To:       GAFP Resident and Student Members

From: Jeff Stone, MD, MHA, MBA, FAAFP, President

There are many ways that our Georgia family medicine residents and medical students can serve at a national level.   All of these opportunities requires the permission of your residency director, or school advisor and a nomination letter from the Georgia Chapter.

Only one GAFP resident and student will be nominated for each potential appointment.  Please review the options and positions available to you and submit an email to the GAFP (ffulton@gafp.org) no later than July 20^th – to be considered for nomination.  Note that priority is given to residents and students who have served at the local/chapter level.

Please answer the following questions:

1. Name/Year in Residency/Residency Program
2. Please rank the commission or other appointment that you wish to be considered (up to 3)
3. Please list the expertise you have to apply for these appointments.
4. Do you have permission from your program to apply?

Residents:  https://www.aafp.org/membership/involve/lead/students-residents/resident/aafp-commissions-resident.html

Medical Students:  https://www.aafp.org/membership/involve/lead/students-residents/student/aafp-commissions-student.html

The Executive Committee will make their selection in early August and then you will have several weeks to get your full application, including a letter of support from the GAFP, submitted to the AAFP by the September 8^th deadline.  Thank you for your review – we encourage you to apply

The AAFP Board of Directors made the decision that, due to the COVID-19 pandemic, we will transition this year’s National Conference to an all-virtual event. We feel this is the best decision to protect the health and safety of attendees.

Just like the in-person event, the virtual National Conference is the must-attend event of the year for students and residents. Your booth in the virtual Expo Hall will be a valuable opportunity for you to share information and connect with students and residents. In addition to many of the benefits you would have received in the live environment, you will get some new benefits for your investment, including:

• “Virtual floors” within the Expo Hall that allow attendees to easily find you based on geography, categories, areas of interest, etc.
• Ability to upload a promotional video, logo, and other branding and to schedule public demos in your virtual booth
• Opportunity to pre-schedule one-on-one video chats, private interviews/demos and more
• More dedicated exhibit time when sessions and networking events aren’t taking place, compared to the in-person event
• New sponsorship opportunities for you to increase your exposure with future health care leaders (details coming soon)

The AAFP is working through all of the logistics for the event, but here is what we know right now:

• National Conference will still take place July 30 – August 1. However, the times have been adjusted to accommodate attendees’ varying time zones.
• Transitioning National Conference to a virtual event will reduce the AAFP’s event costs, so we want to pass savings along to you. The exhibitor fee is being reduced from $1,350 to $1,000. If you already paid your fee, you would get a refund for the difference; please allow up to 45 days for a refund of the exhibitor fee differential.
• Cancellations: Based on the shift to a virtual environment, you can proceed with canceling all airline, hotel and vendor booth orders you may have made in conjunction to your “live event” exhibit participation. If you made a hotel reservation through Visit KC on Passkey, no further action is required. Visit KC will cancel all hotel reservations booked in the AAFP National Conference room block. Each reservation will receive a cancellation acknowledgement email. Please contact housing@ihs-housingteam.com if you have any questions.

Keep an eye on our National Conference website and watch your email for more details in the coming weeks.

Kristy Sloan, CEM
Exhibit Manager | Strategic Engagements

ksloan@aafp.org

The U.S. Department of Health and Human Services (HHS) is reminding eligible providers that they have until June 3, 2020, to accept the Terms and Conditions and submit their revenue information to support receiving an additional payment from the Provider Relief Fund $50 billion General Distribution. All providers who automatically received an additional General Distribution payment prior to 5:00 pm, Friday, April 24th, must provide HHS with an accounting of their annual revenues by submitting tax forms or financial statements. These providers must also agree to the program Terms and Conditions if they wish to keep the funds. Providers who have cases pending before the department for adjudication with regard to eligibility for general distribution funding will not be impacted by this closure. All cases needing individual adjudication will need to be received by HHS no later than June 3, 2020.

