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Matthew A. Lindemann, MD, section chair
First of all, we had leadership changes in the Alaska Section. After more than a year of service as section chair, Kathryn M. Ostrom, MD, has stepped down. I am now section chair, and Wendy S. Cruz, MD, is section vice chair. We appreciate Dr. Ostrom’s passionate leadership and are sorry to see her leave. She will remain a valuable resource for us.
The most pressing issues in Alaska are on the legislative front. A parental notification bill, passed by the legislature in 2010, has worked its way through the court system and was recently brought before the State Supreme Court. Jan E. Whitefield, MD, past section chair, and Susan M. Lemagie, MD, District VIII chair, offered testimony in the lower court proceedings. It could be a year before we get a ruling, so we’ll keep everyone posted.
Last year, a bill making requirements for Medicaid funding of abortion much more restrictive was passed. Previous regulations were vague and allowed abortions to be paid for when a doctor determined the procedure was medically necessary. The bill lists specific criteria for which the state will pay for terminations, most importantly leaving out psychological considerations. Separate from the political issues, this bill is dangerous in that it represents encroachment of legislators into the doctor’s office. We believe that medical decisions should be left to health care providers and their patients. There is a trial pending on this issue.
Our dream of having an ICD-10 coding conference for the section this spring fell through, though we hope to still do it later this summer. The goal is to not only provide needed information, but to incorporate the many new Junior Fellows who arrived this past summer and provide a forum for Fellows across the state to network. Alaska is a big state, of course, with few roads, which presents challenges. We also have three significant parallel health systems—military, native, and private—that don’t often interact. Dr. Ostrom is now serving as ob-gyn chair at Providence Alaska Medical Center and hopes, with her new role, to organize an ob-gyn grand rounds that can be attended virtually by Fellows.
The medical center also has accepted a proposal for a laborist program. Local doctors are not involved at this point, though there will likely be opportunities for us to work for the group. The program would provide 24-hour in-house coverage for emergencies and also decrease the burden on private obstetricians to be in-house for vaginal births after cesarean delivery, thus potentially increasing their availability.
I have been participating in the Healthy Alaskans 2020 campaign, serving on a committee addressing barriers to prenatal care and how we can increase the number of people accessing care in the first trimester. The committee has recognized several areas of concern, and it should issue a final report soon.
Martine N. Roy, MD, section chair
After three years of freezes, Alberta physicians received a 2.5% fee increase on April 1, in a climate of 4.5% inflation. The Alberta Health Services leadership structure is still in a state of transition.
The birth rate in Alberta remains high, and some areas of the province are still waiting on upgrades to provide enough services. Red Deer Regional Hospital should be getting labor and delivery operating rooms in the next three years. Currently, patients still need to be taken to the main operating room for emergency cesarean deliveries. In Edmonton and northern Alberta, we have had to send newborns out to Calgary or other provinces because we lack neonatal intensive care unit (NICU) capacity. Misericordia Community Hospital will be getting a new level 2 NICU, though I’ll believe it once it is open. We’ve been this close before.
On a positive note, the new Calgary South Campus Health Centre opened their ob-gyn department in September 2013. The Alberta Perinatal Health Program is working on addressing preventable hypoxic intrapartum and neonatal deaths. Maternal mortality also remains low in the province.
The Alberta Section Annual Meeting was held in Lake Louise on March 28, in conjunction with the Society of Obstetricians and Gynaecologists of Canada West/Central CME, March 27–29.
Maria Manriquez, MD, section chair
The Arizona Section Women’s Health Day at the State Capitol in February was a wonderful success. Attendees met with State Rep. Eric Meyer (D-Paradise Valley) and State Sen. Kelli Ward (R-Lake Havasu City).
The section cosponsored a statewide Resident Research Day in April. Two residents from each program presented research and competed for cash awards. The Phoenix and Tucson programs at the University of Arizona matched 13 students into ob-gyn. Recruitment for our specialty continues.
