Jackson Jambalaya

Hahahahahahahahahahaha. Little cookie monster got caught with her fingers in the cookie jar

That Connor Reeves sure sounded tough KF. I would have wilted under the pressure LOL

KF- They didn't know who they were messing with. Good job!

You gotta love the arrogance of the State Medical Association. It reflects the arrogance of the doctors that it represents. They are a powerful group and have stormed over many individuals and organizations without regard for what is best for Mississippians. Instead, their focus is solely on what is best for doctors' wallets. I'm quite happy to see them take a jab and left hook from KF.

I am concerned that a private association has that much influence over the Department of Health. The Department complains about lack of funding and their inability to provide services. We have the worst Department of Health in the country and they are worried about being aligned with the Medical Association? They complain about not being able to provide services because of budget cuts and they want to work against a deliver model that would provide poor, underserved patients from receiving services?

So, you are telling me the Department of Health takes direction on what legislation to support from the MS State Medical Association? Is the Department of Health a state or private Department? Our tax dollars are going to fund the agenda of the MS State Medical Association? No wonder the nurses have such an issue providing care to Mississippi's most vulnerable population. What a disgrace.

Conner is smart. Future leader when the queen gives up her crown.

Give it up Charmain. You have targeted doctors and anyone who stood in your way for years. Your bully tactics won't work anymore. You have met your match with Kingfish.

I don't see the problem with MSMA, a great association representing a honored and esteemed profession, working with the Department of Health to kill bad legislation is. I for one am happy that we have a strong medical association working with the Department of Health and the Board of Medical Licensure for that matter. Stay out of our practice.

@10:05- Leader is a strong word.

Gotta love an arrogant elitist, who's bullyi g tactics always works up to now. Sorry, KF has nothing to lose and everything to gain by exposing your sorry ass.

The problem with a for-profit business influencing a tax payer funded Department is that emails between the two are PUBLIC RECORD. Apparently Mr. Reeves did not learn that in law school. Instead of snipping at Kingfish, shouldn't he have advised his boss to not put anything in an email she did not want the public to see? Especially an email that directly shows a private company influencing decision making of a state run agency to restrict trade? Law 101, Mr. Reeves. Think next time before you send an email with no substance. In fact, don't send the email. Always make a phone call.

I am ok with you signing the letter, and in fact, if MSMA needs us, I encourage you to sign. Looks like UMMC and Academy of Peds are signing on too.

Not the best written letter in my opinion, but I think the sentiment is something worth supporting. There is some political risk more for us than MSMA, but if state-owned UMMC is willing to stand up for this, I feel better about us, specifically you as head of a state agency, doing it. It also seems more a quality issue, standing up for more than "audio only." Thus, I think we wont be criticized too much for making a stand about quality of care.

Also, MSMA has been a great supporter of us, and I see no significant negative impact politically by standing with them on this issue.

Thus, sign, and sorry for my delay!


This is very bothersome: "but if state-owned UMMC is willing to stand up for this, I feel better about us, specifically you as head of a state agency, doing it."

Where are the ethics in our state? How can one person, Charmain Kanosky, have so much control over state entities. Does MSMA and UMMC have some type of sweetheart deal, a kickback? What is it?

All you have to do is look at the composition of the Board of Health. You will see that by law, the majority of members must be doctors (and guess what association they all belong to?). And guess who is chairman? And guess who is a card carrying die hard loyal member of MSMA? And guess what department has gone down, down, down during his chairmanship? The Department of Health is nothing more than a division of MSMA designed to make sure that public health efforts don't infringe on the proprietary interests of the doctors in MS. After all, every doctor deserves at least two vacation homes.

This is rich. Finally someone exposing corruption.

Remove the profit incentive from healthcare. Healthcare should be about preventing sickness and healing those that are ill - not making a shit load of money. If you become a doctor solely for the purpose of becoming wealthy you are ethically unsound like Colonel Kurtz and will burn in hell provided there is a hell and the Christians are right....

KF needs to be granted with subpoena power and also diplomatic immunity.

A few things:

As a physician, I would like to state that the Mississippi Medical Association does NOT speak for me.

I am an employed physician at UMMC and let me tell you, this post has gone viral at the Med Center today. There are many, many physicians who feel the same way I do about our current representation by the administration at the Medical Association. I would say the majority I interact with would like to see change.

to answer the questions about kickbacks between MSMA and UMMC, I would say it is not necessarily a kickback but my membership in MSMA is paid for by UMMC, as is all physicians employed at UMMC. If I could find a way to not be a member under this current administration, I would.

I am confident a public records search would show how UMMC pays for all of the membership dues to MSMA of each and every physician at UMMC. Membership dues are not cheap--therefore your sweetheart deal is MSMA receiving a huge chunk of UMMC's money every year for a large amount of membership dues.

However, the majority of physicians here would rather UMMC's money be used for a good cause, not to pay the large salaries of the MSMA administration.

I'd like to have more telemedicine options in the state, but telephone only sounds worrisome to me. I get that some people live in areas where they don't have good enough reception to Facetime (sorry, I know that you love BB, KF), but choosing to ignore public health risks because of delivery hurdles seems foolish. We need more access to quality care, not just "care".

