Connect with District VI on Facebook
In an effort to provide you with current information regarding women’s health, District VI has joined Facebook. We are updating our page regularly with news specifically relevant to District VI members. You can find us at facebook.com/ACOGDistrictVI.
ACOG national is also on Facebook at facebook.com/ACOGNational. If you’re a Facebook member, log in and click on the “Like” button on the ACOG national and District VI pages. Then, you’ll be able to comment on and share any updates posted. You’ll also get ACOG national and District VI news sent directly to your Facebook news feed.
Anyone can view Facebook pages, but only Facebook members can interact with ACOG national and District VI. To become a Facebook member, sign up at facebook.com.
ACOG national is also on Twitter at twitter.com/acognews. To follow its feed, go to twitter.com and sign up as a member. You’ll be the first to hear ACOG news!
Steven W. Remmenga, MD
Health care reform and health care costs have been mainstream conversation for the last several years and continue to dominate headlines and daily news programs as the Affordable Care Act becomes reality. The changes we have seen in health care in the past few years have been staggering and continue to grow on a daily basis. No one is sure where things will eventually end up, but we all know that the landscape of health care in this country will fundamentally change.
While we have focused so much on the reimbursement aspects of health care, other changes will affect graduate medical education, working relationships with non-physicians, and health care research. Even the way we practice will change as pressures increase to switch to a model of large health care organizations and employed physicians rather than private practice, the landscape of American health care in the past.
Physicians in general have never been politically active in comparison to other professional groups, but that is changing. There have been many challenges to women’s health care in the last few years, and I expect this will be an ongoing theme as we move forward. We need to be actively involved in helping our patients not only with contraception issues, which seem to be the dominant focus of most people, but also in areas of prenatal care, well women and primary care, oncology and aging patient populations, our future work force and training that workforce, and research, to name just a few.
ACOG has a federal political action committee, Ob-GynPAC, and the money we contribute to it has been used to gain access to and lobby our elected politicians on important issues that affect our patients and our practice on a daily basis. While Ob-GynPAC has been very active, contributions are needed to fund its efforts. Please consider a donation, even if it is only a few dollars. Every contribution counts, and District VI has been a leader in supporting the Ob-GynPAC. (You will not be favored or disadvantaged by reason of the amount of your contribution or a decision not to contribute. Contributions from foreign nationals are not permitted.)
Every year, ACOG holds a conference in Washington, DC, called the Congressional Leadership Conference, The President’s Conference (CLC), where ob-gyns from around the country meet to learn about and discuss issues important to women’s health. Attendees then meet with members of Congress and their staffs to discuss the issues. It is an intense several days of work that is vital for advocating for our patients and our specialty.
I strongly recommend attending the CLC and/or discussing issues that are important to ob-gyns with our elected representatives. Every section in our district has a legislative liaison who works to advocate for members and their patients at the national and local levels. If there are issues you have questions about or if you’d like information on how you can help, contact your section officers. We need to be proactive as we move forward in the new era of health care in the US.
I look forward to serving as your district chair and will work as your advocate.
2014 Annual District Meeting: Join us in Napa, CA
Denise M. Elser, MD, District VI vice chair
District VI has exciting plans for education and business meetings this year and the years to come. Please mark your calendar now for the 2014 Annual District Meeting with Districts VIII and IX in beautiful Napa, CA, September 4–7.
The meeting will be held at The Silverado, a landmark hotel set in the rolling hills of Northern California. The postgraduate course will feature debate-style presentations provided by department and division heads from academic institutions throughout California. What could be better than kicking off the fall season with education and relaxation among colleagues?
Plans are in the works for the 2015 ADM. Under strong consideration is a first-ever five-district meeting and postgraduate course. Locations being evaluated include Seattle and Colorado Springs. Course content is under development, but it will be sure to include hands-on training difficult to find elsewhere.
More details on these meetings will be available on the District VI website as they become available. The District VI Facebook page is also a great source of information. Please “like” our page if you haven’t done so yet.