After the Annual District Meeting in September, Ilana B. Addis, MD, MPH, section vice chair, will become section chair; Laurie P. Erickson, MD, will become section vice chair; and Julie B. Kwatra, MD, will continue to be our awesome treasurer. I have accepted the position of ACOG representative to the Association of American Medical Colleges Council of Faculty and Academic Societies.
Arizona Section Junior Fellows have been hosting procedure nights and resident panels for medical students. Other activities include fundraising for Latin America, organizing maternity clothing drives, and writing legislators to protect graduate medical education funding at the national level and to advocate for women’s health issues at the state level.
Increased dues are covering the expense of a section lobbyist. We plan to host an expanded Women’s Health Day next year and an educational meeting at the time of the Resident Research Day. With our improved budget, we have been able to send additional students to regional and national events, as well as sponsor more Fellows and Junior Fellows to attend the Congressional Leadership Conference in Washington, DC.
Petra A. Selke, MD, section chair
The British Columbia Section has taken inspiration from the ACOG tradition in which the incoming president announces an initiative for his or her year in office. British Columbia’s initiative under the current leadership is “Engaging the ACOG Fellows of Tomorrow,” recognizing District VIII’s staunch advocacy of Junior Fellow and medical student involvement in the organization.
“Advocacy in Women’s Health” organizers and attendees
The section’s sponsorship of medical students to attend ACOG events has helped confirm their interests in the field of ob-gyn. Devon Rasmussen and Jennifer Yan attended ACOG meetings in 2012 and described their experiences as inspirational. The following year, they matched with their first-choice ob-gyn residency programs.
Michael Hsiao attended the 2013 Annual District Meeting in Maui, HI, and called it one of his top three most exciting experiences in medical school so far. The other two experiences were his first delivery and recognizing twin-twin transfusion syndrome on an ultrasound. He plans to apply for ob-gyn residency programs when he finishes medical school next spring.
Michael was particularly struck by ACOG’s role in patient advocacy and how little British Columbia medical students learn about the topic in school. To this end, he was moved to organize a Canadian Federation of Medical Students’ educational evening titled “Advocacy in Women’s Health” shortly after the ADM. Speakers were Brian Fitzsimmons, MD, immediate past section chair, and me.
Dr. Fitzsimmons spoke about the moral imperative of women’s reproductive choice and the problems surrounding this issue locally and internationally. I spoke about accountability—the importance of analyzing and acting on health outcomes to improve patient safety and care.
We look forward to the energy, enthusiasm, and ideas brought to the section by our “Fellows of Tomorrow.”
Eduardo Cordova, MD, section chair
The new Central America Section officers are:
- Eduardo Cordova, MD, chair, El Salvador
- Floridalma Rivas, MD, vice chair, Nicaragua
- Flory Gonzalez, MD, secretary, Costa Rica
- Cesar Reyes, MD, treasurer, Guatemala
- Tomas Arias, MD, vocal 1, Panama
- Ruben Dario Fernandez, MD, vocal 2, Honduras
The officers held their first meeting during the Central American Federation of Associations and Societies of Obstetrics and Gynecology Meeting in Guatemala in March. We discussed how to increase participation of section members in district and national ACOG activities and how to promote Fellow and Junior Fellow section membership. We also talked about improving the relationship between section Fellows and Junior Fellows and ideas for new activities and sessions to offer in Spanish during ACOG meetings for Latin American sections.
Kimberly D. Warner, MD, section chair
The Colorado Section had a tremendous presence at the State Capitol this year. We hosted a wildly successful Resident Lobby Day, with 12 legislators and about 20 residents present. Lauren Miller, MD, section Junior Fellow chair, Steven C. Holt, MD, section vice chair and legislative chair, and Dick Brown, our lobbyist, planned this event.
Two major bills being monitored this session focus on breast density notification and cost containment. A few anti-abortion and personhood-like bills have not gained any traction.
