NCOGS has resigned because of another opportunity. There is a search committee in place, working with a number of criteria outlined for a replacement.
Certified professional midwives have garnered quite a bit of support in the General Assembly over the last few years. The House and Senate have been made aware of the difference between international training and training in North Carolina for certified professional midwives. There was no vote taken on licensure of certified professional midwives last year, but some representatives are now arguing for it.
The General Assembly has a number of members opposing abortion who are stating that they will pursue proposals to exclude abortion coverage from any federal health insurance exchange. They also have mentioned a plan to outlaw any abortion based on gender preference. North Carolina has not yet established any federal exchanges as required by the Affordable Care Act. Gov. McCrory, who is considered to be a moderate Republican, has stated that he has no plans to sign additional abortion restrictions into law. We hope to have influence in this debate.
Eduardo J. Muniz-Velez, MD, section chair
The Puerto Rico Section is looking forward to the 2013 Annual District Meeting, which will be held with Districts I and III at the Rio Mar Beach Resort and Spa in Rio Grande.
The Annual Puerto Rico Section Meeting was held during the 31st Sunshine Seminar August 2–5 at the Gran Melia Resort in Rio Grande. The meeting had 320 ob-gyns in attendance. Approximately 70% of attendees were ACOG Fellows and Junior Fellows. Two Fellows from Puerto Rico attended the ACOG Congressional Leadership Conference, The President’s Conference, in Washington, DC, March 3–5.
Puerto Rico Junior Fellows participated in grand rounds at the University of Puerto Rico. Topics discussed were incidence and epidemiology of the cesarean delivery rate in Puerto Rico, cervical cancer screening, and human papillomavirus vaccination. Puerto Rico Junior Fellow Section officers and a few of our medical students will attend the 2013 Annual Clinical Meeting in New Orleans in May.
The Puerto Rico Section is collaborating on projects with Puerto Rico Obstetrics and Gynecology (PROGyn). In November, PROGyn organized a seminar on excellence in endometriosis. The keynote speaker was Mauricio Abrao, MD, president of the 12th World Congress on Endometriosis. Most interdisciplinary topics regarding endometriosis were covered, including patient group advocates.
Puerto Rico has a new Democratic governor in office, Alejandro Garcia-Padilla. New state legislators started in mid-January. Bills to aid in implementation of the Affordable Care Act are expected in this legislative cycle. Tort reform will be discussed locally.
The Puerto Rico Section and the March of Dimes sponsored a summit of all ob-gyn department chairs in Puerto Rico in November. It was the second summit of its kind. The keynote speaker was Robert W. Yelverton, MD, District XII chair, who presented a lecture on the “Avoidance of Prematurity in the 21st Century: The 39-Week Goal.”
William T. Creasman, MD, section chair
The South Carolina Section sent three officers to the ACOG Congressional Leadership Conference, The President’s Conference, March 3–5, along with our new section Junior Fellow vice chair, Jill B. McLeod, MD.
The Birth Outcomes Initiative (BOI), a partnership between our section, the South Carolina Department of Medicaid, the South Carolina Hospital Association, and several insurers, continues to grow and attract the attention of policymakers. A press conference was held in the State Capitol on December 12 to review the progress made thus far. The conference was attended by Gov. Nikki Haley, South Carolina Medicaid director Anthony Keck, and various stakeholders. Gov. Haley announced that since the start of BOI, elective deliveries prior to 39 weeks’ gestation have fallen by 60%. Every hospital in the state has signed on to the BOI pledge to eliminate all medically unnecessary preterm deliveries.
Gov. Nikki Haley speaks on the progress of the Birth
Outcomes Initiative at a press conference in the
Current initiatives of BOI include improving the number of women in South Carolina who breastfeed and encouraging the use of group prenatal care. South Carolina Medicaid has authorized increased delivery payments to hospitals and providers that meet certain breastfeeding goals and benchmarks.
Pilot data demonstrating the efficacy and cost-effectiveness for group prenatal care for the prevention of preterm labor has also led to a statewide program encouraging providers to become involved. Through BOI, groups or providers who participate will receive training for their staff, educational materials, and a significant increase in the delivery fee for each participant.
Future plans of BOI include trying to reduce South Carolina’s infant and neonatal mortality rate, which ranks among the highest in the US. The South Carolina Section is proud to have been a founding member of this public-private partnership, and we look forward to continuing to improve the health of South Carolina mothers and babies.
South Carolina Junior Fellows are having great success with their medical student interest group meetings and enjoyed welcoming local third-years back in the fall for their sub-internships. The interest group meetings have become quite large at the University of South Carolina and the Medical University of South Carolina, with residents and faculty members participating together. In addition to meetings, open forums are being held for medical students to ask residents and attendings candid questions.
Junior Fellow section leaders are working to increase awareness of ACOG member benefits and to encourage residents throughout South Carolina to participate in ACOG activities. They plan to host a diaper drive in the near future, as well as a fundraiser for a local domestic abuse shelter. They hope to engage statewide interest in community service and get medical students involved with these events.