This is saddening. Pathetic. Need to clean house.

Kingfish,

In regards to telemedicine you are severely lacking understanding of the core issue.

There are currently 20 telemedicine companies practicing in Mississippi:

•24 7 Dr. Help
•American Well
•ClickMedix
•Doctor on Demand
•E-Psychiatry
•First Stop Health
•FlexCare
•HealthTap
•InSight Telepsychiatry
•LiveHealth Online
•MDLive
•Memorial Hospital at Gulfport
•My Dr. Now
•North Mississippi Medical Center
•Specialists on Call
•St. Dominic Hospital
•Teladoc
•telehealthONE
• University of Mississippi Medical Center (UMMC) – Center for Telehealth
•WorldClinic

This has nothing to do with protecting only 'one system', and that one system being UMMC. That is simply outrageous and false. It has very much to do with understanding the clinical implications of phone-only medicine, and much more to do with implications of language in Bill 1178 bill itself.

You, nor anyone else have yet to directly address among others, the three huge glaring issues with the language in last year's legislation:


1) mandated patient-driven choice of technology even if this technology may not be appropriate;

The bill last year mandated that PATIENTS not qualified health professionals drive the choice of telemedicine technology. That is nuts both from a quality of care perspective and from an innovation perspective.

-I want to start a taxi cab company, but I now have to have an SUV, a convertible, and a truck to start it.
-It's much more expensive to start this service now.
-A patient wants me to take them to the cold frozen mountains.
-I have a taxi vehicle that is 4 wheel drive and warm, but the patient insists it has to be in a top-down convertible.
-I now have to figure out how make my two wheel drive convertible go up the frozen mountain safely when it did not even make sense to be used in this context to begin with.



2) mandated equal cost regardless of communication method even if some methods are significantly cheaper;

-This would be similar to a patient requesting which diagnostic test or procedure they want done, and then for that diagnostic test or procedure to cost the same regardless of type.

NIH Article on TeleDermatology Store and Forward Impact

With this bill, a patient could ‘choose’ not have Store and Forward consults, and request a “live video conference.” This would completely ruin the established innovation in escalation through telemedicine. Not only that, but the Bill would make the much cheaper Store and Forward consult would now have to be offered at a higher price than necessary since the Bill mandates that the cost must be the same regardless of communication method.

How’s that for stifling innovation. And this example is specific to only this specialty.



3) dangerous codification of physician-patient relationship that makes it easily defined for a singular visit and then easily terminated after one visit;

Section 1 Part 3 states:

“the physician agreed to treat or diagnose only a specific condition or agreed to diagnose or treat only at a specific time or place and that condition diagnosis or treatment has ended”

*Based on this language, I can over the phone only consent to treat you for only one specific visit and treat your headache based only over what symptoms you describe to me in that specific visit.
*If you think the issue resolved and later something much more serious happens, well our physician-patient relationship was established and terminated only in the very specific context described above. I am not liable.


One year later, you still refuse to discuss the specifics of last year's bill and their very negative downstream consequences. Instead you frame it as some conspiracy for click bait.


I expect more from you.

Having worked at the Association in the past, I can attest Charmian is a professional bully. First, Mr. Reeves has been heard bragging that Kingfish has always "removed" or "changed" a stance on issues after Mr. Reeves request he do so. And Mr. Reeves only does what Charmian tell him.

Secondly, how can she be objective? While her compensation is considerable, her husband (a physician) is effected by every positon the MSMA advocates. She has a shockingly expensive life-style that she in no way wants altered. She has a vested interest in protecting the financial success of certain physicians - not all doctors and certainly not the public.

Finally, I commend Kingfish on obtaining the emails. There are almost daily private calls, emails, and meetings that are planned to only keep certain board members informed.

If at any point an employee or board member questions the ethical nature or fiduciary duty of an Association action, that employee or member is fired and/or "accidently" omitted from future phone calls.
Please keep up the good work!

I always laugh at the people that make the "quality care" argument. Telemedicine has never been about people with serious illnesses, but rather for those that clog up the Ambulances and Emergency rooms for conditions that could be very simply treated and often don't require a prescription. Call 911 with a cough and you get an ambulance and most likely a firetruck due to "difficulty breathing". Pretty expensive for the ole taxpayer when you round up the costs of all that response, to a condition that could probably be handled with OTC cough syrup.

Lest we forget this painkiller epidemic we now face didn't come from Mexico, but rather from the prescription pads of the very same people who know whats "best" for Mississippi's healthcare future.

June 13, 2017 at 12:50 PM = High wind advisory in effect

Enough deep shoe leather here sweetheart to start a damn shoe factory.

Well, Wow, the post just discusses what one side was promoting and what the other side opposed. It didn't advocate one form of telemedicine over the other. There are indeed various forms of telemedicine although be honest, there is one group that would like to see only one model used in Mississippi and that is it.

Oh, and I have only one email from Mr. Reeves. Don't know when he got me to change anything. Wouldn't know him from Messick.