Junior Fellow chair’s report
Amandeep S. Mahal, MD
District VI Junior Fellows continue to be active and interested in ACOG leadership. Volunteerism within each section is thriving with clothing and diaper drives, bake sales raising money for domestic violence shelters, and work in medical clinics alongside attending staff and medical students.
Last year, the District VI Junior Fellow Advisory Council took a special interest in recruiting medical students to ob-gyn, as we understand the future of our specialty relies on bringing in the best. The district pooled resources, including laparoscopic trainers, forceps models, intrauterine device inserters, and knot tying boards, to host a district-wide medical student recruitment event at the 2013 Junior Fellow Annual Meeting in Iowa City. We asked district members to bring medical students from their section to the meeting. We may repeat a similar event at future meetings.
Speaking of medical student involvement, we had four John Gibbons Medical Student Award recipients join us at the 2013 Annual Clinical Meeting: Kristen Gerjevic, from Iowa; Ginevra Mills, from Saskatchewan; Sarah Takimoto, from Nebraska; and Kristen Turner, from Illinois. We look forward to their future leadership in ACOG and in ob-gyn.
In addition, Tashera E. Perry, MD, District VI Junior Fellow vice chair, attended the ACM as the recipient of the John Burch Endowment Fund Travel Award. Her experience at the ACM and many other activities led to her election as District VI Junior Fellow vice chair. We could not be happier to have her on the council. Shweta J. Bhatt, MD, from Illinois; Gretchen Garbe, MD, from Illinois; Kady A. Kiichler, MD, from Nebraska; Anna C. McCormick, MD, from Illinois; and Mary N. Zaki, MD, from Illinois, also participated in the ACM as Ob-Gyn Reporters.
Dr. Zaki will take part in the ACOG/Japanese Society of Ob-Gyn exchange program in the spring. We wish her safe travels and look forward to hearing about her experience. Jill A. Gadzinski, MD, from Illinois, won the District VI Junior Fellow Prize Paper Award at the 2013 Annual District Meeting.
Our council is working to answer the question: “What would you like ACOG to do for you?” We’ve talked to Junior Fellows in practice, residency directors, and friends. At the Junior Fellow Annual Meeting, we hosted afternoon breakout sessions on topics such as advocacy and leadership. We are planning a series of lectures and breakout sessions for the 2014 ADM that we hope will address some of the issues concerning Junior Fellows. We plan to dive deeply into topics that are sometimes missed in our day-to-day training, such as job searching and contract negotiations.
If you are interested in becoming more involved with Junior Fellow projects, please contact me at firstname.lastname@example.org or any of your section Junior Fellow officers.
Meet your new district officers
Steven W. Remmenga, MD, District VI chair
I am looking forward to my term as District VI chair after serving as District VI secretary. We have a great group of people on the District Advisory Council, which will help immensely as we move into a new era of medicine.
I was born and raised in Lincoln, NE, and attended the University of Nebraska–Lincoln on a Navy scholarship. I was commissioned in the Navy to be a line officer (or ship driver), but I was allowed to go to medical school instead and attended the University of Nebraska Medical Center (UNMC). Following an internship at UNMC, I was sent to Okinawa, Japan, with the Marines. I did my residency at the Naval Regional Medical Center San Diego and then did a tour in the Aleutian Islands as a solo general ob-gyn in a 15-bed hospital.
I became actively involved in the ACOG Armed Forces District while completing my residency program. Then, during my gynecologic oncology fellowship at Walter Reed Army Medical Center, my program director was ACOG president. I spent approximately 10 years at Naval Medical Center Portsmouth before returning to Walter Reed, where I retired from the Navy after 25 years of service. I returned home to Nebraska where I serve as vice chair and director of gynecologic oncology at UNMC.
I love outdoor activities, such as hunting, and reading a good book from time to time. I am a Big Red (Nebraska Cornhuskers) fan, though my assistant high school football coach was Barry Alvarez, past coach and current director of athletics at University of Wisconsin–Madison. My wife and I foster rescue golden retrievers, with three of our own and a pug that thinks it is a golden retriever. We also love spoiling our grandchildren.