As noted in my last report, a bill passed by the Legislature on making information concerning the human papillomavirus (HPV) vaccine more available was vetoed by the governor. Even though it passed by large margins, the Legislature did not override the veto. In January, Rep. Bakari Sellers (D-Bamberg) introduced a bill in the House that, beginning with the 2013–14 school year, would:
- Offer HPV vaccination to adolescent students enrolling in the seventh grade of any public or private school in South Carolina
- Provide an information brochure related to the vaccine with specific content requirements
- Define “cervical cancer vaccination series”
Implementation of this act would be contingent upon receipt of full state and federal funding. No student would be required to have the vaccine before enrolling in or attending school. The success of this bill is debatable at this point in time.
Other bills of note that have been introduced this session include:
- Senate Bill 87 and House Bill 3323: Establish that the right to life for each born and preborn human being begins at fertilization
- Senate Bill 117 and House Bill 3366: Require physicians to ask patients what family members may be involved in health care decision-making
- Senate Bill 182: Declares March Endometriosis Awareness Month
- Senate Bill 204: Requires abortions outside of hospitals to be performed by board-certified ob-gyns with hospital privileges
- Senate Bill 278: Requires South Carolina Medical Association membership as a condition of physician licensure
- Senate Bill 3324: Creates the South Carolina Unborn Children’s Monument Commission to erect a monument on the House grounds as a memorial to children whose lives ended before birth
- Senate Bill 3416: Prohibits physicians or nurses from asking patients about firearms ownership
Regulations related to certification requirements of midwives have also been submitted to the Legislature. They do not include expansions on scope of practice.
Holly S. Puritz, MD, section chair
The Second Annual Virginia Section Meeting will be held September 20 at the Richmond Marriott. We hope to build on the momentum of our successful first meeting. Continuing medical education will be offered, and a Fellow and Junior Fellow business luncheon will be held during the meeting. Residents from each of our five residency programs will present their research in the morning. Afternoon lectures will focus on a broad range of subjects of interest to the practicing ob-gyn. The meeting’s keynote speaker will be Steven L. Warsof, MD, from Eastern Virginia Medical School in Norfolk, who will discuss non-invasive prenatal testing and new genetic screening tests.
A conference on mental health during and after pregnancy will be held in Hampton in May. Section members helped identify speakers for the program, which is being led by pediatricians. Additionally, the Virginia Health Commissioner’s Immunization Task Force and Task Force on Infant Mortality are working with section members to promote shared goals.
The Virginia Section sent six members to the ACOG Congressional Leadership Conference, The President’s Conference (CLC), March 3–5. There was strong statewide interest in the conference this year. Additionally, I served on a panel at the CLC, discussing ACOG’s involvement in state-level legislative issues.
The Virginia Section has started a new program, inviting Fellows and Junior Fellows to spend a day with section lobbyist Melanie Gerheart in Richmond. Testimony is often needed for committee hearings, and it’s difficult to find a physician to testify at the last minute. Committee meetings are held every Tuesday and Thursday. Therefore, physicians are scheduled to attend every Tuesday and Thursday of the two-month legislative session so there will always be someone to speak on behalf of ob-gyns. The program has been very successful to date. Members who receive sponsorship to the CLC are required to commit to this project. All ACOG members are invited to participate.
The Medical Society of Virginia (MSV) has decided to start supporting state society issues as they affect physician-patient relationships. MSV’s lobbying committee has been asking for ACOG’s input on many bills and is lending its support to many of our issues. Several items that were addressed last year are being revisited this year in committee.
The 2013 General Assembly session will last for only 45 days. Despite this short session, Virginia House and Senate members have introduced more than 2,000 bills, making it difficult to track legislation. Thus far, no items have made it out of the committees, including the following bills relevant to our members:
- Senate Bill 826: Repeals the Board of Health’s authorization to fund abortions for women who meet the financial eligibility criteria of the State Plan for Medical Assistance in cases in which a physician certifies that he or she believes that the fetus would be born with a gross and totally incapacitating physical deformity or mental deficiency
- Senate Bill 1082: Removes the requirement that a woman undergo a transabdominal ultrasound prior to an abortion
- Senate Bill 1080: Provides that no law, regulation, or administrative action of an agent of Virginia should require that a person receive ultrasound imaging for non-medical reasons or ultrasound imaging that is not medically indicated as a condition of receiving a medical procedure
- Senate Bill 1115: Eliminates language classifying facilities in which five or more first-trimester abortions per month are performed as hospitals for the purpose of compliance with regulations of the Board of Health related to construction, maintenance, operation, staffing, and equipping of hospitals
- Senate Bill 1116: Provides that regulations of the Board of Health for the construction, maintenance, operation, staffing, and equipping of hospitals shall apply to facilities in which five or more first-trimester abortions per month are performed only when the design or construction of such facility is initiated after July 1, 2013. This bill includes an emergency clause
- Senate Bill 783: Defines “birth control” as contraceptive methods that are approved by the US Food and Drug Administration. Birth control should not be considered abortion
The Virginia Hospital and Healthcare Association (VHHA) and the March of Dimes started a committee to stop early elective deliveries in our state. MSV is also involved, and I was asked to be on the committee. VHHA has approved a plan to ask all hospitals to work together to determine the baseline early elective delivery rate and to assist hospitals in reducing that rate. VHHA is asking for a commitment from the hospitals to submit data and pledge to have policies in place to reduce the rate.