HEY 12:50 is that you Conner?

I'm sure 12:50 was paid a handsome hourly rate by the docs to craft the email that NO ONE will waste time to read.

UMC has expensive new office space off Highland Colony to pay for. Telemedicine is the golden ticket and if a large chunk of dues are paid for by the state's teaching hospital, what's wrong with a lil quid quo pro?

As a physician, born and raised in MS and trained here, the MSMA does not represent me. They're a part of what holds this state back.......good ol' boys promoting their own interest

Well, this is embarrassing for the attorney in question. Just because you have a law degree doesn't mean you can email threats with no legal ground. Wow. He is almost as pompous as the physicians he represents.

http://www.rand.org/news/press/2017/03/06.html

We are lucky folks like "12:57pm" don't make the decisions. Facts get in the way of emotions.

" always laugh at the people that make the "quality care" argument. Telemedicine has never been about people with serious illnesses, but rather for those that clog up the Ambulances and Emergency rooms for conditions that could be very simply treated and often don't require a prescription. Call 911 with a cough and you get an ambulance and most likely a firetruck due to "difficulty breathing". Pretty expensive for the ole taxpayer when you round up the costs of all that response, to a condition that could probably be handled with OTC cough syrup."

How does anything in this article show this Charmaine person has "worked actively behind the scenes .... to keep telemedicine companies from operating in Mississippi that would compete with UMMC"? She said she was fighting a "bad telemedicine bill." I assume that's one of the things MSMA does is fight what it thinks is bad medicine bills.

@5:31- then why did her legal counsel, or lack of legal counsel send the email to KF?

I was taught to stand up for what you fight for or against. Why hide it?

That's like someone who is an avid smoker working to ban smoking statewide.

I’ve seen your comment posted to the “Med Board Cans Executive Director” article at 7:58am today and I’m objecting to its posting. You made an unsubstantiated assertion of fact about actions by Charmain Kanosky and are publishing an allegation that is unfounded and inappropriate. Please remove that comment from the article. Thank you for your attention to this, (Emphasis added by KF)

Telehealth drives up healthcare utilization and spending

http://www.modernhealthcare.com/article/20170307/NEWS/170309914

Direct-to-Consumer Telehealth Prompts New Use of Medical Services; Not Likely to Decrease Health Spending

This Reeves guy taught a CLE I took. I thought he was amateur hour during the CLE. This just goes to prove I was correct. I learn more legal expertise from reading my kid's civics books as I do listening to this dude talk at a CLE. The MS Bar should reconsider allowing hum to continue providing CLEs seeing he doesn't even know the first thing about the law.

@5:56, this is 5:31. What? Reeves just took issue with the allegation that Charmain was working "behind the scenes" or trying to stifle
competition with UMMC. How can going to the Capitol in public to fight a bill be considered behind the scenes? The MSMA is a lobbying association. That's what they do is OPENLY challenge legislation they don't think is good. And asking other respected people in the state (Currier, Lampton) to back them up is also part of that process. Yes, she on behalf of the MSMA was actively fighting legislation that would allow bad medicine (according to them) but it doesn't appear it had anything to do with keeping down competition with UMMC.

I knew when they had a telemedicine press conference a few years ago and I saw Trent Lott sitting front and center that my tax money was going to his private jet.

What the hell is this and who cares? Where's the yawner?

1:09 pm I read 10:50 pm's email. It was very informative.
I am interested in the subject because I effectively used face to face telemedicine after a rare surgical complication that was not described in the " handouts" I took home.
The face to face allowed the doctor to see what I was seeing and experiencing. It saved my life. By the time my surgeon's nurse called, I had already been treated at ER in time.
Indeed, I wish doctors or their staff would have a cell phone or email function just to be able to " see" or " hear" symptoms. The " old way" of doing things doesn't work as well as it did as medicine has become more focused on maximizing the number of patients a doctor sees. The burden of deciding to go to ER falls on the patient as the computer answering messages at doctor's offices on weekends indicate.
Few people would go to an ER by choice if they've ever been once. And, a person usually feels too bad to want to leave home and go anywhere when they need ER.
Medicine should be about the best delivery of health care possible at the least cost possible. If it continues to be about profit and politics, we are insuring a continuing downward spiral in every health care category when compared to other nations.

Pleaaasssseeeeee 9:11 when was medicine ever not about profit and politics?

Thanks for responding, Kingfish.

As a doctor practicing in Miss for over 25 years, I can attest to the tremendous work that MSMA has done to foster good medical practice in our state. Charmain works hard to facilitate that effort. It's a rough job dealing with so many factions. This telemedicine issue is a great example. It is unreasonable to omit a video requirement for telemedicine. That's what Charmain (MSMA), Currier, Med licensure board, etc. were trying to accomplish. Contrary to some opinions posted here, it's not to protect income or UMC. It's to protect patients

FInally, a comment on the positive work accomplished by the MSMA. Thank you, 4:25p.

KF-there is lots of speculation over who is motivating your interest in this group. I know it's hard to believe, but most physicians are first concerned about their patients and protecting them from unsafe practices.