| action-alert-act-now-to-prevent-physician-shortages | Action Alert! Act Now to Prevent Physician Shortages | Latest_News | Shared_Content/News/advocacy-report/2026/April 3/action-alert-act-now-to-prevent-physician-shortages | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/advocacy-report/2026/april/getty-images-8RHFeR8fbOI-unsplash-for-web.jpg" class="pull-right" alt="Concerns with Medicare and Medicaid " /></div>
<h5>Apr. 3, 2026</h5>
<h2>Action Alert! Act Now to Prevent Physician Shortages</h2>
<p><em>Urge Congress to support H.R. 7961</em>
</p>
<p>
The bipartisan <a href="https://www.congress.gov/bill/119th-congress/house-bill/7961">H-1Bs for the Physicians and Healthcare Workforce Act (H.R. 7961)</a> would exempt physicians from the new $100,000 H-1B visa filing fee—helping ensure hospitals and physician practices can continue recruiting the international medical graduates who make up one in four U.S. physicians and serve many underserved communities. Without this fix, rising costs will worsen physician shortages, increase wait times for appointments, and limit access to care.
</p>
<p>
Take action: <a href="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=%2fCampaigns%2f130422%2fRespond">Urge your member of Congress to co-sponsor H.R. 7961 and protect patient access to care</a>.
</p>
<p>
The WSMA has reached out directly to members of Washington's congressional delegation to request their support for this critical legislation.
</p>
</div> | 4/2/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| wsma-raises-concerns-with-cms-on-wiser-model-implementation | WSMA Raises Concerns with CMS on WISeR Model Implementation | Latest_News | Shared_Content/News/advocacy-report/2026/April 3/wsma-raises-concerns-with-cms-on-wiser-model-implementation | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/advocacy-report/2026/april/Medicare-iStock-1047505000-645x425px.jpg" class="pull-right" alt="Concerns with Medicare and Medicaid " /></div>
<h5>Apr. 3, 2026</h5>
<h2>WSMA Raises Concerns with CMS on WISeR Model Implementation</h2>
<p><em>Share your experiences under the new Medicare prior authorization pilot</em>
</p>
<p>
The WSMA recently sent a follow-up <a href="https://takeaction.wsma.org/wp-content/uploads/2026/03/wsma-follow-up-letter-to-cmmi-03262026.pdf">letter to the Centers for Medicare and Medicaid Services' Center for Medicare and Medicaid Innovation</a> regarding physician and patient experiences under the Wasteful and Inappropriate Service Reduction Model.
</p>
<p>
In the letter, the WSMA shares real-world examples from Washington physicians highlighting delays in care, administrative challenges, and ongoing issues with prior authorization and claims processing. These include extended authorization timelines, difficulty accessing the vendor portal, and unresolved discrepancies that have left some practices unable to receive payment despite valid approvals.
</p>
<p>
The letter emphasizes that while we support efforts to improve program integrity, current implementation challenges are causing concerning disruptions in patient care and clinical workflows. We will continue to engage with CMS and advocate for improvements.
</p>
<h5>Follow WSMA guidance for Medicare prior authorizations</h5>
<p>
The WISeR model took effect Jan. 15 and subjects new prior authorization and prepayment review requirements to certain traditional Medicare services. Not sure if your practice is affected? <a href="https://www.wsma.org/wsma/resources/practice-management/prior-authorization-navigator/wsma/resources/practice-management/prior-authorization-navigator.aspx?hkey=97bc759f-c0fe-45fe-aa78-55d6b3ea017f">WSMA's resource</a> outlines impacted services and provides step-by-step guidance on documentation, prior authorization, and claims submission to help your practice navigate these new requirements.
</p>
<h5>Are you subject to WISeR? Share your experience</h5>
<p>
We strongly encourage impacted practices to share their experiences with WISeR with us—including administrative challenges, access issues, and impacts on patient care (positive or negative). The WSMA is uniquely positioned to serve as a conduit between Washington physicians, members of Congress, Virtix, Noridian, CMS, and the media. Your experience under WISeR is critical to informing ongoing congressional oversight and future CMS decision-making. Please contact WSMA Director of Policy Jeb Shepard at <a href="mailto:jeb@wsma.org">jeb@wsma.org</a> to share your feedback.