A webinar was presented to all maternity hospitals in February. I spoke on ACOG’s recommendation that deliveries prior to 39 weeks’ gestation should not be done without maternal or fetal indication. Many of the academic and large hospital systems have a 39-week rule in place. The committee hopes to reach the smaller hospitals in Virginia and offer help and advice on getting a similar policy in place. One of the major problems facing smaller hospitals is verification of a medical delivery prior to 39 weeks. The need for chart review and follow-up can be onerous.
The Junior Fellow Annual Section Meeting was held in September. Contacts were established at each residency program in Virginia. These contacts will relay information to residents from the section.
In an attempt to involve and recruit medical students into the field of ob-gyn, a simulation event was set up at the Carilion Clinic in Roanoke. First- and second-year medical students from local medical schools were invited. For the first hour, students practiced their laparoscopic techniques at multiple simulations stations. In the second hour, students competed against each other to achieve faster laparoscopic techniques. The winning group was given the privilege of shadowing residents on labor and delivery.
Owen D. Walcott, MD, section chair
The West Indies Section continues to share some of the frustrations in the delivery of health care experienced by other District IV demographics. Thankfully, I am pleased to report that some encouraging trends have been developing, which I hope will result in improvements in our poor health indices.
In Jamaica, the government has decided to abandon its experiment with free health care in the public sector. This experiment produced a watered-down system characterized by grossly inadequate resources and overwhelming demand. There is now a proposal to return to user fees with means testing to ensure that the very poor continue to access medical care. Hospitals and clinics will also be authorized to file health insurance claims on insured patients who use public facilities.
Over the past few months, there has been a spate of medical catastrophes among health professionals. Several of our colleagues have suffered strokes and heart attacks, and these occurrences culminated tragically in the untimely death of Wilmot H. Hedrington, MD, one of our most popular and esteemed members. Dr. Hedrington died on January 13. This series of events has prompted us to reexamine the culture of our medical practice and to choose the theme “Heal Thyself—Physician Wellness” for our annual meeting.
The Annual West Indies Section Meeting will be held on April 13. We will look at issues affecting the general health of physicians, including diet and weight control, screening protocols, and stress in the work environment, as well as financial wellness and retirement planning. We hope these topics will encourage some introspection and encourage physicians to adopt healthier, more balanced lifestyles.
Cathy A. Maddan, MD, has completed a successful term as section Junior Fellow chair. Jody-Ann S. Jarrett, MD, is our new section Junior Fellow chair. Junior Fellows continue their outreach and community work, primarily focusing on breastfeeding and adolescent sexuality initiatives. Their annual meeting was held on September 30 and focused on the theme of infertility. Junior Fellows are extremely active, and their energy and enthusiasm is a source of inspiration to all of us.
A recurring theme in West Indies Section reports has been the great need we have for specialist training, especially in the areas of gynecologic oncology and maternal-fetal medicine. We have been able to secure fellowships in Canada, and over the last two years we have seen the return of a gynecologic oncologist and maternal-fetal medicine physician. Currently, two residents are pursuing fellowships in maternal-fetal medicine. We hope this will result in steady improvement in the quality of care offered in our section. We remain open to opportunities for specialist training within District IV.
On another positive note, a state-of-the-art endoscopic unit has been commissioned into service at the University Hospital in Jamaica. Robotic services are not yet available, but the facility has already had a tremendous impact on the level of training and service we are able to provide.
Brenda L. Dawley, MD, section chair
Drug overdose was the leading cause of maternal deaths in West Virginia last year, with the majority occurring two to three months postpartum. A bill designed to reduce drug diversion and narcotic shopping passed. It increases regulations associated with pain clinics and their dispensing of controlled substances. Neonatal withdrawal is an escalating problem.
Smoking, obesity, hypertension, and diabetes continue to be prevalent problems in West Virginia. There have been recent statewide changes in school meals to help eliminate childhood obesity. The West Virginia Tobacco Quitline (877-966-8784) is well funded and utilized. It has helped more than 40,000 West Virginians stop smoking.
The teen pregnancy rate in West Virginia is stable, but I hope it will begin to decrease as sex education efforts in high schools, access to contraception through family planning clinics, and use of long-acting reversible contraception in adolescents increase.