Denise M. Elser, MD, District VI vice chair
After serving as District VI treasurer, I am eager to begin my term as District VI vice chair. I grew up in Chicago and received most of my education and training in Illinois. I attended undergraduate school at the University of Illinois and completed medical school and my residency at Rush University Medical Center. For my urogynecology fellowship, I ventured south to the Medical College of Virginia in Richmond, but I was homesick and have been back in the Chicago area ever since. I am lucky I was exposed to ACOG early in my career. My chairs at Rush University Medical Center and the Medical College of Virginia served as ACOG presidents.
I enjoy working at a private urogynecology practice in the southern and western suburbs of Chicago. Thankfully, I passed the female pelvic medicine and reconstructive surgery board exam this past June. At home, there is never a dull moment. I am surviving (so far) a house full of teenagers and a variety of pets. I’ve worn many hats as a soccer and hockey mom and am an avid hockey and football fan. I also enjoy working out, golfing, and attending theater and concerts.
Bridget B. Keller, MD, District VI secretary
I am thrilled to be serving District VI as secretary. I am originally from St. Cloud, MN. After completing my undergraduate degree at the University of Minnesota, I traveled to Eastern Virginia Medical School in Norfolk for my medical degree. Because Minnesota girls always seem to come home eventually, I decided to explore the country more and moved to the West Coast for my residency.
I first got involved in ACOG as a resident at the Oregon Health and Sciences University. When I moved home to Minnesota after residency, I joined the Minnesota Section Advisory Council. I’ve been in practice at Park Nicollet Clinic in Minneapolis for 13 years. My free time is spent running, skiing, and enjoying time with my husband and children.
Thaddeus L. Anderson, MD, District VI treasurer
I have an undergraduate degree in pharmacy and a medical degree from the University of Illinois. I completed my residency at the University of Iowa. After four years of service in the Army Medical Corps, I moved to Dubuque, IA, where I practice general ob-gyn. I have served on the Iowa Medical Society Maternal Mortality Committee since 1997 and as chair since 2011.
For ACOG, I have served as a member of the Coding and Nomenclature Committee, National Nominating Committee for 2013, and Committee on Professional Liability, on which I also served as vice chair. For District VI, I have served as McCain Fellow, legislative chair, and Iowa Section chair.
Amandeep S. Mahal, MD, District VI Junior Fellow chair
I am honored and excited to serve as District VI Junior Fellow chair. I’ve been involved in ACOG since my third year of medical school when a great mentor and teacher introduced me to this wonderful organization. Since then, I’ve had the privilege to represent District VI at clinical leadership conferences, annual clinical meetings, and various other district and section meetings. I hope I can be a resource for you and all ACOG members. My goals for my tenure as chair are to help spur new programming and ideas for Junior Fellow members and to respond to the needs of young physicians and ACOG leaders.
Currently, I am a fourth-year resident at the University of Iowa Hospitals and Clinics. After completing my training, I will sadly depart from my beloved District VI to begin a female pelvic medicine and reconstructive surgery fellowship at Stanford University in California. Watch out, District IX, here I come! I will be leaving the district in good hands with Tashera E. Perry, MD, our talented Junior Fellow vice chair.
Tashera E. Perry, MD, District VI Junior Fellow vice chair
Thank you for the opportunity to serve District VI as Junior Fellow vice chair. Hailing from Westfield, NJ, I received my undergraduate degree in biology from Mary Baldwin College in Staunton, VA. I then completed a two-year research fellowship at the National Institutes of Health in Bethesda, MD, before making my big move “out West.” I graduated from the Pritzker School of Medicine, University of Chicago, and happily remain in Chicago as an ob-gyn resident at the University of Illinois.