</p>
</div> | 4/2/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| wsmas-latest-prior-authorization-reform-bill-signed-into-law | WSMA's Latest Prior Authorization Reform Bill Signed Into Law | Latest_News | Shared_Content/News/advocacy-report/2026/April 3/wsmas-latest-prior-authorization-reform-bill-signed-into-law | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/advocacy-report/2026/april/SB-5395-bill-signing-photo-cropped.jpg" class="pull-right" alt="WSMA 2026 priority legislation updates" /></div>
<h5>Apr. 3, 2026</h5>
<h2>WSMA's Latest Prior Authorization Reform Bill Signed Into Law</h2>
<p><em>Legislation sets parameters on AI use and determination timelines</em>
</p>
<p>
Last week, WSMA priority legislation <a href="https://app.leg.wa.gov/BillSummary/?BillNumber=5395&amp;Year=2025&amp;Initiative=false">Senate Bill 5395</a> was signed into law by Gov. Bob Ferguson. The bill, developed in partnership by the WSMA, the Washington State Hospital Association, and Proliance Surgeons, is the third prior authorization reform bill the WSMA has helped advance through the legislative process since 2020, working to address a top priority issue for our state's physician community and patients.
</p>
<p>
Aligning with recent WSMA House of Delegates policy, SB 5395 prohibits insurance carriers from solely using artificial intelligence to deny prior authorizations, ensuring that a licensed health care practitioner makes such determinations. The bill also clarifies a prohibition in state law around retroactive denials of prior authorizations and requires insurance carriers to post policy updates on a single site.
</p>
<p>
SB 5395 builds on legislation from 2023 that requires integration of prior authorization processes into electronic health records to help streamline and expedite determinations. That law goes into effect Jan. 1, 2027, dovetailing with a similar federal law that was put in place subsequent to WSMA's legislation. The federal law applies to prior authorizations for physical health care services, while the state law goes further and also applies to prescription drug authorizations.
</p>
<p>
In 2020, the WSMA and WSHA successfully advocated for a bill requiring tracking of insurance carriers' utilization of prior authorization, directing <a href="https://app.leg.wa.gov/ReportsToTheLegislature/Home/GetPDF?fileName=FINAL%202025%20Prior%20Authorization%20Report_43836481-1f6e-428a-9a65-00de64d2e8b2.pdf">annual reports</a> from the Office of the Insurance Commissioner. As expected, the reports have found the vast majority of prior authorizations are approved, underscoring frustration that the process primarily serves to drive up costs for practices and cause delays for patients accessing care.
</p>
<p>
While we're proud of our work to help reform prior authorization processes and our state's standing as a leader on this issue, we know there's more to be done. We’ll continue to work at the state and federal levels to advance WSMA policies on prior authorization and mitigate its administrative and financial burdens.
</p>
</div> | 4/2/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| your-input-needed-during-opioid-prescribing-workshops | Your Input Needed During Opioid Prescribing Workshops | Latest_News | Shared_Content/News/advocacy-report/2026/April 3/your-input-needed-during-opioid-prescribing-workshops | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/advocacy-report/2026/april/opioid_hydrocodone_bottle-645x425px.jpg" class="pull-right" alt="WSMA 2026 priority legislation updates" /></div>
<h5>Apr. 3, 2026</h5>
<h2>Your Input Needed During Opioid Prescribing Workshops</h2>
<p><em>WSMA comments emphasize need to simplify and streamline prescribing rules</em>
</p>
<p>
Members of the physician community with expertise in pain management or insights into how Washington state's opioid prescribing requirements can be improved are strongly encouraged to attend the following upcoming virtual workshops hosted by the Washington Medical Commission to gather stakeholder input on potential changes to state opioid prescribing rules for allopathic physicians and physician assistants:
</p>
<p>
</p>
<ul>
<li>April 27, 1–3 p.m.</li>
<li>June 1, 1–3 p.m.</li>
<li>July 13, 1–3 p.m.</li>
</ul>
<p>&nbsp;</p>
<p>
Register to attend the virtual workshops <strong><a href="https://wmc.wa.gov/policies-rules/rules-and-regulations-progress">here</a></strong>. Submit written comments <strong><a href="https://wmc.wa.gov/rule_making_2025/opioid-prescribing-general-provisions-mds-and-pas">here</a></strong>. For background, the commission has already convened several workshops, most recently on March 23. Materials from that meeting, including the latest draft proposal, public comments, and the rulemaking timeline, are <strong><a href="https://wmc.wa.gov/sites/default/files/OPGPRulesWorkshopMaterials2.23.26Rev.%202.19.26.pdf">available here</a></strong>.