For more information visit:
https://www.hhs.gov/about/news/2020/05/20/providers-must-act-june-3-2020-receive-additional-relief-fund-general-distribution-payment.html

As a follow-up, here is the link to our webinar recording, and links below containing several tools and resources to help us work together to roll out contact tracing across Georgia:

1. Webinar Slides, including:
   1. Healthy Georgia Collaborative overview and process (Slides 4-10)
   2. Guidance for reporting positive COVID-19 cases to DPH (Slide 12)
   3. Talking points to educate patients about contact tracing (Slides 14-16)
2. Webinar Q&A Summary
3. General Public FAQs about contact tracing 
4. General Public FAQs about coronavirus 

For any questions or support related to contact tracing at DPH, please reach out to the following channels:

• Contactpublichealth@dph.ga.gov
• COVID-19 Hotline: 844-442-2681

The Georgia Academy of Family Physicians in partnership with the Georgia Department of Public Health is bringing you webinars with key information that is vital to Georgia’s family physicians and your patient population.  These educational webinars offer a streamlined, comprehensive approach to services that are needed and accessible to clinicians. Please register and plan on participating to hear the latest updates.

Tuesday, June 9^th – Sexually Transmitted Infections in Southern Adolescents – 12:00pm – 1:00pm

Webinar Objectives:

• Review the epidemiology of common sexually transmitted infections (STIs) in southern adolescent populations
• List key strategies to optimize sexual history taking and review the recommended STI screenings in adolescents
• Describe the presentation of common STIs relevant to adolescent populations
• Describe public health measures for the prevention of STIs among adolescents

Please click the link to register for the Tuesday, June 9^th webinar.

https://attendee.gotowebinar.com/register/505592136468525325

Thursday, June 11^th – Patient Privacy Considerations in Family Medicine at 12:00 pm – 1:00 pm

Webinar Objectives:

Educate family physicians and staff regarding general health information and the law pertaining to minors and those transitioning to adults.

• Age of majority/emancipation.
• What are the medical rights of minors (under age 18)?
• What information can or must be shared with parents?

Learn what exceptions apply to the general rules above?

• Rules for mental/behavioral/substance health
• Rules for pregnancy, reproduction, abortion, etc.
• Emergencies
• Are there differences for emancipated youth, youth in foster care, youth with developmental delays?

Discuss Best practices for your medical practice.

• Obtaining consent.
• How legal rights and privacy change at age 18 and why it’s important to discuss with that topic with parents and patients.
• Recommendations for policies regarding how the office addresses consent and privacy.
• What resources are available to you for additional information?

Please click the link to register for the Thursday, June 11^th webinar.

https://attendee.gotowebinar.com/register/8515932368423314443

Can’t Listen Live? Register anyway – and we’ll send you the link once it’s posted on our website

“Sorry” Need not be the Hardest Word: Stopping Malpractice Litigation Before It Starts by M. Scott Bailey and Max Wallace

Family physicians, perhaps more than any other specialty of medical practitioners, hold a special place in the lives of those that they care for. A physician who tends to all an individual’s varied health concerns, oftentimes treating multiple generations of the same family, can form a bond with patients that transcends that of the typical doctor-patient relationship. As gratifying as that bond can be to patient and provider alike when disputes or untoward outcomes arise the relationship can become adversarial. No physician wishes to hear that a patient is displeased, much less that a patient is contemplating litigation for some real or perceived injury. Every doctor should know, however, that when faced with the specter of a malpractice suit there are many ways to allay a patient’s concerns while mitigating risk of litigation.

Perhaps the most common pre-litigation scenario a medical provider encounters is a patient who feels harmed by the provider in some way. In almost all cases, there is no better way to resolve a nascent conflict than by offering a simple apology. Imagine that a physician mistakenly prescribes medication to which a patient has a reaction or prescribes the right medication in the wrong dose. Assuming the effects of these errors are mild, it is possible that a patient will be harmed more emotionally than physically. In such a circumstance, a simple admission of error or expression of regret by the physician can give a patient peace of mind and quickly defuse any lingering animosity. Even in cases with more severe injuries, it is remarkable how many patients turned plaintiffs indicate that if only they would have heard their doctor acknowledge the injury with an expression of sympathy or regret, they may not have pursued litigation.

