AAPS MO Chapter meeting minutes from July 15th, 2017

The Missouri Chapter meeting of the AAPS was held in Springfield, MO at the Hotel Vandivort. The meeting was called to order by President, Dr Jenny Powell at 12:00 noon. Dr Powell welcomed our guests and gave an overview of AAPS mission, values and how physicians can benefit from being members.
Physician guests included Dr Bill Graham, Dr Luke Van Kirk, Dr John Lilly, Dr Jim Blaine, Dr Matt Green and Dr Shelby Smith. Other guests included Representative Steve Helms, Gloria Bledsoe, Christopher White, and Ashley White.
Members present included: Dr Jenny Powell, Dr Phil Dean, Dr Todd Rice, Dr Bruce Schafly  and Dr Nancy Russell as well as lay members, Wes Powell and Tommy Newhouse.
Minutes from the April meeting were read by secretary Russell, motion to accept the minutes as read was by Dr Phil Dean and seconded by Dr Todd Rice. Minutes were approved as read.
Vice President report by Dr Phil Dean reported on an article in “Pain Medicine News” entitled, “When Pain Management becomes a criminal offense” and educated us on the highlights of this article and it was encouraged that all physicians prescribing pain medications read this article.
Treasurer’s report by Dr Todd Rice; no dues are collected by this chapter and AAPS provides the meeting room and meals for all that attend.
Secretary’s report by Dr Nancy Russell asked each attendee to sign the attendance list and circle their email if they would like to receive the national AAPS newsletter.
Citizen Advocate report by Wes Powell reported that our guest, Dr John Lilly was supportive to AAPS at the State level and we appreciate his efforts. Advocates for AAPS bills can be our voice in Jeff City.  Wes Powell has been volunteering and leading our voice on several bills at the State level for several years. Please contact Wes or Dr Jenny Powell if you are interested in initiating a bill at the state level.
Old Business:
Anonymous complaints about physicians are now being investigated by the Missouri State Board of Healing Arts which was not done in years past. Diane Franklin, State Representative in Dr Jenny Powell’s district has agreed to put forth a bill to disallow the Missouri State board investigation of these complaints. This would not oppose confidential complaints. Contact your local state representative in support of this potential bill.
Dr Powell also informed us that MPM-PPIA malpractice carrier does cover state board complaints and gives discounts to direct pay physicians.
New Business: None
Guest Speaker
Dr Bill Graham of Springfield, MO introduced guest speaker, Missouri State Representative from the 135th district, Steve Helms. Mr. Helms is Vice Chair of the professional registration committee. He spoke in favor of direct primary care and preserving the physician/patient relationship.  HIs goal is to initiate a work group to bring several bills to Missouri to make laws in favor of State government control instead of Federal government control is several areas. For example, medical insurance is still state regulated but federal government places penalties and incentives.
Our next speaker, Dr John Lilly was introduced by Dr Jenny Powell. Dr Lilly presented an impressive powerpoint presentation regarding the prescription drug monitoring program bill that is going forward to be passed in the State of Missouri. He presented statistics from all 50 states showing numbers and graphs over several decades of how this program has not decreased prescription drug induced deaths in the last decade. In fact, in most states the death rates have gone up steadily in spite of the time the law was initiated. Our MO chapter of AAPS has spoken out against this bill for privacy reasons as well as the reasons mentioned above, however they were more organizations speaking in favor of the bill and could be passed soon.
Upcoming Dates: 
Annual AAPS meeting in Tucson, AR October 5-7, 2017
Missouri AAPS Chapter meeting in St Louis on November 4th, 2017 at J. Gilbert’s restaurant starting at 11:30 am.
Meeting was adjourned at 2:05 PM by Dr Jenny Powell

AAPS MO Chapter Meeting: July 15, 2017

Don’t miss out on the Summer Missouri Chapter meeting! 
(note: the minutes from the spring meeting can be found by clicking here)

Details copied below. Please note the exciting special guests who will be joining us. Hope to see you there!

TIME:

Meeting starting at
12:00 PM noon
Saturday, July 15, 2017
(meet and greet
starting at 11:30am).

LOCATION:

Hotel Vandivort.
305 E Walnut St,
Springfield, MO 65806.
Click here for map.

ENJOY:

Meal provided by AAPS. Update on AAPS past and future activities, plus the fellowship of your colleagues!

SPECIAL GUESTS:

We are honored that State Representative Steve Helms will join us!  Rep. Helms, a newly elected State Representative from the 135th District, is very familiar with Direct Primary Care and gave a very articulate and passionate endorsement of that business model at a Greene County Medical Society reception for legislative candidates last fall.