</p>
<h5>WSMA comments on changes to state opioid prescribing rules</h5>
<p>
The WSMA has submitted <a href="javascript://[Uploaded files/News and Publications/newsletters/2026/WSMA-cover-letter-for-suggested-opioid-rule-edits_02112026.pdf]">comprehensive comments</a> outlining the need to simplify and streamline Washington's complex opioid prescribing rules. The WSMA continues to emphasize the importance of maintaining patient access to appropriate pain care while ensuring regulatory clarity and flexibility for physicians.
</p>
<p>
If you plan on engaging with the stakeholder feedback opportunity, the WSMA would welcome your comments, as well. Contact the <a href="mailto:policy@wsma.org">WSMA policy department</a> with input.
</p>
</div> | 4/2/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| wsma-legislative-priorities-advancing-as-session-winds-down | WSMA Legislative Priorities Advancing as Session Winds Down | Latest_News | Shared_Content/News/advocacy-report/2026/March 6/wsma-legislative-priorities-advancing-as-session-winds-down | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/advocacy-report/2026/february/2026-Leg-Session-Graphic.png" class="pull-right" alt="WSMA 2026 Legislative Session Updates" /></div>
<h5>Mar. 6, 2026</h5>
<h2>WSMA Legislative Priorities Advancing as Session Winds Down</h2>
<p>The 2026 legislative session is scheduled to adjourn next Thursday, March 12, and the final days of session will be dominated by budget negotiations and deliberations over whether to establish a state income tax. If you missed last week's update on legislative budget proposals, you can read it <a href="https://wsma.org/Shared_Content/News/ceo-rounds/2026/ceo-rounds-feb-24-2026-legislative-budget-proposals-released-what-they-mean-for-health-care">here</a>. Meanwhile, in addition to House Bill 2242, which will preserve access to preventive care and vaccines in our state, the WSMA has been successful in advancing—and defeating—a number of key legislative priorities this year.</p>
<p>Over the last week, votes have been taken in House and Senate committees to approve insurance reforms related to prior authorization (<a href="https://app.leg.wa.gov/BillSummary/?BillNumber=5395&amp;Chamber=Senate&amp;Year=2025">SB 5395</a>) and prompt payment and insurance carrier claw backs (<a href="https://app.leg.wa.gov/BillSummary/?BillNumber=5845&amp;Year=2025&amp;Initiative=false">SB 5845</a>). Legislation to extend the statutory deadlines of the Medicaid Access Program (<a href="https://app.leg.wa.gov/BillSummary/?BillNumber=2385&amp;Year=2025&amp;Initiative=false">HB 2385</a>) is also advancing.</p>
<p>Defending against bills we oppose is just as important as advancing bills in Olympia, and as of this writing all scope of practice bills the WSMA opposes are considered "dead" for the 2026 session. A Senate proposal to expand scope of practice for pharmacists did get serious consideration this year, and the WSMA will be working with proponents of the bill over the legislative interim to try to work toward an appropriate compromise on the issue. The prime sponsors of the legislation in both the House and the Senate are pharmacists and have signaled their intention to have a bill approved in the 2027 session.</p>
</div> | 3/27/2026 10:47:40 AM | 1/1/0001 12:00:00 AM |
| ceo-rounds-mar-27-2026-legal-victory-strengthens-critical-safeguard-for-physician-practice | CEO Rounds: Mar. 27, 2026 - Legal Victory Strengthens Critical Safeguard for Physician Practice | Latest_News | Shared_Content/News/ceo-rounds/2026/ceo-rounds-mar-27-2026-legal-victory-strengthens-critical-safeguard-for-physician-practice | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;">
<img src="https://wsma.org/images/Newsletters/ceo-rounds/ceo-rounds-article-graphic-2025-1290x850px.png" class="pull-right" alt="CEO Rounds with Jennifer Hanscom, WSMA CEO graphic" />
</div>
<h5>