I joined ACOG in 2009 with the hope of learning the skills necessary to become an informed and effective lobbyist for the interests of my patients and colleagues at the institutional, state, and national levels. As an Illinois Section Junior Fellow officer, I’ve had the honor and privilege of channeling my desire for civic engagement into productive work for the benefit of my fellow residents and disadvantaged women in the city of Chicago. I am thrilled to continue this work at the district level.
Of course, even busy residents need a break! In my free time, I go to the gym before moonlighting as an amateur gastronome and connoisseur of classic cocktails, circa 1930s. If you are ever hungry in Chicago, I have many delicious suggestions!
Young physician news
Tamara G. Helfer, MD, District VI young physician
I hope to see many of you at the Annual Clinical Meeting in Chicago in April. ACOG President Jeanne A. Conry, MD, MPH, has been working hard to make it a relevant program to all. Attendees can look forward to new events, such as subspecialty panels discussing cutting-edge topics, curbside consults, and educational tracks in obstetrics, gynecology, and practice. Chicago is a great location for the entire family to see historical sites, professional sports, theater, and a variety of museums.
Six years ago, District VI instituted a young physician position on its advisory council. The response has been so wonderful that the council is instituting a second young physician position. Each position lasts three years, with a one-year overlap. Christine S. Goudge-Walker, MD, from Minnesota, has been appointed to the new young physician position. Please join me in welcoming her to the leadership team.
The District VI Mentorship Program continues to promote formal and informal mentorship concepts. District VI young physicians will host mentorship luncheons at the Wisconsin Section Annual Meeting in August and the Annual District Meeting in September. Watch for information on these events, and plan to attend. The luncheons are intended to provide mentorship and advice to Junior Fellows, Junior Fellows in practice, and young physicians. If you are no longer in one of these membership categories, we still want you to be involved. Serve as a mentor! We are setting up a database of members who would like to do so and encourage everyone to sign up.
This year will be my last as your young physician representative. It has been a pleasure serving the district. If I can assist you in any way, please contact me at email@example.com.
Thaddeus L. Anderson, MD, District VI treasurer
The ACOG State Legislative Roundtable was held September 20–21 in Washington, DC. Topics for discussion included breast density legislation, midwifery, maternal mortality, reproductive health, and medical liability reform. Emerging issues of substance abuse and neonatal abstinence syndrome, environmental health, and immunization opt-out legislation were also covered. Participants attended talks from experts on Affordable Care Act implementation, lobby days, and legislative campaigns.
Health insurance exchanges began to accept applicants in October, but not without challenges—some of which we’re still facing today. The following table lists the plans of each state in District VI for health insurance exchanges and Medicaid expansion.
Health Insurance Exchange
State-federal partnership, may transition to state-run exchange
State-federal partnership, may transition to state-run exchange
Restrictions on abortion services have been a major legislative push by conservative Republican legislators across the US. North Dakota passed legislation banning abortion after fetal cardiac activity is detectible, or at six weeks’ gestation. The law has been temporarily blocked by a federal judge, but legal battles continue. Maura P. Quinlan, MD, Illinois Section chair, has given legislative education talks at several Illinois residency programs. Her lectures warn about the legislative restrictions affecting women and reproductive rights. Read the section reports for more state and local legislative news.
ACOG’s federal political action committee, Ob-GynPAC, is now making monies available for use for Ob-GynPAC members in state elections. Up to $50,000 each election cycle will be available for members, on request, to use in state elections, where allowed by state law. The OB-GynPAC Governing Committee will approve distributions on a first come-first served basis.
Also, please consider donating to Ob-GynPAC. The bipartisan PAC helps elect and re-elect members of Congress who support our specialty. During the 2011–12 election cycle, 85% of candidates the PAC supported won their House races, and 80% won their Senate races. (You will not be favored or disadvantaged by reason of the amount of your contribution or a decision not to contribute. Contributions from foreign nationals are not permitted.)