Dr. Bill Graham will give a report from the DPC Summit he attended last month in Washington, DC, including info from the session on federal legislation initiatives.

RSVP: email nancy@nancyrussellmd.com

Missouri AAPS Chapter Minutes from 4-22-2017

AAPS Missouri Chapter meeting minutes

Meeting was called to order at 12:35pm on Saturday, April 22nd, 2017 by President, Dr Jenny Powell. The meeting was held at The Hereford House in Independence, MO. Minutes were read by myself, Secretary, Dr Nancy Russell. Motion to approve was made by Dr Phil Dean and seconded by Dr Helen Gelhot. Minutes were approved.

Vice President, Dr Phil Dean introduced his 2 guests; Lisa Rose, LPC and Cindy Hubbard, BS. Dr Jenny Powell encouraged all guests to join AAPS and donate to the legal fund to promote Andrew Schafly’s work and the AAPS council.

Secretary, Dr Nancy Russell asked if everyone received the email for this meeting. Dr Jim Dennighoff, M.D. states his email needs to be added to the list and will be done. Dr Russell reminded members that they can gift a one year membership to any physician by contacting the national office. If anyone does not have their name on the National AAPS email list, please contact Dr Russell at nancy@nancyrussellmd.com and your name will be added.

Old Business

Gene Trait lab that performs pharmacogenetics for physicians has been very helpful for Dr Phil Dean. Dr Dean reminded us that it is helpful to know the patient’s status of the MTHFR gene if the patient has heart disease, blood clots or history of miscarriages as they may need high dose methylfolate. This testing may also help with third party reimbursement for a certain drug category based on the patients pharmacogenetics.

New Business

Dr Powell reminded us that AAPS legal counsel is available to members if they are in need of assistance with a State Board of Healing Arts complaint. If a member is asked to be interviewed by the State Board for a complaint against them, Andrew Schafly, Attorney, states to record the conversation with their permission and ask how they received the complaint. If there is a subpeona for medical records. comply with this request and inform the board representative that the patient will be informed. In 2015, the Texas State board of Healing Arts ruled that an anonymous complaint cannot be accepted  for consideration, It was discussed to introduce a state bill in Missouri regarding anonymous complaints.

State Legislative Update

Wes Powell, Citizen representative for Missouri Chapter of AAPS gave the report.

Anti-MOC with Dr Frederick went to a public committee hearing on February 8th, 2017. It is presently sitting in committee and may or may not be voted on. This bill is probably dead at this point but could be re-introduced next year.

The personhood amendment is at a stand still and may go away as Right to Life came out against it as they could lose donations.

HB 90 & 68 for Prescription Drug Monitoring passed through committee and passed the House. The Senate added 7 amendments and sent it to conference. The House then repealed it and now it goes back to the Senate to look at again in its original form. Our Missouri Chapter of the AAPS is opposed to this bill due to privacy issues and as it is against the Constitution to collect this information on patients.

The end of State sessions for voting on Bills is 5-12-17.

Our guest speaker was Kirk Umbehr of Atlas MD, a direct primary care medical office in Wichita, KS with 5 physicians that began its operation in 2010. There is an annual or monthly fee charged to patients that includes unlimited office visits with no co-pays and small fees for lab work and prescriptions. Atlas MD offers an EMR system that supports direct primary care practices for $300 per month with excellent security and a step above HIPPA requirements. Atlas MD consults with physicians to help them convert or start a medical practice based on this model and has assisted 250 physicians in this process.

Upcoming dates:

  1. Thrive, Not Just Survive, Hebron, KY Friday, June 9th, 2017.
  2. Missouri AAPS Chapter Meeting, Saturday, July 15th, 2017 at Vandervort Hotel, Springfield, MO around 12 noon. Dr Bill Graham will be attending and bringing guests.
  3. Annual AAPS conference, Tucson, AZ, October 5th to 9th, 2017.

The meeting was adjourned by Dr Jenny Powell.

Minutes Respectfully Submitted,

Dr Nancy Russell

SB 314 – PDMP would harm, not help, patient care

Dear Distinguished Members of the Missouri Legislature:

We write today in opposition to SB 314, a bill to facilitate the monitoring of Schedule II, III, and IV prescriptions written by Missouri physicians for their patients.  As physicians, we take an oath to “first do no harm” which is why we are speaking out against this legislation today.

Those supporting this bill no doubt hope to lessen the misuse of certain medications.  This is a worthy goal; however, interfering with the patient-physician relationship with more rules and regulations is the wrong solution.  SB 314 will not only fail to solve the problem but will cause additional damage.

Red tape and bureaucratic mandates, proliferating on a national and state level, are harming patient care. Inserting additional bureaucracy between patients and physicians, as is done by SB 314, will inevitably lead to loss of access to vital medical care for Missouri’s pain patients.