Mar. 27, 2026
</h5>
<h2>
Legal Victory Strengthens Critical Safeguard for Physician Practice
</h2>
<p>
Jennifer Hanscom, WSMA CEO
</p>
<p>
Physicians often recognize the WSMA for its advocacy in Olympia. That work is essential, but it’s only part of the story. The WSMA advocates for physicians wherever decisions affecting the practice of medicine are made: with our congressional delegation, in the regulatory arena, with insurers, in the media, and before the courts.
</p>
<p>
It’s this last area—legal advocacy—that often goes undetected. Court cases can stretch on for years and their outcomes are rarely suited to easy summaries. Yet, this work is critically important, particularly in a state environment where our state’s legislative leadership has historically shown little support for tort reform.
</p>
<p>
Much of WSMA’s legal advocacy occurs through "friend of the court," or amicus curiae briefs. These briefs present a physician-centric perspective in cases that can shape the legal framework that governs medical practice. Often these briefs are aimed at preserving the limited but important protections physicians have under state statues and case law.
</p>
<p>
That work paid off again last week.
</p>
<p>
The Washington State Supreme Court affirmed a key jury instruction known as the “exercise of judgment†standard. This instruction reminds juries of a fundamental reality: medicine is not an exact science. It states that the physician is not liable for choosing among reasonable alternatives, provided that decision was made with appropriate care and skill within the standard of care.
</p>
<p>
This protection has been challenged before. In Fergen v. Sestero (2015), dissenting justices argued the instruction was "slanted." However, with support from the WSMA and partners, the court upheld it, and that reasoning later contributed to a unanimous decision in Paetsch v. Spokane Dermatology Clinic, PS.
</p>
<p>
More recently in Beard v. Everett Clinic, the issue resurfaced. The question before the court was whether the instruction requires only that a physician's decision fall within the standard of care, or whether the physician's decision-making process must also independently meet that standard.
</p>
<p>
Recognizing the stakes, the WSMA filed an amicus brief, joined by the AMA Litigation Center, the Washington State Hospital Association, the Washington Academy of Family Physicians, and the Washington Chapter of the American College of Emergency Physicians, with support from Physicians Insurance.
</p>
<p>
In a victory for the profession, this month the Supreme Court affirmed the lower court's decision and upheld the use of the instruction, once again rejecting efforts to narrow or eliminate it. <strong>This outcome reinforces a critical safeguard for physicians: that reasonable clinical judgment, exercised within the standard of care, remains protected.</strong>
</p>
<p>
Behind the scenes, this work requires significant time, expertise, and collaboration. The WSMA relies on specialized outside counsel and strong partnerships to ensure the physician voice is effectively represented in the courts.
</p>
<p>
The WSMA is grateful to our legal team and the lawyers who brought this case to our attention, as well as our partners in the brief. We are equally grateful for our partnership and support from the AMA Litigation Center, the Washington State Hospital Association, Physicians Insurance, and, in this case, the Washington Academy of Family Physicians and the Washington Chapter of the American College of Emergency Physicians. The engagement and support from these groups increased the impact of the amicus argument.
</p>
<p>
To learn more about how the WSMA decides to engage in amicus briefs or legal actions, visit the <a href="https://www.wsma.org/wsma/advocacy/legal/wsma/advocacy/legal/legal.aspx">Legal page</a> in the advocacy section of our website.