The Gellhaus Resident Advocacy Fellowship allows a senior ob-gyn resident to work in Washington, DC, for two to four weeks with the ACOG Government Relations and Outreach department. Expenses for travel, housing, and meals are covered by this fellowship. If you are interested or know someone who may be, contact Stacie Monroe at firstname.lastname@example.org for information. Tashera E. Perry, MD, District VI Junior Fellow vice chair, has been selected as a 2014 Gellhaus Resident Advocacy Fellow.
My friend and fellow Iowan, Marygrace Elson, MD, will serve as the 2014 District VI McCain Fellow. Dr. Elson is a professor at the University of Iowa and a member of the Iowa Medical Society Board of Directors. She has been active in legislative advocacy at the state and national levels. She also will take over leadership of the District VI Legislative Committee. I would like to thank District VI members for their support during the last five years as I held this position.
The American College of Nurse-Midwives and ACOG: Partners in women’s health
Lynne Himmelreich, CNM, MPH, FACNM, clinical associate professor of ob-gyn, University of Iowa
At the 2013 Annual District Meeting, I provided an update on the joint efforts of the American College of Nurse-Midwives (ACNM) and ACOG to improve women’s health care quality and safety and to advance collaboration between ob-gyns and certified nurse-midwives (CNMs) and certified midwives (CMs). I am currently a member of the ACNM Board of Directors, representing the Midwest.
Founded in 1955, ACNM leads the US midwifery profession through education, clinical practice, research, and advocacy, representing approximately 12,000 CNMs and CMs. CNMs and CMs are masters-prepared, nationally-certified and recertified by the American Midwifery Certification Board. CNMs are legally recognized in all 50 states, whereas CMs—who take the same certifying exam as CNMs but are not dually prepared in nursing—are working to expand their recognition. In 2011, CNMs and CMs attended 309,514 births, 11.7% of all vaginal births, 7.8% of all US births, and 92.2% of midwife-attended births in the US. While some CNMs and CMs work in birth centers or home birth practices, more than 95% of births attended by CNMs and CMs occur in hospitals.
ACOG President Jeanne A. Conry, MD, PhD, accepts the American College of Nurse-Midwives Organizational Partner Award.
In 2013, ACOG was awarded the ACNM Organizational Partner Award in recognition of ACOG’s important role in working closely with ACNM to promote high-quality midwifery practice.
ACNM and ACOG have an ongoing focus to increase collaboration between ob-gyns and CNMs/CMs to improve the quality of women’s health care and maternity care at the national, state, practice, and clinician levels. Examples of partnerships on the national level include:
- ACNM is active in the ACOG-convened Women’s Health Registry Alliance and the ACOG-CDC maternal mortality initiative
- ACNM, ACOG, and others hosted a May 2013 congressional briefing on the Quality Care for Moms and Babies Act
- ACNM, ACOG, and Childbirth Connection organized an April 2013 meeting to discuss how to expand access to safe, high-quality vaginal births after cesarean delivery
- ACNM, ACOG, and the American Academy of Pediatrics, among others, are partners in the US Agency for International Development global development alliance Survive and Thrive
Other opportunities for collaboration between ACNM and ACOG include interdisciplinary education with CNMs/CMs and ob-gyn residents; building and supporting collaborative practices; national, regional, and state quality improvement initiatives; efforts to obtain a federal maternity care shortage designation; and advocacy efforts related to the implementation of the Affordable Care Act.
At the district and section level, ACNM encourages its Board of Directors and state affiliate leaders to become ACOG educational affiliate members and attend ACOG district and section meetings. There is an ACNM affiliate organization in every state and federal territory, the uniformed services, and the Indian Health Service. ACNM seeks better collaboration on shared policy objectives and would like to work with ACOG to improve the quality and safety of maternity care and women’s health based on the shared principles of the ACOG/ACNM collaborative practice statement issued in 2011.
During the ADM, I also previewed ACNM’s work to promote normal physiologic labor and birth to consumers and other clinicians. ACNM is preparing to launch a new website called BirthTOOLS—an acronym that stands for Tools for Optimizing Outcomes of Labor Safely. BirthTOOLS is intended to reach clinicians and health care staff looking to improve access to normal physiologic birth in hospitals. It will incorporate real, pragmatic resources and case studies designed to help staff implement changes in their own facilities.