The dense breast notification bill requires that each mammography report provided to a patient include information that identifies the patient’s breast tissue classification based on the breast imaging reporting and data system established by the American College of Radiology. If the health care facility that performed the mammography determines that a patient has dense breast tissue, the facility is required to notify the patient of the determination using specific language. The section has many concerns with this bill, including creating unnecessary fear in patients and the lack of evidence around offering any other screening tests instead of or in follow-up to dense breast notification.
The cost containment bill creates the Colorado Commission on Affordable Health Care and tasks the commission with studying and making recommendations regarding health care costs, focusing on evidence-based cost controls, access, and quality of care. The governor and legislative leadership from both houses and parties are to appoint the 12-member commission, assuring representation from across the state with expertise in various subject areas, including health care administration, finance, delivery, and consumption.
Additionally, the commissioner of insurance, the executive directors of the departments of public health, environment, human services, health care policy, and finance, and an administrator from the all-payer health claims database are to serve as ex officio, nonvoting members of the commission. The commission would make recommendations regarding legislative and regulatory modifications that could make health care affordable while improving access and quality of health care.
The Colorado Section Annual Summer Educational Symposium will be held in Vail, June 13–14, at the beautiful Sonnenalp Resort. Please join us!
Lori E. Kamemoto, MD, MPH, section chair
The 26th Annual Hawaii Section Ob-Gyn Update Meeting was held November 9–11, 2013. It was a successful education meeting that was highly rated by attendees and financially solvent. The 27th Annual Hawaii Section Ob-Gyn Update Meeting will be held November 8–10, 2014, at the St. Regis Princeville Resort overlooking beautiful Hanalei Bay on Kauai. Everyone is welcome!
The Hawaii Section held its Annual Dinner Meeting on April 9. We hosted speakers on accountable care organizations and the Affordable Care Act. The dinner is free to our members.
The Hawaii Legislature was in session from January to May. Bills of interest include a home birth safety bill, which was not passed. The section continues to work on this important issue. A bill that would establish a maternal mortality review panel in Hawaii passed the Senate and one House Committee in 2013. It was still alive during the 2014 session, but did not pass. Bills to establish an infant mortality board also did not pass.
Multiple bills exempting breastfeeding mothers from jury duty were introduced. The section submitted testimony in support of the bills. One of the bills passed the Senate and the House, but it was held up in conference committee. The section also submitted testimony in support of reinstating the Department of Health Child Death Review positions, which would provide administrative support for a maternal mortality review panel.
The Hawaii Section held its first Legislative Day on February 14. Seventeen people attended, including Fellows, Junior Fellows in practice, and residents. The half-day event started with lectures and discussions, which were followed by scheduled appointments and cold calls with legislators.
Our legislative agenda has sufficiently grown to the point where we felt we would benefit from a part-time lobbyist. Therefore, the Hawaii Section hired its first lobbyist, Lauren Zirbel, who started this session. We are lucky to have her on board as she has a lot of legislative experience in addition to medical organization experience. She has been helpful in providing valuable advice and administrative support to the Hawaii Section Legislative Committee.
The Hawaii Section was awarded the Improvement in State Legislative Advocacy Award at the Congressional Leadership Conference in March. Mahalo to the ACOG Government Relations Committee for this award, our District VIII officers for their support, and to our hardworking Legislative Committee for its legislative activities.
The Hawaii Section Practice Subcommittee held its first meeting on July 18, 2013, and has held monthly meetings since then. This subcommittee works on practice issues of importance to our members.
The subcommittee brainstormed and hosted an ICD-10 coding practicum on February 15. It was an all-day session with lectures and practice problems. The event had 175 registrants, which included physicians, nurse practitioners, and office staff from Hawaii and Guam. We surveyed attendees about possible insurance problems and will try to use this data to approach insurance companies in the future.