Pain patients across the country are encountering increasing challenges in finding appropriate care as physicians incorrectly take the blame for misuse of certain medications. These patients and their physicians require the freedom to make decisions about appropriate care without second guessing by the State of Missouri.

In addition, SB 314 is not evidence-based policy. Data from other states demonstrate no improvement in misuse/misdirection of controlled substances or a decrease in deaths as a result of implementation of similar provisions.

If PDMP laws work one would expect Missouri to be number one in the nation in misuse of scheduled medications and related-deaths. Instead we fall in the middle.  These laws simply fail to achieve their stated goals.

Finally, PDMP laws are a blatant violation of Article I Section 15 of the Missouri Constitution. SB 314 violates patient security and privacy and therefore causes harm.

“First Do No Harm” should be the motto of all those who write these prescriptions for patients in the first place. To be true patient advocates, we must discourage the support of data collection on our patients in any form regardless of the best of intentions and especially when doing so will degrade patient care.

Sincerely,

Missouri Chapter, AAPS
Jennifer Powell MD FAAFP, President of the Missouri Chapter

Missouri AAPS Chapter meeting minutes from 02-11-17

The MO AAPS chapter meeting was held on 02-11-17 at 44 Stone Public House in Columbia, MO. The meeting was called to order by President, Dr Jenny Powell at 12:01 P.M. Guests were welcomed.

Minutes were read by secretary, Dr Nancy Russell; motion to approve by Dr Phil Dean, seconded by Dr Helen Gelhot and approved by majority vote.

Legislative report by Wes Powell, Citizen representative for AAPS MO Chapter

Anti-MOC- a public hearing was held this past week in the MO House of Representatives. Representative Dr Frederick stated this bill had been passed last year and additions to make it more stringent were presented and a hearing is to follow. Additions to the current bill are to have MOC-maintenance of board certification not be used as a requirement for hospital privileges or insurance company panels. The bill originally was passed to not allow MOC to be necessary for MO licensure.

Prescription drug monitoring bill was in the House of Representatives this past week. Wes Powell and 3 others testified against this bill and 40 persons spoke for the bill. MSMA and AAFP representatives spoke in favor of the bill. Opponents to this bill cited that it is against the law to gather data on patients without a subpoena. DrJohnLily.com is a website that shows that drug monitoring does not help with drug abuse problems. Missouri ranks in the middle of drug abuse cases. Unintended consequences presented by Wes Powell included physicians dropping out of pain management.

House Joint Bill for Amendment HJR-18 is a bill to grant personhood to fetuses; life begins at conception. If passed, discussion regarding tubal pregnancy, miscarriage, in-vitro fertilization, etc could have some unintended consequences. If passed through both the state senate and house and signed by the Governor would still go to the people for a vote.

Simon’s Law has not been assigned to committee but could be brought up as a MSMA resolution. This bill would give parental rights to newborns in the NICU situation.

Old Business

If you have an issue you would like to bring to the State Legislature, contact Wes Powell at Wes@dpcareclinics.com.

New Business

Andrew Schafly, our AAPS general counsel’s work now is focused on the Supreme Court nominee.

Rand Paul, M.D., Senator and AAPS member has a repeal and replace bill established for the ACA; the affordable health care act or Obamacare.

Treasurers report: Dr Todd Rice

There are no dues to be a member of the Missouri Chapter of AAPS.

Secretary report: Dr Nancy Russell

New member emails and email requests have been updated to the Missouri Chapter email list.

VP report: Dr Phil Dean

TEN healthcare lab in St Louis does an extensive and accurate urine drug screen at a reasonable cash price. Dr. Dean has used this lab and is very confident in their results and does a screening and ongoing testing for all patients in his practice on controlled pharmaceuticals. A representative from the lab explained the ease of sending the test kits and a 24-48 hour turn around time on results.

Gene Trait labs in Columbia, Missouri gave a presentation regarding their testing on pharmacogenetics and how genetic testing can be helpful in determining and assessing what drug categories would be best for a patient based on DNA results. It is most helpful with narcotics, anti hypertensive, diabetic and ADHD medications. A full report is kept on file and sent to the physician to assist with medication management. Their website is updated regularly as new drugs come on the market and the patient’s report can be updated if their medications change.

Upcoming Dates:

  • Thrive, Not Survive meeting in Hebron, KY on June 9th, 2017 from 1-9 PM.
  • Annual AAPS meeting in Tucson, AZ, October 5-7th, 2017.
  • MO Chapter AAPS meeting in Independence, MO on Saturday, April 22nd, 2017 at the Hereford House, 19721 E. Jackson Drive at 12:00 P.M.
  • MO Chapter AAPS meeting in Springfield, MO on July 15th, 2017.

