Our Summer Family Medicine CME Weekend is fast approaching on June 8-11. 

NEW THIS YEAR – GAFP is live streaming and recording all this Summer’s CME sessions. As a virtual attendee, you’ll be able to engage with the presenter, ask questions and gain much-needed CME! All sessions will be available for playback for a limited time post-meeting.

For more details and to register, please visit our meeting website. Virtual Registration closes June 6 at Noon so we can send participants all the needed information.

This year’s meeting will offer a total of 16 CME credits. Here’s the FULL line-up!

• Leadership topic: Laws and Regulations Surrounding Staff Cannabis Use
• A Narrow Window of Opportunity: Diagnosis and Management of Rheumatoid Arthritis in Underserved Populations
• Leadership topic: Legal Ramification for Workplace Violence
• Leadership topic: Developing a Healthy Organizational Culture
• Developmental Disabilities Sensitivity Training
• Leadership topic: Work-Life Balance
• Effective Self-Monitoring Blood Pressure in Primary Care
• Innovative Approaches to Address Agitation in Alzheimer’s Disease
• Medications for Opioid Use Disorder
• Risks in the Changing Tide: Protecting Emotional Health in Menopause
• Social Determinants of Health and Health Equity
• Target BP: A Patient-Centered Approach to Managing Hypertension
• Assessment of Pediatric Anxiety & Depression in a Primary Care Setting
• Colorectal Cancer & Lung Cancer Screening in Primary Care
• Taking the Stress Out of Managing Patient Complaints
• Women’s Mental Health Care During Preconception, Pregnancy and Postpartum

Questions? Call or email Ali Bohannon (abohannon@gafp.org/404-321-7445).

AAFP: Application for CME credit has been filed with the American Academy of Family Physicians. Determination of credit is pending.

AMA: Georgia Academy of Family Physicians (GAFP) is accredited by the Medical Association of Georgia to provide continuing medical education for physicians. Georgia Academy of Family Physicians designates this live activity for a maximum of 16 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The last few weeks were a whirlwind of AAFP leadership meetings, and the Georgia Academy was #GeorgiaStrong and participated as one of the leading chapters of the American Academy of Family Physicians. Leaders in the organization attended the Annual Chapter Leadership Forum, the National Conference of Constituency Leaders, the Family Medicine Advocacy Summit, and the State Legislative Conference.

We thank our leaders for taking time away from their family and busy practices, to represent the Georgia Academy.

NCCL attendees – Voting Delegates

• Women: Elvan Daniels, MD
• Minorities: Carmen Echols, MD
• New to Practice: Macy McNair, MD
• IMG: Nkiruka Udejiofor, MD
• LBGTQ+: Christina Kelly, MD

ACLF attendees

• Sharon Rabinovitz, MD
• Le Church, MD
• Susana Alfonso, MD
• John Gerguis, MD
• Mike Busman, MD
• John Vu, MD
• Director of Education – Sarah Bigorowski

Family Medicine Advocacy Summit is the AAFP’s annual meeting where members meet with key members of our Congressional delegation.  Those that participated this year include:

• Susana Alfonso, MD – Board Chair
• Sharon Rabinovitz, MD – President
• Thomas Hoang Nguyen, MD – Mercer (Macon) Family Medicine Resident
• Loy “Chip” Cowart, MD – Legislative Committee Chair
• Casey J. Henritz, DO – Legislative Committee Co-Chair
• Alexandria Poitier, MD – Alliance Resident Trustee – Morehouse Resident
• Andy Herink, MD – Mercer (Macon) Family Medicine Resident
• Yoonhee Kim, MD – Mercer (Macon) Family Medicine Resident
• John S. Gerguis, MD – AAFP Congress of Delegate Alternate Delegate

Easy and Quick Applications Open and Ongoing While Funds Remain

Because many Georgia Academy members continue to be aware of those struggling in their communities, especially in rural areas, applications for the 2023 Georgia Healthy Family Alliance Immediate Needs Community Grants will be accepted as long as funds remain. Grants of up to $1,000 will be awarded for Georgia Academy member-identified immediate needs in their communities. Some examples of recent grants were supporting local small businesses devastated by the tornado that ripped through Griffin, and diapers for a domestic violence shelter in Habersham County.   

