Annual Session 2022 Presidential Address
It has truly been a pleasure to serve as President of MSMA this year. I thoroughly enjoyed my years as Speaker of the House of Delegates and considered becoming MSMA President lagniappe, “a little something extra.”
Lagniappe doesn’t always promise to be good, and my year has had successes and disappointments as well as ongoing challenges.
I started the summer of 2021 with cautious optimism.
The COVID 19 vaccine had become available in December 2020 and we had a good response from Mississippians who were most vulnerable. Through the Spring of 2021 there was a welcome decline in COVID cases.
Plans were made to have a “MSMA Mardi Gras” inaugural gala complete with a band, beads, masks and a Second Line parade led by yours truly and her Presidential Prancers.
Our celebratory plans got canceled when the Delta variant hit last summer. Although this was a disappointment, it paled to the devastation caused by the Delta wave. Mississippi’s health care system was burdened well beyond its limits and the true tragedy was that the large majority of the cases and deaths were preventable had more Mississippians been vaccinated.
As a pediatrician, I have been a proponent of vaccines for my entire career, and I am proud that Mississippi leads the nation on childhood vaccination rates due to our strong vaccination laws.
It was a disappointment when the Mississippi Legislature passed a law prohibiting a mandate for COVID-19 vaccination in schools and businesses and also allowed for COVID-19 vaccine exemptions for anyone with a “sincerely held religious objection to receiving the COVID-19 vaccine.” It served as a reminder that the current anti-vaccination sentiment is a threat to the health of our children.
We must continue to do all we can to prevent any weakening of requirements for childhood immunizations.
It was also a disappointment, but not a surprise, that the 2022 Mississippi Legislature passed medical marijuana legislation despite the lack of evidence-based medicine on any true medicinal properties.
As we enter this era of legal marijuana use I do have some concerns that need to be addressed. Caution must be used when allowing women of childbearing age to access marijuana. These women should enter an agreement similar to those who are prescribed Accutane that they will use methods to prevent pregnancy while they use marijuana since we know the multiple deleterious effects of marijuana on the unborn child.
We also need to continue to discourage the use of marijuana products delivered by smoking. The medical community has made great strides in curbing tobacco smoking and the public’s exposure to secondhand smoke, and we must do the same for marijuana. Fortunately, the current law does prohibit smoking marijuana in public, but does not address the significant issue of second-hand smoke with psychotropic properties for children and others in the household. I have had preliminary discussions with Dr. Larry Walker, Interim Director of the National Center for Cannabis Research and Education at the School of Pharmacy at the University of Mississippi, regarding the development of a metered dose inhaler for the delivery of cannabis instead of smoking. I wholeheartedly support Dr. Walker’s efforts and hope MSMA will encourage our lawmakers to invest in his project.
Our biggest legislative success of the 2022 session was the passage of the telemedicine bill permitting physician-to-patient interaction. Telemedicine does not and will not replace in person medical care, but it was a tremendous help and a useful tool during the pandemic and will remain a valuable option in the future.
We were successful in thwarting an effort to grant nurse practitioners independent practice by presenting the findings of the Hattiesburg Clinic study showing increased costs associated with nurse practitioners to the Senate Public Health and Welfare Committee. This was coupled with testimony from Dr. Italo Subbarao, Dean of the William Carey College of Osteopathic Medicine, on their efforts to train primary care physicians to practice in Mississippi and Mrs. Meredith Boston, a nurse practitioner in the Baptist system who outlined the ideal model where she had direct physician supervision and did not have her own patient profile. Chairman Hob Bryan decided not to bring the bill to a vote in committee but did make comments about the minimum retrospective chart review not being adequate supervision. I agree with Chairman Bryan. We must develop standards for physician-nurse practitioner collaboration that goes beyond the current standards.
Physicians are the most qualified to lead the healthcare team and your MSMA constantly reinforces this fact.
But being the most qualified means nothing if you don’t actually get out there and do the leading. Today’s healthcare team has the benefit of well-trained mid-level providers that help physicians do their work. However, as a referring physician. I expect my patients to be seen by the physician leader.
I was able to represent MSMA at some Component Society meetings between COVID waves and I am happy to report that your MSMA does well with DEI (Diversity, Equity and Inclusivity) initiatives that have become a popular societal topic.
MSMA does diversity well. We represent all facets of the field of medicine and we strive to be diverse in our membership.
MSMA is a leader in promoting health equity in Mississippi. At our 2021 Annual Session you were presented the report of the Mississippi Healthcare Coverage Access Review Executive task force.
The task force was formed to explore and pursue a range of viable options to increase access to healthcare for Mississippians, particularly the working poor.
Options identified included a Section 1115 Medicaid demonstration waiver which has been used successfully in Arkansas, Louisiana and West Virginia.
Another option presented by the task force was to amend the current state plan. Mississippi has amended the state plan several times over the past few years to better meet the needs of patients and physicians which makes it a realistic avenue for helping more Mississippians access healthcare.
Mississippi has been saddled with healthcare access issues long before the COVID-19 pandemic. The current landscape continues to demonstrate how urgent and critical the need to increase access to healthcare is in Mississippi. Our working poor still do not have access to healthcare and our rural hospitals are failing. MSMA must continue to work with elected officials, policymakers, and the business community to make this a reality.
We must also engage our lawmakers to reinstate Medicaid postpartum coverage to the 12 months available during the pandemic. This much needed postpartum healthcare was available for two years and should have been continued.
Our organization does have some challenges in the area of inclusivity.
There has been a Board of Trustee medical student position for 20 years and the William Carey College of Osteopathic Medicine has been in existence for over a decade, yet there has never been a William Carey student elected to serve on the Board. I am requesting that the Medical Student Section allow the Nominating committee to alternate between the two schools as they formulate their slate of nominees for student Trustee.
The Council on Constitution and Bylaws has reviewed and revised the bylaws and the House of Delegates will consider their recommendations during this Annual Session. One of the recommendations is to add multiple sections in addition to the three we have currently. I was pleased that they included my suggestion for an Employed Physician Section. Approximately 50% of Mississippi physicians are employed and frequently their healthcare employers emphasize production numbers or shifts worked and not the positive impact physicians provide to the community.
A 2018 AMA study showed that Mississippi physicians support 51,305 jobs and generate $8.2 billion in economic activity.
It is important for MSMA to be a voice for these employed physicians and a dedicated Employed Physician Section is a good start.
I am also pleased that the Publication Committee has agreed to add a Senior Editor position to the Journal staff. This allows our retired editors who wish to continue to contribute to the Journal an avenue to showcase their journalistic talents and be properly recognized.
As my year as MSMA President nears its end, I would like to thank my family, friends and the MSMA staff that have supported me this year. I leave you with a quote from one of my favorite musicals, Wicked. In the duet with Glinda and Elphaba they tell each other “because I knew you, I have been changed for good.”
I have; thank you MSMA!