Rosie Monardo, MD, section Junior Fellow vice chair, is working with University of Hawaii faculty on health insurance coverage for the provision of long-acting reversible contraception postpartum and with other procedures. They are putting together materials to present to insurance companies. The Hawaii Section plans to help arrange meetings and supports this issue.
Thomas Shieh, MD, the section’s Guam representative, has worked for years on expanding the provision of epidural anesthesia in labor on the island. As a result, the hospital there has recently started to provide it. However, Guam insurance companies, including Guam Medicaid, do not support payment for epidurals in labor, saying they are not medically necessary. We have been in contact with ACOG and district leaders to formulate a plan to support payment for this service.
Dr. Shieh was nominated for the ACOG International Service Award. As president of the Guam Medical Association, Dr. Shieh planned and attended several multi-disciplinary medical missions to provide medical relief for the victims of Philippine Typhoon Haiyan. On his first medical mission tour, he was accompanied by John Lee, MD, section treasurer. We are very proud of both of them for their commitments to helping others. Dr. Shieh also was recently honored with Guam’s 2014 Small Business Association Person of the Year Award for his many community service activities. He will represent Guam at their annual award ceremony at the White House later this year. Congratulations, Dr. Shieh!
The Hawaii Section continues to be involved in community committees and meetings to improve women’s health care. Members have participated in meetings with the National Governors Association Learning Network on Improving Birth Outcomes; Hawaii Pregnancy Risk Assessment Monitoring System Board; Hawaii Department of Health Collaborative Health Initiative; Hawaii Medical Service Association; Hawaii Women’s Coalition; and Hawaii State Commission on the Status of Women.
Steve W. Robison, MD, section chair
Greetings from the Gem State! The past six months have been a time of transition for the Idaho Section. We would like to welcome Cynthia R. Hayes, MD, as the new section vice chair. I have spent time learning my responsibilities as section chair.
I had the opportunity to attend the Montana Section Meeting in January in Big Sky. The meeting was informative, and the skiing was great. I would like to look at hosting a combined Idaho and Montana Section Meeting next year.
I also attended the Congressional Leadership Conference in March in Washington, DC. It was an excellent meeting that taught me about the legislative process. I met with the staff of our Idaho senators and representatives to discuss relevant issues related to women’s health. I hope more of our members can participate in this meeting in the future.
I have established contact with some of the legislators in Idaho. To my knowledge, there aren’t any current major legislative issues at the state level that would have an impact on women’s health.
Tyler J. Bradford, MD, section chair
Did you know that Montana is the home of the world’s shortest river? The Roe River spans just 200 feet, although there is fierce competition with our fellow Oregonians and the D River in Lincoln City.
Montana now has a formal maternal mortality review process, thanks to the work of William J. Peters, MD, past District VIII chair and past section chair. Dr. Peters spearheaded efforts to pass a bill amending the state’s Fetal, Infant, and Child Mortality Review Prevention Act to include maternal mortality review. The section received the Accomplishment in State Legislative Advocacy Award at the Congressional Leadership Conference in March for its work on this issue. The Maternal Mortality Review Working Group will give their first report to the Legislature in June.
Shaun J. Gillis, MD, section vice chair, organized another successful Montana Section Meeting in January in Big Sky. We plan to continue these meetings, as they have been a great way to stay educated and network with the community of ob-gyns across the state.
Timothy C. McFarren, MD, section chair
Nevada’s health insurance exchange has been troubled. Signups for private insurance are lagging due to persistent computer and billing errors. Meanwhile, Nevada’s Medicaid enrollments have soared. Approximately 150,000 new people are now covered through managed care plans under Medicaid. Though, this increase has presented its own problems. There is a backlog of 60,000 applications because the state doesn’t have enough staff to process them. Additionally, there are not enough providers to see all the new Medicaid patients. Many patients may still use the emergency room for their health care needs. That state expects 300,000 people to be covered by Medicaid by the end of next year.