To date, GHFA has awarded more than $53,000 in Immediate Needs Grants since 2020. The Immediate Needs Grant application and review process has been streamlined to allow staff to transmit funds within 3-5 days.   

See below for the application – or a downloadable application can be found on the GHFA website at www.georgiahealthyfamilyalliance.org. Contact Kara Sinkule – ksinkule@gafp.org or call 404-321-7445 with any questions.

In the foreground holding the check (L to R) Jenyfer Navichoque, Dr. Patrick ‘PJ’ Lynn, Atrium Health Floyd Family Medicine Resident, Maria Henriquez, Alexis Klima. In the background, Atrium Health Floyd Family Medicine Residents and Dr. Kelly Culbertson.

On May 2, Amerigroup presented the Rome/Northwest Tar Wars Strike Force with a check for $75,000 to expand its programming, curriculum, team training and staffing efforts to ensure that Rome-area youth understand the harm of vaping and using tobacco products. The money helps ensure more students learn about the health effects of tobacco, nicotine and vape use, the cost associated with using these products, and the advertising techniques used by the tobacco and vape industry to market their products to youth.

Vaping is a public health crisis among youth nationally and in Georgia, where 1 in 4 high school students report using e-cigarettes. According to the Georgia Department of Health, Northwest Georgia has a significantly higher smoking prevalence than the overall state average rate. To prevent 4th through 8th graders in Rome and surrounding counties of Floyd, Polk, and Chattooga from using tobacco and nicotine products, Rome/Northwest Tar Wars Strike Force, a local chapter of Tar Wars, provides local youth anti-tobacco and anti-vaping education, and prevention programming.

Since 2019, more than 6,500 students in Floyd County have participated in Tar Wars. Statewide, Tar Wars will impact at least 45,925 students in 117 schools across 22 counties in Georgia during the 2022-2023 school year. 

“As a company committed to the health and wellness of our communities across Georgia, we want to do all that we can to combat the devastating impact of smoking,” said Mel Lindsey, President, Amerigroup Georgia. “By supporting local organizations that are working to reduce smoking rates and improve public health, we can make a meaningful difference in the lives of our members and the communities we serve. We are honored to partner with the Rome Tar Wars Strike Force on this important work.”

Present to receive the Amerigroup funding on behalf of the Rome/Northwest Tar Wars Strike Force was Georgia Healthy Family Alliance Trustee, Patrick ‘PJ’ Lynn, MD. Dr. Lynn’s leadership of the Strike Force has been vital to Tar Wars’ successful implementation and funding support in the region.

“The rapid increase of e-cigarette usage among youth is a major public health crisis that requires robust programming and education so that young people understand the dangers and are equipped to seek out healthy alternatives to smoking,” said Patrick ‘PJ’ Lynn, MD. “Thanks to our partnership with Amerigroup, we can continue to promote healthy habits and lifestyles, and create a brighter, healthier future for Rome-area youth.”

About Tar Wars

Tar Wars tobacco and vape early education and prevention program is presented in collaboration with school districts across Georgia; and has impacted the lives of more than 10 million children worldwide since developed by family physicians in 1988. It’s an evidence-based, effective and interactive curriculum that has evolved to educate generations of Georgians. Traditionally beginning at the 4^th and 5^th grade level, students are educated on the health dangers and financial impact of tobacco, nicotine, and vape products. The program seeks to educate children before they are ever exposed to tobacco and vape to prevent tobacco, vaping associated lung injury, related illnesses and deaths. When youth never start smoking or vaping, they never have to quit.  For more information about Georgia’s family physicians’ efforts to fight for healthy children, visit www.georgiahealthyfamilyalliance.org

About Amerigroup Community Care of Georgia

Amerigroup Community Care of Georgia helps improve healthcare access and quality for more than 600,000 low-income Georgians by developing innovative care management programs and services. Members are assured care that is not only accessible but also accountable, comprehensive, integrated, and patient-centered. Amerigroup Georgia provides ongoing community relations and outreach to encourage members to become active participants in their health care. Through health education programs, members are empowered to choose and sustain a healthy lifestyle. For more information about Amerigroup Community Care of Georgia, visit www.myamerigroup.com/ga

Sarah C. Dupont, MD, MPH (of Atlanta) was recently published in the New England Journal of Medicine focusing on Public Health and the competing values of COVID-19 masking. Read more here:  https://www.nejm.org/doi/full/10.1056/NEJMp2207670

