Special Contributor
Ronald Uva, MD, FACOG
Defending the Specialty:One Ob-Gyn's Story
As an ACOG Fellow for over thirty years and as District II Legislative Chair and incoming Vice Chair, it has been my duty and privilege to lead the fight for tort reform.
With the passion that I have for delivering babies, the pride I have in my profession and the empowerment beholden to me by the women I serve, I strive to affect tort reform and to maintain the respect for our specialty that it so richly deserves. My practice in Oswego certainly is a microcosm of the overarching problems that we face throughout our Empire State: we cannot recruit, we retire early, we restructure our practices to avoid liability exposure, and sadly relocate to other states that place a premium on our expertise and devotion.
Our members have seen their premiums rise astronomically secondary to awards that have no bearing, in most cases, to negligence. With a new governor who expressed an implicit desire to change the landscape, we felt that we were finally on the cusp of meaningful reform. To trim the budget, Governor Cuomo realized that he needed Medicaid Redesign and that this redesign was predicated on the savings that would be realized through tort reform. The design plan put forth, which was ultimately accepted by ACOG, was an indemnity fund for neurologic injury and a cap on non economic damages of $250,000. Having met with Commissioner of Health Shah, ACOG representatives and I were reassured that these two proposals were the governor’s prime objective.
I met with the Editorial Board of the Syracuse Post Standard along with a representative of MSSNY and a representative of the Liability Reform Alliance of New York to press our case. The Editorial Board “got it” and indeed published a piece that exposed the trial bar’s opposition to change as protecting its own interests at the expense of the women in New York State. Indeed, the president of the trial bar sent a message to his members gloating over the defeat of our initiatives and praising how their PRIVATE meeting with Cuomo, Skelos and Silver won the day for them. We had no private meetings.
The final version of the budget had no cap and a version of indemnity that helps the hospitals but may not lower our malpractice rates. Despite thousands of phone calls to our legislators and thousands of signatories of our petitions, the will of the people was ignored. The frustration and rage of our membership is intense and palpable and our ability to deliver care compromised.
I assure you that I have not stopped fighting and I plead with the membership to not give up. Become engaged and defend the specialty that you love. The women in our lives: mothers, wives, daughters and granddaughters deserve no less.
For more details on New York’s final budget, Click Here for the Albany Connection portion of the newsletter.
From the Executive Director
Donna Montalto, MPP
Taking a Stand...On Behalf of New York Women
Given the current political landscape in Albany, on April 4 we convened a conference call of District II’s ob-gyn members. During that call, the Executive Committee and the Legislative Committee outlined the status of medical liability reform. (For details, see the Albany Connection portion of the newsletter). We received a great deal of feedback from members on how District II should move forward. By the end of the call, it was determined that we would keep the pressure on lawmakers through a new campaign.
While the campaign is still in the planning stages, I can tell you that we have already sent letters to Governor Andrew Cuomo, Senate Majority Leader Dean Skelos and Assembly Speaker Sheldon Silver. The letters express District II’s outrage over lawmakers’ total disregard for making meaningful medical liability reform a reality in New York State – and what their inaction means for ob-gyns and the patients they serve. District II will disseminate the letters to the media and the public to further raise awareness about this issue. In addition, we plan to launch a new website that will educate, inform and – most importantly – empower women to demand that lawmakers fix the broken system today – so they have ob-gyns tomorrow. We are currently exploring various public relations firms to help us launch the site, while complimenting it with other campaign components ranging from posters to petitions.
If you would like to get involved with our campaign, please call us at (518) 436-3461 or send an email to info@ny.acog.org. We hope you will join District II as we take a stand…on behalf of New York women.
 Albany Connection
Tort Reform Defeated in
2011-12 Budget
On Thursday, March 30, Governor Cuomo and legislative leaders passed the on-time $132.5 billion budget. This one year budget will eliminate a $10 billion deficit in New York State.
MRT Budget Proposals
District II lobbied the Executive Branch, Legislature, and the Commissioner of Health in SUPPORT of a $250,000 CAP on non-economic damages. This proposal was in Governor Cuomo’s original budget bill that was recommended by his Medicaid Redesign Team (MRT).