For more information about ACNM, visit the ACNM website. I am happy to be a resource and can be reached at email@example.com. I look forward to promoting collaboration between ACOG section leaders and their ACNM affiliate counterparts.
Maura P. Quinlan, MD, Illinois Section chair; Sloane L. York, MD; Jessica Kiley, MD; and Christopher G. Olson, MD, at the 2013 Illinois Section Lobby Day
Illinois passed a sexual education act in 2013, requiring sexual education to be age appropriate, medically accurate, and comprehensive. A nurse practice act was also passed, maintaining a collaborative agreement between advanced registered nurse practitioners and physicians.
A bill to license direct-entry midwives was introduced late to the Legislature, just prior to recess, and was not passed. Bills mandating stricter requirements for clinics providing medical or surgical abortions and the offer of ultrasounds to women prior to abortion also failed to pass. The section will host a Lobby Day on March 20. All members are welcome to attend.
Section leadership now has representation from members throughout the state and from most of the medical schools. Section members are collaborating with the Chicago Department of Public Health and other professional organizations for Vaccinate Illinois Week to raise awareness for influenza vaccination.
Congratulations to Tashera E. Perry, MD, District VI Junior Fellow vice chair and former section Junior Fellow officer, who was selected as a 2014 Gellhaus Resident Advocacy Fellow. Dr. Perry will spend two to four weeks working with the ACOG Government Relations and Outreach department in Washington, DC.
ACOG Assistant Secretary Thomas M. Gellhaus, MD, past District VI chair, speaks at the Iowa Section Meeting.
The Iowa Section held a successful meeting in October in conjunction with the University of Iowa. Section members were active in the Iowa Medical Society Lobby Day held in February. Legislative asks included improved funding for Medicaid in the state budget, reduced medical liability litigation, and expedited restitution to patients harmed by medical care.
Funding to support additional residency training, a 1% increase in Medicaid reimbursement, and the repeal of site-of-service fee differential for Medicaid passed through the Legislature in 2013. Legislation regarding breast density reporting, tort reform, and shackling of pregnant prisoners did not pass. The Iowa Department of Corrections adopted new restraint procedures for pregnant prisoners that met the section’s goals. Legislation for licensure of direct-entry midwives and breast density reporting has been proposed again in 2014.
The Iowa Board of Medicine adopted a proposed rule to regulate drug-induced telemedicine abortions in Iowa. Additionally, the governor must now approve reimbursement for each Medicaid-funded abortion.
Michael J. McCoy, MD, section chair, chaired the Iowa Medical Society Tort Reform Task Force under the Iowa Medical Society Committee on Legislation. The task force’s recommendations were to:
- Pursue establishment of an early disclosure and compensation model
- Enact legislation to establish an affirmative defense in medical liability suits for the practice of evidence-based medicine
- Enact a provider shield law
- Enact legislation that sets parameters for contingency fee arrangements in medical liability cases
Congratulations to Marygrace Elson, MD, section vice chair, who was recently selected to be the 2014 District VI McCain Fellow.
The Manitoba Section is launching TeamSTEPPS training in the province to improve patient safety. The Regulated Health Professions Act is expected to be functioning by September 2014. It will set standards of practice for medicine, nursing, midwifery, and other allied health professions. Winnipeg continues to struggle with high delivery volumes at St. Boniface Hospital. A new Women’s Hospital is under construction.
The master agreement between Manitoba physicians and the province expired March 31. Health care budgets are strained, with low probability of fee increases. Doctors Manitoba is setting up work groups to make a proposal to Manitoba Health, a department within the government, by September 2014. Then, negotiations will begin. The next provincial election is projected to be October 4, 2015.