Samuel Le Church, MD (of Hiawassee) and the Georgia Academy’s President-Elect was recently quoted in a Modern Healthcare article that highlights Georgia’s nationally recognized Community Preceptor State Tax Credit. Read the full article here: https://www.modernhealthcare.com/education/preceptor-tax-credits-physician-training-georgia-colorado-missouri

Dr. Church also published a blog in the FPM Journal on a guide to the new codes for suture/staple removal. Read these key tips here: https://www.aafp.org/pubs/fpm/blogs/gettingpaid/entry/suture-staple-removal.html

As a physician you know that monitoring a young child’s development is crucial to their overall wellbeing. The Georgia Department of Early Care and Learning (DECAL) offers a set of tools for families to monitor their child’s progress using the CDC’s Learn the Signs. Act Early. developmental checklists and learn where to go for developmental screenings if they have concerns. You can find the Developmental Milestones website at http://development.decal.ga.gov. The research-based checklists were developed by the Centers for Disease Control and Prevention (CDC) in conjunction with the American Academy of Pediatrics (AAP) and are offered in English, Spanish, Vietnamese, Chinese and Korean. There are checklists for twelve different age groups, 2 months to 5 years, one for each of the AAP’s recommended well child visits. Each checklist shows skills in the four developmental domains, language and communication, movement and motor skills, social skills, and cognitive skills. We recommend that families complete the checklist prior to their well-child visit, as it’s a great way for families to communicate with their healthcare provider about their child’s development.

Features of DECAL’s Developmental Milestones Website

• A side-by-side comparison tool that allows families to look across age ranges for a complete picture of their child’s development
• Tips and activities for helping children at every age develop their skills and guiding questions to support conversations with health care providers
• Photos and videos illustrating many of the milestones
• A link to the CDC’s free Milestone Tracker App that can be downloaded to any mobile device
• Links to resources for concerns about possible developmental delays and other support for families.

You can help your patients access these free tools. Email childdevelopment@decal.ga.gov and we will send you postcards that you can make available.

Bridget Ratajczak is DECAL’s Child and Family Development Manager and the CDC’s Act Early Ambassador to Georgia.

Dr. Henry Gordon Davis Jr., MD, 104, of Sylvester, died on Sunday, April 23, 2023 at his residence. Dr. Davis was a leader within the Georgia Academy and the AAFP and, as a past President of the Georgia Academy, and worked tirelessly during his years on the Board to serve his fellow members. Those who knew Dr. Davis knew him to be an amazing leader and informed member during his tenure on the Board. As proof, Dr. Davis deservedly received the GAFP’s Family Physician of the Year award, our highest honor, in 1982. Dr. Davis was also a 1980 recipient of the Medical Association of Georgia’s Distinguished Service Award. 

He was a graduate of the University of Georgia, followed by studying at the University of Georgia School of Medicine, now Medical College of Georgia and received his Medical Degree in 1945. After a brief stint in the Army following his medical school internship, he practiced family medicine in Sylvester from 1948 until his retirement in 1995, including the delivery of 3,465 babies including two of his daughters and six grandchildren.

Dr. Davis realized a need in the community to care for the elderly and infirm who were no longer able to care for themselves, and first built Georgia Care, Inc (now Pruitt Health Sylvester) in 1964, followed by Georgia Care of Tifton, Inc (now Rehabilitation Center of South Georgia) in 1966 and Georgia Care of Albany, Inc (now Pruitt Health-Albany) in 1967.

Dr. Davis was a Georgia Healthy Family Alliance (GHFA) Board Trustee and generous donor to the Alliance and the GAFP Board of Directors donated $500 to the GHFA in his honor as a past president of the GAFP.

He was remarkable man and physician and will truly be missed!

The Advisory Committee on Immunization Practices (ACIP) approved the Recommended Child and Adolescent Immunization Schedules, with full recommendations at ACIP Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger — US, 2023.

