HJAR May/Jun 2021

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2021 11 pharmacists to allow them to treat a range of medical conditions. AMS worked closely with legislators and pharmacists to again find some common ground that allowed AMS to support the end product. That bill is nowAct 503 of 2021 and allows pharma- cists to use point of sale testing to for the flu and strep throat. If the tests are positive, they can provide the medications to treat these conditions without a physician’s pre- scription. There are provisions in the bill giving the Board of Pharmacy and the State Medical Board joint authority over these practices. The bill also contains provisions allowing physicians to dispense a variety of medications from their office for both acute and chronic medical conditions. Telemedicine has been another major issue for AMS. In 2015, we drafted and sup- ported legislation creating Arkansas’ first statute regulating the use of telemedicine. We followed that up in 2017 with several amendments. This year, HB 1063 was filed by Rep. Pilkington. This bill set out to cod- ify the Governor’s executive order allowing professional relationships to be established using any method if the provider has access to the patient’s medical record. Current law requires a professional relationship to be established prior to utilizing any form of telemedicine. That can be accomplished pri- marily through an in-person visit or by use of real-time, audio-visual visits. AMS was able to get amendments added to the bill to require insurance carriers to cover office visits provided by audio only, which they are doing now under the pandemic, and to pro- hibit insurers from steering patients to com- mercial telemedicine vendors rather than Arkansas physicians and other providers. While AMS opposed an amendment added in the Senate, we still support the provisions relating to insurance coverage. That bill has been sent to the Governor for signing. Editor The employment status of the average physician has changed over the years from individual or privately-owned group practices to more physicians becoming institutional employees. How has this trend impacted the practice of medicine, and do you see the trend reversing in the near future? Wroten I don’t really see this trend revers- ing, at least not anytime soon. The other question is more difficult to answer. As far as the clinical aspect of medical practice, I’m not convinced much changes. Physi- cians, regardless of employment status, recognize their first obligation is to their patients. There is some evidence that turn- over is more of a problem with employed physicians than say a physician who has laid down stakes in a community and built or become a partner in a private practice. That tends to be a lifetime, or at least a long-term commitment. However, employed physi- cians have contracts that renew every two to three years, creating more opportunities for turnover. This of course affects patients, particularly in primary care practices. What is more (or was more) of a concern is the effort by State Senator Dan Sullivan to pass a law allowing the corporate practice of medicine. Corporations (think Wall Street, Amazon, insurance companies, etc.) are not licensed and have no fiduciary duty to patients. They would likely place a great deal of pressure on physician employees to maximize profits at the expense of patient care. The physicians would continue to have their actions subject to oversight of the state medical board, but the corporate “owners” would be untouchable. AMS recognizes that this would not be good for patients. AMS strongly opposed this bill in the current leg- islative session, and it failed twice to gain enough votes to pass the Senate. Editor A shift has also occurred with medical schools graduating more specialists and less primary care physicians. Do you believe Arkansas currently has enough of the right type of physicians in the right places today, and what does the pipeline look like in the next 10 years? Wroten I’m not an expert in this area and suggest maybe a sidebar from someone at UAMS. What I can address is what is likely over the next few years. We have two new medical schools in Arkansas, accepting a combined total of nearly 300 new students every year. To the extent that we can find residency slots in the state for these new graduates, Arkansas is likely to see a strong growth in all areas, including primary care.