Responses to the Opioid Problem in Nevada

Similar to other states in the US, Nevada has experienced increases in indicators related to opioid use, abuse, and overdose in the past several years. Nevada has consistently ranked in the top quartile of overdose deaths in the nation. It ranted 16th in the nation for prescription drug use in 2016. Visits to the Emergency Department (ED) for opioids have increased significantly – from 3,095 in 2010 to 7,035 in 2015. Heroin related deaths increased 22% from 2014 to 2015.

Several efforts are underway to address Nevada’s opioid crisis. This spring, Nevada received a $5.6 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) as part of the State Targeted Response (STR) to the Opioid Crisis grants program. This program will expand access to medication assisted treatment (MAT) and prevention services throughout the state, and physicians will have an important role to play in this initiative. One of the more innovative aspects of Nevada’s STR program is the implementation of peer support recovery teams that will work with opioid overdose patients presenting in the ED to provide peer coaching, overdose prevention education, naloxone, linkage to MAT, and other supportive services.

WCMS Mini-Internship Offers Insider’s View to Local Residents

The Mini-internship is a community outreach program that brings doctors and community leaders together in a one-on-one setting, and offers an insider’s view of medical professionals in action. The unique experience benefits the doctors, the interns, and the medical society.

This year’s session took place from May 17-24 and was sponsored and hosted by Saint Mary’s Regional Medical Center. Thanks to their medical staff; Kendall Barrett, Barbara Neal, and Yvette Viado, for their hard work that facilitated the interns access to all hospitals, medical practices, which resulted in a successful turnout.
On the last day the interns and some of the participating physicians gathered to celebrate over dinner. We had a group of interns from diverse backgrounds come together as one to openly share the moments they each had with physicians they shadowed for the day.

“The attitude is: Let’s do something that makes a difference. Let’s figure it out,” said an intern at the roundtable when discussing the healthcare system and related issues we hear about every day.

“It caused me to think about the aftercare that will be needed as our population continues to age. I hadn’t thought about that,” said another intern who shadowed a physician in the family medicine specialty.

WCMS Dean’s Dispatch

Our University of Nevada, Reno School of Medicine Department of Physiology and Cell Biology is now ranked 4th in the U.S. for research funding from the National Institutes of Health (NIH), according to the Blue Ridge Institute for Medical Research.

The $11.74 million in research dollars secured by Dr. Sanders and his talented faculty and staff places UNR Med just behind prestigious institutions like University of Michigan ($18.8M), the University of North Carolina at Chapel Hill ($16.4M) and Vanderbilt ($14.88M) and ahead of others like University of California San Francisco ($11M), Penn ($10.4M), Johns Hopkins ($9.38M), Yale ($8.99M), and UCLA ($9.28M).

Observations from the Legal Trenches

Reminders Regarding Delegation

During the last biennial license renewal period for physicians licensed by the Nevada State Board of Medical Examiners, I discussed the frequent delegation of the completion of renewal applications to third parties, such as an office manager and the potential issues related to such delegation. As physicians are once again in the middle of a biennial renewal period, the time seems right for a quick reminder about delegation.

Delegation of tasks is often necessary for busy physicians to accomplish the myriad of demands placed upon them. This often includes delegating administrative tasks such as billing, ordering of both medical supplies, completion of applications and/or contracting matters. Patient care tasks are also often delegated (to the extent legally allowed) to others such as medical assistants. While delegation of tasks is certainly acceptable, and necessary, it is important to remember that ultimately the practitioner is responsible for those tasks that are delegated and can bear the consequences if something goes awry.

Mary Ann McCauley, WCMS executive director; Sarah Penrose, NMSA office manager; Wendy Hernandez, WCMS administrative assistant, and Andy Pasternak, MD, WCMS president, joined members of AWCMS to celebrate the installation of their 2017-18 board and officers.

Among the Past Presidents present at the Installation Luncheon were Ruth Halvorson - 1979-80, Naomi Sande - 1988-89 and Carol Coppola - 1995-96.

These three members have known each other and worked together in the organization for more than 50 years.

Do You Know the REAL Background of Vaccines?

The greatest scientist of the 20th century, and no one knows his name. This documentary tells the inspiring story of Dr. Maurice Hilleman, a man with a singular, unwavering focus: to eliminate the diseases of children.

WCMS Dean’s Dispatch

The School of Medicine held an extraordinary event on April 28, an event that was student-driven and community physician-focused. It was a first, at least for a long time, but it will not be the last!

We gathered at The Grove in south Reno to honor the critical contributions of community physicians and clinical teachers who have dedicated their time, their expertise and their patients to teaching the next generation of Nevada physicians.

Nearly 70 community faculty members turned out for the event hosted by the Office for Community Faculty, under the leadership of April Heiselt. We brought together the most precious resources of the University of Nevada, Reno School of Medicine—our students and their teachers—to celebrate the magic of medical education and the process by which bright students become outstanding physicians.

Sitting at the Table

We are approaching the home stretch for this session of  the Nevada Legislature. The last few months have been an eye-opening experience for me. I’ve been involved with organized medicine for a number of years, this is the first time I’ve been involved with the NSMA legislative core group meetings from the get-go.

The committee has been meeting weekly to review the bills that may affect our patients and how we practice medicine. Staring with over 200 bills, the list is narrowing down. Our legislative team, lead by Catherine O’Mara, has targeted 30-40 bills as priorities and are following them closely in Carson City (I’m thinking for the next session, we need to budget for a pair of roller skates to help them get from session to session)

Athlete’s Heart Draws Strong Interest Among Reno Residents

WCMS hosted its first public seminar of the year at Craft Wine & Beer to address heart conditions in athletes and how they differ from the general population. It was presented at no cost to more than 100 area residents and featured three cardiologists who spoke about the differences in diagnosing and treating the heart of an athlete who exercises more intensely than the average person. Go to youtu.be/GiB7C6r9WDE to view the seminar.

Observations from the Legal Trenches

Provision of Interpreters in the Provision of Medical Treatment

Physicians are familiar with the term “covered entity” in the context of discussing the applicability of HIPAA requirements to an individual or entity. The use of the term may not be as readily identifiable in determining when a physician or medical practice must provide an interpreter under the American Disabilities Act (ADA) for those with certain disabilities or “limited English proficiency” under the Civil Rights Act (CRA). In such instances the definition includes “an entity that operates a health program or activity, any part of which receives Federal financial assistance” as defined by 45 CFR §92.4. A “health program or activity” includes hospitals, health clinics or physician practices among others. “Federal financial assistance” includes reimbursement from Medicaid and/or Medicare. Below is a brief discussion of one such circumstance.