Key updates include:

Changes:

• COVID-19: routine schedule now includes primary and booster doses in immunocompetent and immunocompromised individuals. ACIP COVID-19 Vaccine Recommendations | CDC
• Influenza: Live attenuated influenza vaccine should not be administered to close contacts of immunosuppressed persons who require a protected environment. ACIP Recommendations — US, 2022–23 Influenza Season | MMWR (cdc.gov)
• Measles, mumps, rubella (MMR): MMRV added as option in the MMR row. Additional MMR doses are recommended during a mumps outbreak. ACIP Recommendations – Use of a Third Dose of Mumps Virus–Containing Vaccine in Persons at Increased Risk for Mumps During an Outbreak (2018)
• 15-valent pneumococcal conjugate vaccine (PCV 15): 13-valent pneumococcal conjugate vaccine (PCV13) and PCV15 may be used interchangeably in both healthy children and those with increased risk of invasive pneumococcal disease.
• Language was added to clarify the minimum interval between doses 3 and 4 in a catch-up schedule: “This dose is only necessary for children aged 12–59 months regardless of risk, or aged 60–71 months with any risk, who received 3 doses before age 12 months.” Use of PCV-15 Among U.S. Children: Updated Recommendations of ACIP — US, 2022 | MMWR (cdc.gov)

Clarifications:

Hepatitis B: Language has been added on recommendations for infants born to mothers who are HBsAg positive or unknown. In addition, Heplisav-B and PreHevbrio may be used for catch-up use in persons aged 18 years and older.

• Human papillomavirus (HPV): is not recommended during pregnancy.
• Meningococcal ACWY: Menveo one-vial formulation should not be given prior to 10 years of age.
• Meningococcal B: If the second dose of Trumenba is administered >6 months after the first dose, then a third dose is not needed. If the third dose of Trumenba is administered earlier than 4 months after the second dose, then a fourth dose should be administered >4 months after the third dose.
• Inactivated polio: Recommendations have been added for adults at increased risk for exposure to polioviruses. Polio Vaccination Recommendations for Specific Groups (2022)

Merck’s MMR, MMR-Varicella, and Varicella Vaccines:

On February 27, 2023, FDA approved changes related to Merck’s MMR, MMR-Varicella, and Varicella vaccine to be administered via intramuscular (IM) injection in addition to sub-cutaneous (SQ) injection.  This change does not apply to GSK’s MMR vaccine.

Links to the updated package inserts for these vaccines are shown below:

Package insert for MMR vaccine: Measles, Mumps and Rubella Virus Vaccine Live | FDA
Package insert for MMR-Varicella vaccine: PROQUAD | FDA
Package insert for Varicella vaccine: VARIVAX (refrigerated and frozen formulations) | FDA

Georgia’s congenital syphilis rate is at its highest level since record-keeping began in 1998. The rate has increased every year since 2016. Congenital syphilis is preventable. Each case is one too many when adequate prenatal care, syphilis testing, and early treatment can save lives. This year the Georgia General Assembly passed Senate Bill 46 which revises current testing requirements for pregnant women by requiring clinicians who care for a woman during pregnancy to perform HIV and syphilis testing at the first prenatal visit, 28-32 weeks gestation, and upon delivery.

This law will go into effect on July 1, 2023. Syphilis treatment (benzathine penicillin G only) initiated at least 30 days before birth has proven effective at decreasing the chances that a baby is born with congenital syphilis.

Treatment for HIV should be initiated immediately. HIV antiretroviral therapy during pregnancy, at the time of delivery, and prophylaxis to the newborn dramatically reduce perinatal transmission of HIV.

In addition to the new requirements put in place under Senate Bill 46, Georgia law also requires all Georgia physicians, laboratories, and other clinicians to report patients with syphilis infections to the Georgia Department of Public Health (Georgia Code OCGA §31-12-2). Both laboratory-confirmed and clinical diagnoses are reportable within the specified time intervals.

Ensuring your patients are tested at appropriate intervals will help protect the health and well-being of every mother and infant in Georgia.

If you have any questions, don’t hesitate to contact your district public health office, or call the Georgia Department of Public Health at 1-866-PUBHLTH (1-866-782-4584).

The Georgia Department of Public Health, in partnership with Georgia Academy of Family Physicians, has developed the following survey to help us better understand developmental screening practices in Georgia. We will use this information to develop and provide additional education, training, and support for family physicians and their staff.

The survey will ask about your experiences with identifying and referring children and other state-related services you utilize to support children in your practice. As a thank you for your input, 15 participants will be randomly selected to receive a $30 Amazon gift card (assessment must be completed by June 7 to be in the running).

Complete survey