MNsure, Minnesota’s health insurance exchange, had a rocky start in October. Issues with the exchange’s call center persist. Kathryn Duevel, MD, a retired ACOG Fellow, is the only health care provider on the MNsure Board of Directors. The Minnesota Section will continue to work with its lobbyist this legislative session. The Minnesota Medical Association Day at the Minnesota State Capitol is scheduled for March 13. All are welcome to attend.
Several bills related to women’s health and the ob-gyn specialty passed the state Legislature in 2013, mandating:
- Funding to train health care workers about maternal depression
- Medicaid coverage for doula services
- Grants to prevent fetal alcohol syndrome
- A 5% increase in funding for nursing homes
- The unionization of in-home child care and personal assistants
Legislation to license facilities providing 10 or more abortions per month did not pass.
The Minnesota Section, in conjunction with the Minnesota Department of Health, has a multidisciplinary maternal mortality project underway. The project committee meets quarterly to review cases of maternal mortality in the state. Elizabeth P. Elfstrand, MD, gave an excellent report and presentation on the project at the 2013 Minnesota Section Annual Meeting in November.
The 2014 Minnesota Section Annual Meeting will be held November 22 at The Depot in Minneapolis. Douglas W. Laube, MD, MEd, past ACOG president, will be a featured speaker.
Congratulations to Christine S. Goudge-Walker, MD, on her election as District VI young physician, and to all the new section officers.
An initiative to reduce elective deliveries prior to 39 weeks’ gestation has been in motion since January 2013. All hospitals in Nebraska have hard stops in place for elective deliveries prior to 39 weeks. The number of these elective deliveries in the state is now less than 1% and approaching 0%.
The Newborn Associated Adverse Events Task Force continues to meet. The task force is a collaborative group that was formed through the Nebraska Medical Association working with the Nebraska Section to deal with the adverse neurological outcomes of newborns due to hypoxic ischemic encephalopathy and cerebral palsy from a care and financial standpoint. The Neonatal Encephalopathy Task Force is developing a case manager navigator program to help families get care for their affected children.
The Nebraska Medical Association has proposed two bills to increase the medical liability cap. The new total award amount would be $2 million to $2.5 million with a $250,000 non-economic cap on medical liability awards. Medicaid expansion in Nebraska is still being debated. Senators are offering amendments involving patient responsibility and a sunset clause in case federal funding doesn’t continue at 90%.
Several bills that impact reproductive health passed during the 2013 legislative session. One bill asks voters to change the state’s constitution to recognize “the inalienable right to life of every human being at any stage of development.” This proposition, which will be on the November 2014 ballot, would confer human rights on fertilized eggs and attempt to outlaw all abortion. Another bill makes it a misdemeanor for any provider to assist with abortive services for the reasons of sex selection or genetic abnormalities.
Another bill passed into law makes it a felony to perform an abortion on a woman before determining if there is a detectable heartbeat unless there is immediate risk of life or irreversible bodily harm to the woman. This law has been temporarily blocked by a federal judge. However, abortion after 20 weeks’ gestation is still banned in the state.
On a brighter note, the Legislature did appropriate an extra $7.4 million to increase the number of medical students to 70 per year as well as the number of residency positions within the University of North Dakota medical system. Also, congratulations to Siri J. Fiebiger, MD, who was named the Association of Professors of Gynecology and Obstetrics Educator of the Year for 2013.
The Saskatchewan Section is attempting to re-establish a provincial perinatal mortality and morbidity committee, in addition to a provincial perinatal database. Saskatchewan has an HIV rate that is four times the average rate in Canadian reproductive aged women. This high rate is due to the prevalence of injection drug use. A provincial HIV in pregnancy strategy and dedicated detox for pregnant women is under development.
Patient safety continues to be a focus of the section. The Saskatchewan government has adopted the Lean approach to improve the way its services work. Nearly 100% of the larger medical centers in the province are using surgical checklists in ob-gyn and improving patient and staff safety with a project called Stop the Line. The Saskatchewan Surgical Initiative has improved wait times for select gynecologic surgeries. However, wait times for non-emergency surgeries have not improved.