The CAP proposal was omitted from the final version of Governor Cuomo’s budget and a New York State Medical Indemnity Fund for neurologically impaired infants passed within the budget and was signed into law. Unfortunately this new indemnity fund for birth related impairments is NOT ACOG’s long sought-after neurologically impaired infant (no-fault) proposal. Under this new indemnity fund program, impaired newborn cases would proceed through the court system and still require a finding of negligence/causation. The fund offers a source of revenue (other than physicians and hospital insurance carriers) to pay for future health care costs associated with birth related neurological injuries. Presumably the indemnity fund will reduce premium costs for physicians and hospitals by lowering medical malpractice insurance carrier’s exposure to the payment of lifelong medical care; health care is often a very large portion of the pay-outs for birth related injury lawsuits. According to advocates for this new law, the long term goal of the Medical Indemnity Fund is to make neurologically impaired infant cases less appropriately adjudicated in the civil justice system.
There are a multitude of details to be implemented with this indemnity fund but the strong commitment by the state to ameliorate the liability crisis for the obstetricians and hospitals must not be overlooked.
Hospital Quality Initiative in the State Budget
ACOG District II has lobbied the State for the adoption and implementation of a statewide quality agenda for perinatal care which would identify essential components of an effective hospital perinatal safety program. Click Here for letter to Commissioner Shah dated April 13, 2011. District II will be asked to participate in this new statewide hospital quality initiative along with the new Obstetrical Patient Safety Workgroup. The workgroup will be comprised of medical, hospital and academic experts and other stakeholders chosen by the health commissioner.
The New York State quality initiative will work to improve obstetrical care outcomes and quality of care by identifying and implementing evidence based practices and clinical protocols that can be standardized and adopted by hospitals.
Many patient safety initiatives have already been implemented by ACOG District II including most recently our team training programs to teach the NICHD standardized nomenclature for electric fetal monitoring training and certification.
Other budget highlights impacting women’s health include:
Rates for Teaching General Hospitals
State reimbursement for teaching general hospitals currently includes reimbursements for direct and indirect graduate medical education. New state regulations may now incorporate quality related measures pertaining to the inappropriate use of certain medical procedures including, cesarean deliveries.
The new regulations shall now require reports and information to assess the cost, quality and health system needs for medical education funding. Such regulations may impose a fee on general hospitals sufficient to cover an amount needed to audit the institutions cost reports.
For Medicaid Stat Facts in the 2011-12 Budget, Click Here.
Medical Education
Colorectal Cancer Materials in YOUR Office this Month!
Fellows and Junior Fellows in Practice: Be on the lookout this month for District II’s latest colorectal cancer awareness materials – including a patient/provider questionnaire, as well as important education for patients on the risk factors associated with colorectal cancer. Until then, promote proper colorectal health within your practice! Click Here to view the Colorectal Cancer chapter of the ACOG District II Focus on Female Cancers Resource Guide.
Expanding the Well-Woman Educational Initiative
District II continues to expand its Well-Woman Educational Initiative (WWEI) which began in September 2010. Educational modules for ob-gyns and their patients on immunizations, smoking cessation, and colorectal cancer are currently underway. District II has applied for grant funding to address several other topics – osteoporosis, thyroid disease management, healthy weight, and menopause. Stay tuned to ACOG Update over the coming months to find out how you can become part of these potential projects.
Smoking Cessation Survey: Thank You!
We’d like to thank the first 200 participants who completed our smoking cessation survey in March! We are happy to report that over 500 members participated and the results were shared with our newly created Smoking Cessation Task Force. Click Here to view the list of the 200 winners who received a $5 gift card from Starbucks.
DII Patient Safety Opportunity
District II is anxiously awaiting a funding decision on an exciting, cutting edge patient safety initiative. In December 2010, District II applied for funding through the New York State Health Foundation that will allow for the implementation of the MoreOB program at five selected obstetrical hospitals. The long-term comprehensive patient safety program addresses preventable adverse events that occur in labor and delivery and have identifiable causes. This is an opportune time for a program such as this, as the state budget includes extensive provisions to increase obstetric patient safety throughout New York over the next year.