Sharon T. Phelan, MD, section chair
The New Mexico Legislature was in session for just 30 days this year. Linda Siegle, section lobbyist, continues to be effective in helping our members promote various bills. The Legislature passed a bill requiring the addition of newborn screening for cyanotic congenital heart disease via oxygen saturation screening prior to discharge from the hospital. We petitioned against this bill in support of pediatric providers who were concerned about the high rate of false positive results. The section got the commitment of the New Mexico Department of Health to wait to implement the requirement until a safe, effective triage structure is created.
New Mexico Section Lobby Day participants
Bills offering gross receipt tax deductions for health care practitioners for payments received through a health care insurer or managed care provider and comprehensive programming to prevent births among adolescents also did not pass.
As part of the legislative session, we hosted the Fourth Annual New Mexico Section Lobby Day at the New Mexico Roundhouse in January. The section sponsored four members to attend the Congressional Leadership Conference in Washington, DC, in March. Tony Ogburn, MD, also attended as District VIII legislative chair.
Over the past six months, the New Mexico Section has worked hard with representatives from the New Mexico Department of Health, New Mexico Hospital Association Hospital Engagement Network, and providers from pediatrics, family medicine, midwifery, and ob-gyn to establish a perinatal collaborative. We held an initial kick-off meeting in September 2013 with Barbara Rose, MPH, Ohio Perinatal Quality Collaborative program director. After much discussion and debate, we chose two primary topics to focus on—eliminating early elective deliveries and reducing neonatal abstinence syndrome.
New Mexico Section members work to establish a perinatal collaborative.
The section sponsored a bill to provide funding to establish a collaborative. Our efforts were unsuccessful, but the bill will be reintroduced next year. Overall, the feedback we received from legislators on this issue was positive.
The Annual Women’s Health Symposium was held February 21–22 as a collaboration of the New Mexico Section and the New Mexico chapter of the American College of Nurse-Midwives. The keynote speakers were Jeffrey F. Peipert, MD, PhD, from the University of St. Louis in Missouri, and Lisa Low, PhD, CNM from University of Michigan in Ann Arbor. Dr. Peipert spoke about long-acting reversible contraceptives, and Dr. Low spoke about physiologic approaches to labor and birth. Our Junior Fellows hosted a Stump the Professors session that was well received and a lot of fun.
Eve Espey, MD, MPH, was recently selected as the new chair of ob-gyn for the University of New Mexico School of Medicine. Dr. Ogburn is the Region 5 CREOG Council representative, as well as incoming CREOG chair. Suzanne Burlone, MD, is the new District VIII Junior Fellow legislative chair. William F. Rayburn, MD, MBA, has assumed the position of associate dean of CME for the University of New Mexico School of Medicine.
Marguerite P. Cohen, MD, section chair
The Oregon Section had four Fellows and three Junior Fellows attend the Congressional Leadership Conference this year. Participants met with Sen. Jeff Merkley (D-OR), Rep. Suzanne Bonamici (D-OR), and staff for six of the seven members of Oregon’s congressional delegation. The conference inspired two of our Junior Fellows to work on developing a section lobby day for the 2015 session of the Oregon Legislature.
As you probably know, Oregon has been working on Medicaid expansion and health reform for more than 20 years. The creation of the Oregon Health Plan was innovative, allowing women to access prenatal care and markedly decreasing the number of obstetric patients in our state who were truly uninsured. We also prided ourselves on being part of the Silicon Forest, ready to have our own state exchange, Cover Oregon—an online marketplace where individuals can compare and contrast insurance policies. Consumers could then have their eligibility for federal subsidies assessed and shop for the insurance policy that would match their needs.