Other strategic priorities for the section and province include strengthening primary care, increasing the rural family physician supply, improving mental health and addiction services, and decreasing youth tobacco use.
Sanford Health in Sioux Falls is starting a surgical residency program with two residents per year. Several ACOG section members will help with didactic training and surgical training for the residents. Establishing a surgical residency is a prerequisite to starting an ob-gyn residency in the future, which has been discussed.
Sanford Health has implemented a policy to stop elective inductions prior to 39 weeks’ gestation. There are now financial disincentives for facilities that deviate from this standard of care. Therefore, many other health systems in the state have adopted the policy. Several health care systems in the state are also implementing SCOPE (Safety Certification in Outpatient Practice Excellence for Women's Health Program) standards for outpatient procedures.
Increased revenues in 2013 have provided a $75 million surplus in the state, which is earmarked to increase school funding and Medicaid reimbursement. A task force recommended refusing federal money for Medicaid for fear of an unfunded mandate in the future. This recommendation was contentious and will likely be reviewed again in 2014. The South Dakota State Medical Association has advocated for the increase of medical school class sizes from 50 students to 65 and the expansion of Medicaid for all South Dakota residents below 100% of the federal poverty level.
Several bills of interest to ob-gyn were passed by the Legislature. One bill offers debt repayment for family physicians that practice in rural areas. Another bill increases documentation for sale of phenylpropanolamine and other precursors for methamphetamine. A third bill permits confiscation of personal property and income from convicted sex traffickers.
The Wisconsin Section continues its efforts to build a more visible and influential political presence in the state. Over the last year, members have worked closely with ACOG’s Government Relations and Outreach staff to develop and distribute formal documents and opinions on issues affecting women’s health care in Wisconsin. These efforts, including video messages by advisory council members, culminated with an editorial piece by Kathy D. Hartke, MD, section vice chair and legislative chair, supporting women’s health care autonomy. Section leaders extend their sincere gratitude to Dr. Hartke for her dedication and efforts in expressing the section’s opinions.
The section was well represented at the ACOG Congressional Leadership Conference, in Washington, DC, March 2–4. Several new members were welcomed to the section’s contingent, assisting in relaying ACOG viewpoints to elected federal officials. Please consider applying for a position as a member of the 2015 Wisconsin Section contingent. Additional information will be available in early fall of this year.
The section participated in the Wisconsin Medical Society’s Lobby Day on February 12. This event is an excellent way to become involved in advocacy close to home. Please contact your section officers if you’d like to learn more about this opportunity. The Wisconsin Medical Society helped pass legislation that defines informed consent as information a reasonable physician would provide. The Wisconsin Section will sponsor a booth and will be represented at the Wisconsin Women’s Health Policy Summit in March 2014.
The 2013 Wisconsin Section Annual Meeting was held at the Kalahari Wisconsin Dells. It was a great success, and plans are already underway for the 2014 meeting, which will be held at the same venue August 8–9. With ICD-10 conversion rapidly approaching, the Section Advisory Council has decided to focus the meeting on coding and ICD-10 implementation. Additional details will be available soon.
Please also save the dates for the Annual Clinical Meeting, April 26–30, in Chicago and the Annual District Meeting, September 4–7, in Napa, CA. As always, feel free to contact any of the section officers if you have any concerns, interests, or issues you would like to discuss.
Calendar of events
Minnesota Medical Association Day
Contact: 612-670-7810 or firstname.lastname@example.org
Illinois Section Lobby Day
Contact: Maura P. Quinlan, MD, email@example.com
Annual Clinical Meeting
Wisconsin Section Annual Meeting
Contact: Jeffrey Rodzak, MD, firstname.lastname@example.org
Annual District Meeting (with Districts VIII and IX)
Contact: Marion Johnson, 202-863-2530
Minnesota Section Annual Meeting
Contact: 612-670-7810 or email@example.com
Congressional Leadership Conference
Contact: Stacie Monroe, 202-863-2505