ACOG: MakenaTM Price Reduction is Inadequate
A new FDA-approved drug to prevent preterm birth in certain high-risk women, Makena first fueled debate over its pricing strategy. On April 1, KV Pharmaceuticals, the drug’s manufacturer, reduced the drug’s cost from $1,500 per dose to $690 per dose. ACOG responded by saying the price reduction is inadequate. To read the press statement, Click Here.
In addition, KV Pharmaceuticals suffered criticism last month from compounding pharmacies that had been providing 17α hydroxyprogesterone caproate at a low cost for many years. The FDA has since clarified how the compounded version of 17P should be administered and will continue to allow compounding pharmacies to maintain their practices.
To read the FDA’s statement, Click Here.
Honored in Moscow
Richard Waldman, MD, FACOG
President, ACOG
 Finance
District II Audits Completed
For the year ended December 31, 2010, we again engaged the firm of Shallo, Calluscio, Bianchi & Fucito CPAs PC to do our audit work. This year we had separate audits to complete – one for the American College and one for the American Congress of Ob-Gyn. Upon completion, an unqualified (or clean) audit was issued for each entity. In addition, a separate report was issued with regard to the existing internal controls for District II and compliance with certain provisions of laws, regulations, contracts, and grants. These reports state that there were no material weaknesses in the identified deficiencies found, and there were no instances of non-compliance or other matters for either entity.
Membership & Meetings
Call for Nominations
Nominations are currently being accepted for the positions of Chair and Vice Chair for the following District II Sections: Section 1 (Manhattan), Section 4 (Long Island), and Section 7 (Hudson Valley). The terms of office for Section Chair and Vice Chair are three years, beginning in November 2012 and ending in October 2015.
By June 1, 2011 Fellows from these Sections who are interested in running for these positions should submit the items listed below to District II via email, info@ny.acog.org, or mail, ACOG District II, attn: Carolyn Barie, Director, Membership and Meetings Services, 152 Washington Ave., Albany, NY 12210.
- A letter stating the office or offices for which they would like to be a candidate;
- A one-page summary statement of their curriculum vitae (Click Here for a sample of this format); and
- A complete curriculum vitae.
Junior Fellow District Officer Elections
District II is seeking interested and qualified Junior Fellows for Vice Chair and Secretary-Treasurer positions for the 2011-2012 term. The Junior Fellow Vice Chair serves a three-year term: one year as Vice Chair, one year as Chair, and one year as Immediate Past Chair. The Secretary-Treasurer serves a one-year term. Terms begin at the conclusion of the 2011 Annual Fall District Meeting. The deadline for submissions is June 1, 2011. Click Here for more information.
Junior Fellow Section Officers Reflect on SOLD & CLC Experience
My name is Omar F. Duenas, MD, a resident at Bronx Lebanon Hospital Center and also a Junior Fellow member of ACOG. As a section officer for the Bronx Section of District II, I had the opportunity to participate in the Section Orientation Leadership Development (SOLD) program and Congressional Leadership Conference (CLC) held in Washington. I never imagined that just being a resident could allow me the opportunity to have a voice and represent the interest of all of us with our Congress and Senate Representatives. The medicine in this country is going through a series of changes that requires of all of our efforts. I feel fortunate and proud that ACOG helps me to serve my colleagues and I encourage all of you to participate and be involved in our efforts. Thank you ACOG!
My name is Rasha Allam, MD, a resident at SUNY Upstate Medical Center and the current Junior Fellow Vice Chair for the Syracuse Section of District II. I would like to extend my sincere appreciation to everybody who helped in making SOLD & CLC happen. Thank you also for giving the Junior Fellows the opportunity to attend such wonderful events. For the first time since I started my residency (four years ago), I feel that I belong to a big wonderful family (MY ACOG). We met with the people who we only hear their names or see their pictures, we were able to make friends from districts all over the country, we learned a big deal of political information that will definitely help us to serve our ACOG community better in the future.
Attention Medical Students
Interested in attending a District II meeting? The John Gibbons Medical Student Travel Award is available to provide financial help for medical students to attend ACOG meetings. Click Here to see a list of our upcoming meetings. Click Here for more information on the travel award.
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