Meeting was adjourned by President, Dr Jenny Powell at 2:15 pm.

Respectfully submitted,
Nancy Russell, M.D., AAPS MO Chapter Secretary

Save the Dates: April 22 and July 15, 2017

Save the dates for these 2 upcoming meetings of YOUR Missouri Chapter of AAPS:

Saturday, April 22 meeting in KC will feature a guest speaker from AtlasMD, the EMR company of AAPS’ Dr Josh Umbehr.  His brother, Kirk, will speak on behalf of the company and DPC. Reminder that Nancy will schedule the meeting at Hereford House in Independence, MO; meet and greet at noon, meeting to begin at 12:30.

Dr. Bill Graham, who arranged our last Springfield meeting, will again reserve the meeting room at the Vandervoort Hotel in Springfield MO for the July 15 meeting, meet and greet at 11:30 and meeting to begin at noon.  He will be inviting his state representative to speak, and also Dr. David Barbe, a family physician from the Mountain Grove/West Plains/Mountain View/Birch Tree area, who is also the current AMA President.

February 11, 2017 – Quarterly Meeting

Don’t miss out on the first Missouri Chapter meeting of 2017!

Details copied below. Hope to see you there!

TIME: Meeting starting at 12:00 PM noon on Saturday, February 11, 2017 (meet and greet starting at 11:30am).

LOCATION: 44 Stone (in Cellar Room) 3910 Peachtree Drive, Columbia MO  65203, Phone: 573-443-2726.  Click here for map.

ENJOY: Meal provided by AAPS. Update on AAPS political actions and news and the fellowship of your colleagues!

RSVP: email nancy@nancyrussellmd.com
Our guest speaker will be Tim McCarty from Gene Traits Laboratories.  The lab is located in Columbia, Missouri and has performed genetic testing for over 20 years. This lab can take a saliva sample from a patient and identify their pharmacogenetics. This helps identify medications that are compatible with the patient’s genetic make-up as well as those that are not. The testing can be very helpful for cardiovascular, mental health, pain management, etc. medical treatment.

July 16, 2016 – Quarterly Chapter Meeting

Please bring your appetite and your interest in state policies!!

TIME: Meeting starting at 12:30 PM (meet and greet starting at 12 NOON).
Note: Restaurant does not open until noon.

LOCATION: Hereford House, 19721 East Jackson Drive, Independence, MO. North of I-70 between Blue Springs & Independence Center, take Little Blue Parkway Exit to the north. It is just east of Hilton Garden Inn motel.

ENJOY: Meal provided by AAPS. Update on AAPS political actions and news and the fellowship of your colleagues!

RSVP: email nancy@nancyrussellmd.com

AAPS MO Chapter Supports Simon’s Law

A DNR order can be placed in a child’s medical record without parental consent.

Simon’s Law is designed to address this injustice. Missouri House Bill 1915 was named after Simon Crosier, who died in a St. Louis hospital at age three months and whose parents were horrified to learn—only after his death—that a DNR had been secretly placed in his medical chart.

Bill Text:
http://www.house.mo.gov/billsummary.aspx?bill=HB1915&year=2016&code=R

Additional Background: click here

A rally will be held on April 19 at 6pm in Rolla.  Click here for details.

AAPS is asking legislators to support HB 1915: click here to read our letter.

Whether you can attend or not, please contact your Missouri legislators to educate them about this bill.

If you don’t know your legislators’ names please visit:
http://www.senate.mo.gov/legislookup/default.aspx

House member contact info:
http://www.house.mo.gov/member.aspx (click on name for email address).

Senate contact info:
http://www.senate.mo.gov/senators-listing/

MO Chapter Spring Meeting!

Saturday, April 23, 2016 at 12:00 Noon

Please plan on joining us for our Missouri Chapter quarterly meeting on Saturday, April 23, meeting starting at noon (meet and greet starting at 11:30) at Sophia’s, 3915 S. Providence Road, Columbia MO. Elections for officers will be held, and we will receive an update on Missouri state legislation.

Hope to see you there!

Directions: from St.Louis area – I-70 W to Grindstone Parkway in Columbia, take the Grindstone Pkwy/New Haven Rd form US 63 South, Grindstone Pkwy to South Providence Rd; from Kansas City area – I-70 E, take exit 124 to MO 740/Stadium Blvd, follow N. Stadium Blvd to South Providence Rd; from Jefferson City – US 63 North to Columbia, take the New Haven Road exit, continue on Grindstone Pkwy to South Providence Rd.