Regents act to boost public view of primary care

The Board of Regents voted at its spring meeting on several measures to enhance public and political perception of primary care and/or general internal medicine. One measure supports legislation that would fund research on the value and cost-effectiveness of primary care, while another calls for monitoring the national news for negative coverage of primary care and establishing a prompt media counter-response.

The Regents also approved a policy monograph aimed at improving the Food and Drug Administration's (FDA) regulation of prescription drugs. Recommendations include increasing the FDA's funding and ability to regulate drugs made outside the U.S.; expanding the FDA's regulatory authority in the design of pre-approval trials and studies; prohibiting the practice of bundling drugs to limit marketability and availability; and improving the adverse events reporting system.

In addition, the Regents recommended giving the FDA authority to require that newly approved drugs have a special symbol on their labels to increase public awareness that they are new, and to limit direct-to-consumer ads for the first two years after a drug's approval.

The Regents also voted to:

• Endorse a curriculum on cardiovascular disease prevention, which the College created in conjunction with the American College of Cardiology Foundation and the American Heart Association;
• Promote separate payment for Medicare-covered preventive services rendered during a Welcome to Medicare visit or a “medically necessary” visit and clarify Medicare rules about the role that counseling and coordinating care should play in billing for the visits;
• Publicize to College members the possible dangers of signing ambiguous forms from health insurers, and highlight cases where companies implemented misleading or fraudulent policies. The Regents will also work with other medical societies to inform regulators about any fraudulent representation by insurers;
• Establish benchmarks for reasonable health insurance administrative costs, and explore means for reducing and controlling those costs. The Regents will also set guidelines on the percentage of premium that should be spent on delivering patient care;
• Approve a plan to increase College membership, which would include offering trial memberships of up to nine months, offering online memberships at a reduced rate, lowering the introductory dues rates for new members and increasing the number of joint dues discounts with subspecialty societies;
• Approve a position paper on privacy issues surrounding the use of health information technology;
• Advocate for an amendment to the Controlled Substance Act that would allow for secure electronic transmission of controlled substance prescriptions; and
• Send a formal response letter regarding the Institute of Medicine's latest report and recommendations on resident duty hours. The letter expresses concern that a proposed five-hour protected sleep period will increase patient hand-offs, and that limiting in-hospital night shifts to four consecutive nights will make scheduling difficult.