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tv   Key Capitol Hill Hearings  CSPAN  October 21, 2015 4:00am-6:01am EDT

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that are in competition for that time, but itime, but i think there is no question about the importance of this education. certainly as we look at issues around the importance of education and the subscribers around this issue, continuing education is not in dispute. it has been in implementation, particularly as it relates to reimbursement and the logistics around getting it in place. i do not think there is disagreement about the importance of education. >> i have been involved in higher education before coming to congress and understand that there is a lot of discussion and work that goes into providing curriculums. however, when our med schools are saying they get three to five hours possibly in med school, it is simply not enough, and at this point to come up with one set curriculum, i think is a problem.
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let's do more. and so i am curious, do we need to be requiring it? does it need to be mandatory? should there be certain hours that all prescribers are required to take a year. i am a lawyer. there are some -- what are the other panelists thinking? this is troublesome for me, not just for physicians, but what should we be doing? any ideas? what can we do to fix this problem? we have been talking about it far too long, and educators have not resolve the issue. >> two very practical possible solutions. consolidate the efforts of adding to the curriculum for pain and addiction based on the governing body for the
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national medical schools rather than having a heterogeneous group of schools come up with there own curriculum. this has been put out there as a recommended curriculum. is there and available in many locations. but you need to have them mandate that this is a parta part of the curriculum. it is currently not. >> unlike my colleague who went through medical school, i did not. are there other parts that are mandated, or is it all left up to each individual med school? i am certain there must be a lot of mandatory curriculum items. why would this not be one of them? >> every student has to rotate through the core curriculum which has not changed in 100 years. when you look at it, it is internal medicine, general surgery, and the connections
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between those, pediatrics and you rotate through critical care, inpatient care, and outpatient care. adding on specialties has always been an option. they see it as a high-end specialty. and tell you mandated so that they stand next to someone doing this they're is no way to glean from a book how hard it is to talk to some of these patients who have had a horrible early life, and if you mandated, they will find it. there is someone board certified in pain or addiction to do this. i'm sorry. my friends will not like me. physicians who prescribe controlled substances should have mandated acm. >> ii am curious and see that my time is up. i am curious if anyone disagrees with that notion?
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>> absolutely not. >> no. >> i don't disagree. >> thank you, and i yield back. >> the chair thanks the gentle lady. member of the full committee is recognized for five minutes for questions. >> thank you. thank you for this thoughtful discussion. i understand the drug addiction treatment act was passed to expand access to addiction treatment by integrating it into the general medical study. for. for doctor waller, can you describe how dated 2,000 expanded access to addiction treatment services? >> yes, sir. thank you for your hard work. >> we have good partners.
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>> one of the things that it has done is allowed for clinics such as mine, which i work for a medical system. i am an employee of a hospital system and i open our doors and see patients based upon referrals and deliver the highest quality of care. both for pain and addiction and all of the psychosocial aspects. from a primary care aspect it allows them to treat in place and especially in the rural part of america, there are no methadone clinics, inpatient treatment clinics, and in my home state we have an upper peninsula that is devoid of treatment. this is aa large portion of the population that is left without. being able to not make this field withfeel like a criminal act, not be fearful of the dea walking into your office while you are seeing
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a patient for hypertension, and the availability of the medication to prescribe is key. it is expanded in many areas, but we have a lot to go. >> in terms of expanding, expanded access in some ways, but the law did set certain limits, and it is clear that we have outgrown those rules. asrules. as you know, 96 percent of the states and the district of columbia had opioid abuse or dependence rates higher than the treatment capacity rates. i am concerned that the crisis has outgrown those rules. could you explaincould you explain how the current of 100 patients has limited our ability to respond to the current opioid epidemic? >> two areas we have dug in deeply.
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the 1st year you can only see 30. he isyour certification and the next year you can apply for 100. for that, those of us who are specialty trained out pretty quickly. and so we early within our areas. and primary care we have a large percentage of doctors who have chosen not to write this medication. what it looks like is a large amount of capacity. 400 23 primary care doctors. it is consistent. they do not feel like they have training, support to evaluate and initiate treatment in patients and stabilize them. they feel comfortable with maintenance, but the reason we don't see that is because
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they do not feel like they have the appropriate knowledge and backup. they do a good job with this. once they learn about the disease, their ability to treated is good, but it must be stabilized therefore raising the for peoplefor people who do this is a specialty and have board certifications. and then allow us to not have a barrier, seven month waiting list to see patients. >> if you have an opinion on the current prohibition of certain other professionals that might assist here, nonphysician providers including nurse practitioners, physician assistants, does that limit patient access? >> it absolutely does. i have two physician assistants and my office who are the of my patient evaluation seeing patients as i am sitting here, but we
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are limited in what that they can do. they are frozen and cannot see a knew patient and start them, even if they are under my supervision, i cannot pick up a phone and they don't have the legal right to write that prescription. starting in a way which is appropriately supervised so that they have someone to go to for difficult patients and can onboard knowledge and training is important, but to be able to write this for a practical standpoint has to happen. they are moving forward the biggest part of our healthcare system. >> thank you, and with that, i yield back. >> the chair thanks the gentleman, and that concludes the questions of the members were present. there will be other members who have questions and follow-ups that we will send you in writing. we ask that you respond promptly. members should submit there questions by the close of business tuesday, november the 3rd. members have ten business days to submit questions for
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the record. very informativevery informative and important issues we are dealing with. thank you for your expert testimony which will help us as we proceed to move the legislation, the subject of the hearing, and i want to thank each of you for coming and presenting your expert testimony today. without objection, the subcommittees adjourned. [inaudible conversations] [inaudible conversations]
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