Advocacy Successes
Physician Advocacy Successes
Good health policy is made with physicians in the discussion.
MSDC, working with its members, partners, and other organizations, has won major policy victories to help its members practice medicine. Below is a sampling of those victories. Do you want to be a vital part of the next policy victory helping improve the health of the District? Contact us today.
Opioid Policy
- MSDC was added to the opioid fund oversight panel by the Council in its legislation authorizing the oversight body
Scope of Practice
- MSDC supported legislation to ban the sale of flavored electronic smoking devices and restrict the sale of electronic smoking devices.
- Working with a coalition, MSDC added funding to the DC budget to support the hiring of more license specialists to help with the delay in processing medical licenses.
Women's Health
- B24-143, to regulate certified midwives, passed the Council with MSDC's support
Health Equity
- Mayor Muriel Bowser signs into law the Electronic Medical Order for Scope of Treatment Registry Amendment Act of 2019. The eMOST Registry Amendment Act permits the creation of an electronic database of advanced directive wishes for District residents that can be tied into the health information exchange.
- Mayor Bowser signs into law the School Sunscreen Safety Temporary Amendment Act of 2019. The bill permits students to bring and apply sunscreen during the 2019-2020 school year.
- MSDC comments on the importance of funding United Medical Center (UMC) and health facilities in Wards 7 and 8 in the mayor's budget. Those comments are used almost verbatim in CM Trayon White's comments advocating for funding of United Medical Center.
Scope of Practice
- DC Health publishes draft regulations removing the 3 mandatory CME hours for HIV/AIDS awareness and replaces them with a requirement to fulfill 10% of mandatory CME hours with a topic from a public health priority list. DC Health then waived the requirement for 2020.
- The Strengthening Reproductive Health Protections Act of 2020 is signed into law with MSDC support. The bill prohibits government interference in reproductive decisions between a patient and doctor, and prohibits employers from penalizing physicians for practicing reproductive medicine outside of their work hours.
- The Mayor's Commission on Healthcare Systems Transformation releases its final recommendations. One recommendation is for the District to explore options to make providing health care more affordable, including financial relief for higher malpractice insurance rates.
- The Council removes "telephone" from the list of prohibited types of telemedicine to allow physicians and other providers to be reimbursed for telephone telemedicine appointments after MSDC and health community advocacy.
- MSDC worked with the Council to modify onerous language in the Health Care Reporting Amendment Act that potentially would have penalized physicians from seeking help for substance abuse or addiction issues.
Opioid/Drug Policy
- The Department of Health Care Finance (DHCF) waives prior authorization for key medication assisted treatments (MAT) treating substance use disorder patients in Medicaid.
- The Mayor signed into law The Access to Biosimilars Amendment Act of 2019, a top MSDC priority as it would help prescribers to prescribe more cost-effective drugs for patients.
Behavioral Health
- The Behavioral Health Parity Act of 2017, a major priority for MSDC and DCPA, officially becomes law. The legislation requires all health benefit plans offered by an insurance carrier to meet the federal requirements of the Wellstone/Domenici Mental Health Parity and Addiction Equity Act of 2008.
Health Equity
- The District Council passes B22-1001, The Health Insurance Marketplace Improvement Amendment Act of 2018. The bill prohibits the sale of Short Term, Limited Duration health plans and Association Health Plans (AHPs) in the DC Health Benefits Exchange.
Scope of Practice
- DC joins 28 other states in the Interstate Medical Licensure Compact with B22-177 becoming law. The IMLC is designed to ease physician licensure in multiple states.
Women's Health
- The Maternal Mortality Review Committee is established by law. The Committee is responsible for finding solutions to maternal health crisis in the District. District physicians are an important part of this vital committee.
- B22-106, The Defending Access to Women's Health Care Services Amendment Act, becomes law. The act requires insurers to cover health care services like breast cancer screening and STI screenings without cost-sharing.
Opioid Policy
- Right before the Council adjourned for the session, it passed B21-32, the Specialty Drug Copayment Limitation Act. The bill limits cost shifting by payers for prescription drugs.
Behavioral Health
- B21-0007 passes the Council. The Behavioral Health Coordination of Care Amendment Act of 2016 permitted the disclosing of mental health information between a mental health facility and the health professional caring for the patient.
Women's Health
- MSDC was proud to have worked on B21-20. The law requires payers to cover up to 12 months of prescription contraception, advancing women's health and equality.
JAMA Surgery - Female Surgeons Face Higher Risk of Infertility, Pregnancy Complications
A new study in JAMA Surgery and covered by The New York Times highlights the challenges female surgeons of reproductive age face in having children.
The study notes that currently 38% of surgery residents and 21% of practicing surgeons in the U.S. are women, with medical school graduate rates approaching sex parity. It also notes in the introduction that physicians face pressure to delay having children until after training, which for almost all surgeons is at "advanced maternal age". Other studies have shown that female surgeons are more likely to be childless, but there is little research on infertility and complications.
The study was led by Dr. Eugene Kim, who had a female surgeon colleague that suffered life-threatening pregnancy complications. The survey study included 850 surgeons (692 women and 158 men). The results showed female surgeons had twice the rate of pregnancy loss as the general population (42%). Compared to the male surgeons, female surgeons were more likely to delay having children due to their training, and had fewer children overall, and were more likely to use assisted reproductive technology.
The study also compared female surgeons with female partners of male surgeons to study if societal factors accounted for pregnancy and childbearing struggles. The results found female surgeons were more likely to suffer physical and behavioral setbacks during and after pregnancy than their non-surgeon counterparts. This led the authors to conclude that the physician lifestyle, and not solely societal factors universally impacting women, leads to female surgeons' childbearing struggles. Some of the factors highlighted include:
- Lack of paid leave or maternity leave during training
- Perceived damage to reputation due to absence
- 40+ hours of work weekly causing physical complications
- Prolonged standing with less water and food due to demands ofjob
- Reliance on IVT and ART to conceive
The authors propose three recommendations to address these issues:
1. Training programs should include clear, widely disseminated policies to support pregnant and expecting trainees
2. Institutions and practices should adopt supportive work plans for pregnant physicians and physicians on maternity leave
3. Trainees and physicians should be provided with resources, time, and space to meet their reproductive and childcare needs.
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