Oregon expected to lead the nation in expansion of access to health insurance promised by the Affordable Care Act. Oregon contracted Oracle to build the online marketplace. We greeted October 1, 2013, with great hopes that were soon dashed. The website was not ready to be used, and, in fact, it was not functioning at all. For a time, we were even ranked number 49 out of 50 in states getting the uninsured signed up. With time, the ability of consumers to assess insurance options has improved, but they can only sign up for policies with a paper application. Oregon officials recently decided to discontinue Cover Oregon and switch to the federal system. They acknowledged that the state exchange was too expensive and too troubled to fix.
So is the Affordable Care Act a success or a failure? Without a doubt, the act has improved Oregonians’ access to health insurance, especially for those with preexisting medical conditions that prevented them from buying insurance on the individual market. Young people are able to remain on their parent’s policies until age 26. And the guarantees for annual women’s wellness exams and contraception will benefit ob-gyns.
In the past, the Oregon Legislature was in session every other year for about six months, with additional special sessions as needed for specific issues. But three years ago, the state instituted a short session lasting five weeks starting in February every other year. In this year’s short session, there were relatively few bills introduced that would impact the practice of medicine our state.
One bill dealt with legislative interference, prohibiting public bodies from adopting rules, enacting ordinances, or instituting policies that require health care practitioners to provide medically inaccurate information or medical services inconsistent with appropriate and evidence-based standards or that prohibit health care practitioners from providing medical services consistent with appropriate and evidence-based standards. Unfortunately, the bill languished in committee at the end of the session.
Another bill requiring insurers to provide full coverage of diabetes without any copays for women who are pregnant was passed.
The 22nd Annual Oregon Section Meeting was held in Portland on April 12 at the Oregon Medical Association Foundation Educational Center. For many years, we held the Annual Meeting at the Sunriver Resort in Central Oregon. Because of declining enrollment, it became economically unfeasible to continue to hold the meeting there.
The meeting was also changed to a compressed, single-day format. Local experts spoke on the Choosing Wisely campaign, management of the benign fallopian tube for risk reduction for serous cancers, classification of lower genital tract neoplasia, ova preservation for aging patients and those undergoing chemotherapy, quality measurement in obstetrics, facilitating home to hospital transfers, the role of simulation in training residents and practicing physicians, and an update on the state of the Oregon health insurance exchange.
The meeting was well attended, fiscally sound, and a grand way to spend a sunny spring day in Portland. We will begin planning next year’s meeting soon. Please consider coming to Portland for an exciting weekend of education and fellowship!
W. Lawrence Warner, MD, section chair
The Utah Section sponsors three educational dinner events each year. Our first dinner of the year was on January 16 and featured Alan T.N. Tita, MD, PhD, from the University of Alabama at Birmingham, who gave a presentation titled “Care of the Obese Gravida: Challenges and Opportunities.”
February 5 was Doctor’s Day at the Utah State Legislature, and I represented our section. Attendees met with state senators and representatives to ask for their support on three bills regarding:
- Pharmaceutical dispensing of non-scheduled drugs in physicians’ offices
- Charity care amendments to expand the Good Samaritan Act
- The requirement of health care providers to clearly identify their license type in a clinical setting and prohibition of any deceptive or misleading representations by providers
A bill to repeal a law that was passed last year lowering the definition of stillbirth from 20 weeks’ gestation to 16 weeks will be introduced. The law was introduced and passed in the last moments of the 2013 legislative session and was not well thought out as to impact and cost. The Utah Medical Association and the Utah Section had no opportunity for input prior to its passing. Once we had the opportunity to give our input and educate legislators, the sponsor of the original bill agreed to sponsor the repeal.
In preparation for the 2014 legislative session, Christopher V. Hutchison, MD, section vice chair, has been representing our section at the Utah Medical Association Legislative Committee meetings.
We are still working on our outreach initiative to rural hospitals in the state. The most recent email we sent was an outline summary of the ACOG Task Force Report on Hypertension in Pregnancy. Since the last district meeting, I visited the hospital in Kanab, which is on the Utah-Arizona border. We continue to receive notes of appreciation from these hospitals for our efforts to keep them up to date with best practices in ob-gyn.