Georgia law recognizes the value of allowing physicians to speak candidly about mistakes in a patient’s care, or express sympathy for a patient experiencing an unexpected outcome. In fact, the law prohibits plaintiffs from introducing a variety of sympathetic behavior by the physician into evidence at trial. Physicians can safely express regret, apology, sympathy, commiseration, condolence, compassion, mistake, error, or a general sense of benevolence to patients, their relatives, or their representative. Physicians should therefore feel free to use such language as “I am sorry this happened,” “I know how difficult this must be,” or even, “I made a mistake.” This law intends to allow providers to be frank with patients without fear of a well-intentioned statement being turned against them. Family physicians chose their specialty in part because of the long-term relationships they develop with their patients. The law encourages physicians to foster that relationship even in the face of a poor outcome or disputed treatment.

Moreover, it is never too early or too late to issue an apology or sympathetic statement. Georgia, unlike other states, does not limit the time frame in which these discussions can occur. The Colorado Candor Act, for example, enables similar privileges for physicians to discuss bad outcomes with patients. The Candor Act in fact goes further than Georgia law in some ways, enabling physicians to discuss the details of how a bad outcome occurred and what steps are being taken to prevent future errors. Colorado, however, requires that a medical provider send formal notice of intent to initiate such a conversation within 180 days of a given incident. Georgia imposes no such requirement, and while providers should limit their conversations with patients who experienced a bad outcome to general expressions of mistake and regret, they should feel free to initiate these conversations at any time.

A second common scenario that family physicians encounter is how best to handle non-compliant patients. Sometimes, despite a physician’s best efforts a patient simply will not cooperate in their own treatment. In such a circumstance, the physician should take steps to terminate his care of the patient while ensuring that the patient is not abandoned. First, the physician should be sure to document the patient’s non-compliance and any efforts the provider has taken to correct the patient. If the patient remains intractable, the physician should draft the patient a letter, explaining in detailed, non-disparaging terms why the provider is terminating the doctor-patient relationship. This letter should also make clear that the physician will continue treating the patient for a reasonable, but brief, period such as 30 days, if necessary. The letter should also provide the patient with referrals to other providers and ready access to their medical records. In the event a provider feels uncomfortable drafting such a letter, she can contact her insurance carrier who should quickly appoint counsel to draft the letter on her behalf. If a physician follows all the above steps, even the most difficult patient will be hard pressed to make a case for abandonment or unfair treatment.

The third prelitigation circumstance doctors are likely to encounter are requests for patient records. These requests can range from benign attempts by a patient to gather their own information to formal demands issued by plaintiff’s attorneys on behalf of a new client. By the time a records request is made by a lawyer, litigation may be unavoidable. A physician’s handling of records, however, can either bolster or cripple his defense of the litigation. When compiling medical records providers should document the records request in their file and notify their insurer of the request. It is even more crucial that providers supply complete and accurate records, with no edits. This advice may seem intuitive, and very few physicians would intentionally alter patient records to change the facts. Many physicians are tempted, however, to simply clarify a point in their chart or trim distracting and irrelevant information from records. It is difficult to overstate how prejudicial these well-intentioned edits can be to a physician’s case. In the age of electronic medical records, plaintiffs and their attorneys always discover what changes a physician made to a patient’s records as well as when those changes were made. The physician is then placed in the unenviable position of explaining why he changed a patient’s records after the treatment in question. When it comes to producing medical records, honesty truly is the best policy. Even the most problematic documentation is more easily addressed than an attempt to cover up a mistake.

In all, Georgia law encourages physicians to be open and honest in their dealings with their patients, even if that honesty is accompanied by difficult conversations such as admitting a mistake or terminating a patient’s care. By being forthright and frank with patients and contacting their insurer with any concerns, doctors can effectively insulate themselves against many incidents that might otherwise become lawsuits. In the unfortunate event that a lawsuit is filed, a physician can rest easy knowing that she took reasonable steps to address a patient’s concerns and that litigation was initiated in spite of her best efforts to avoid it.

 Scott Bailey and Max Wallace

Huff Powell Bailey LLC

https://www.huffpowellbailey.com/

404.892.4022