At the encouragement of District VIII leadership, the section applied for a Council of District Chairs Service Award for our outreach efforts. We are pleased and honored to have received this award. It was presented to the section at the Annual Clinical Meeting in Chicago.
Finally, at the 2013 Annual District Meeting in Maui, I shared a copy of the Emergency Physician Reference Notebook that I put together for the hospital where I practice. This simple idea has gained significant traction since then. The notebook provides a quick, easy reference to hospital protocols and best practices, thus encouraging minimization of variation among practitioners.
Judith A. Jacobsen, MD, section chair
The Washington Section had a busy six months, planning the Washington State Legislative Day with ferocity. Our new project this year was the creation and filming of an information video, “Lobbying: The Good, the Bad, and the Ugly.” Overall, the Legislative Day was a huge success. We had eight new attendees, with many private doctors now interested in getting involved.
Washington State Legislative Day participants
The legislative focus was again to gain support for the Reproductive Parity Act. This legislation would uphold the Washington State law requiring that any insurance company providing maternity care also be required to cover pregnancy termination. The act robustly passed in the House, but for the third year in a row was held up by the Republican-controlled Senate Health Committee.
The national tide of proposed laws requiring breast density notification also arrived in Washington, and we opposed the legislation. ACOG national was helpful with data and legislative toolkits. This bill passed in the Senate, but died in the House. Budget issues in this session overrode other issues getting attention.
The section is developing an electronic welcome packet to send to new Fellows entering practice in Washington. For now, we are relying on word of mouth about new doctors in our state, but I am looking for a way to have ACOG national automatically notify us. The welcome packet includes links to the Washington State Medical Association enrollment site and information about the Washington State Obstetrical Association (WSOA) and the Seattle Gynecological Society (SGS). We financially support the WSOA and SGS yearly conferences. They serve as our educational meetings, and we hold our yearly business meeting at the WSOA conference.
The Washington Section will be nominating a candidate for the ACOG International Service Award. Stayed tuned for more updates.
Susan M. Sheridan, MD, section chair
Greetings from Wyoming! We are excitedly escaping a long, cold, and windy winter here and have high hopes for the spring.
I am sad to report that Lisa Williams, MD, resigned as section vice chair due to the demands of her private practice. She previously served as section chair. Dr. Williams is a solo practitioner in a busy community, and her time and commitment for several years was greatly appreciated. The section is currently seeking a new vice chair. I have placed a few phone calls and will be sending an email to section members to elicit interest. We are few in numbers here in Wyoming, but we are recruiting interested Fellows who want to get involved and may not know how to get started. In the meantime, I have committed to continuing as section chair for another term.
The section has made significant progress with Wyoming Medicaid in regards to its policy on induction of labor. The current policy, which expired in July 2013, stated that no inductions would be allowed without a medical indication. Furthermore, medical indications were not delineated. The policy put restrictions on elective or social inductions after 39 weeks’ gestation. In a rural state like Wyoming, those restrictions can place a burden on patients and their families and, particularly in rural areas with limited practitioners, on physicians.
With the help of a political consultant, we were able to address the issue. The consultant had meetings with the director of the Wyoming Department of Health, who is aware of concerns regarding the policy. Meetings with the state director and medical director of Wyoming Medicaid were also held.
We recently presented information, including new studies and ACOG Committee Opinions, to the physician advisory group for Medicaid. We discussed the importance of limiting inductions prior to 39 weeks to those with clear medical indications, while revising the policy to remove the limitations on inductions after 39 weeks. Amid much discussion regarding the cost of inductions, risks and benefits of inductions, and legal ramifications for Medicaid, there was unanimous agreement to revise the policy in our favor. This has been my first encounter with effecting policy change, and I was elated with the outcome. Our political consultant was an enormous help in this endeavor. In the future, her expertise may serve the section well, and I hope to advocate for financial support should the need arise.