</p>
</div> | 3/27/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| the-wsma-celebrates-match-day-the-best-is-yet-to-come | The WSMA Celebrates Match Day! The Best Is Yet to Come | Latest_News | Shared_Content/News/Latest_News/2026/the-wsma-celebrates-match-day-the-best-is-yet-to-come | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img alt="WSMA celebrates 2026 Match Day" src="/images/Newsletters/latest-news/2026/march/match-day-2026-1200x628px.png" class="pull-right" /></div>
<h5>Mar. 19, 2026</h5>
<h2>The WSMA Celebrates Match Day! The Best Is Yet to Come</h2>
<p>By Graham Short</p>
<p>
Friday, March 20 is Match Day! On Match Day, we celebrate the next step in a medical student's training to become a trusted healer and advocate for their patients. This day reminds us that working with patients is the reason physicians become physicians: to heal and save lives, a core theme of our <a href="[@]wsma/advocacy/your-care-is-at-our-core.aspx">Your Care Is at Our Core campaign</a> to restore the trust at the heart of the patient-physician relationship.
</p>
<p>
Celebrating Match Day at the WSMA is also celebrating two key demographics in our membership: our medical student members and our resident physician members. On Match Day, medical students learn which residency program they will join, marking the transition from student to physician-in-training. Students and physicians-in-training are intimately involved at the WSMA, informing policymaking (all members have a voice through our <a href="[@]wsma/events/annual_meeting/virtual-reference-committees.aspx">reference committees</a>), serving on our <a href="[@]wsma/about/who_we_are/board-of-trustees.aspx">board of trustees</a> and <a href="[@]wsma/about/who_we_are/house-of-delegates.aspx">House of Delegates</a> as a trustee, delegate, or alternate delegate, and informing the WSMA on its resources for students and residents through the <a href="[@]wsma/about/who_we_are/early-career-sections.aspx">WSMA Early Career Sections</a>. As a sign of our commitment to supporting students and residents on their journeys to becoming physicians, membership in the WSMA is <a href="[@]wsma/membership/join_renew/dues_categories.aspx">free</a>.</p>
<p>
Match Day is a reminder that medical students are a crucial part of not just the WSMA but of the health care ecosystem. They're tomorrow's physicians but today's eager learners and explorers—as such, they inform and teach the older generations of physicians, creating a two-way street of inspiration, information, and integration, making a stronger, united health care workforce.
</p>
<h3>Match Day memories</h3>
<p>
For this year's Match Day, the WSMA turned to its executive physician leadership—once and always former students themselves—to jog their memories of Match Days gone past. In them are lessons and insights for today's new cadre of physicians-in-training. Enjoy these memories and have a happy Match Day!
</p>
<p>
<strong>Bridget Bush, MD, WSMA president:</strong>
</p>
<p>
"I did the military match in December, so I already knew where I was going for the March Match Day. That being said, it was the first time since Katrina I got to see my classmates as we gathered in Houston. In fact, it and Graduation Day in May were the last days I saw most of them including my dear friend Adam who we lost to suicide in 2021. I have my 20th medical school reunion this April and it seems crazy to have been so long from that [Match] day!
</p>
<p>
"I loved seeing my classmate's faces as they opened their envelopes. The sense of pride at how awesomely we had all done (I was continuously impressed by the quality of doctors my classmates were becoming). I felt grateful to be a part of the class and the community, even though touched with a tinge of envy as I was only matched to an internship in the Navy (you must apply again for residencies during your internship in that branch).
</p>
<p>
"Some of it was bittersweet as I knew this was a milestone on our paths forward signifying that our medical school journey was nearly complete. I felt more acutely the loss of the time in New Orleans because of having to leave with Katrina. Fourth year was supposed to be the year I explored the city more, enjoyed more of its offerings in music and culture and food. Maybe that explains why I feel I have to go back there every few years."
</p>
<p>
<strong>John Bramhall, MD, PhD, WSMA immediate past president:</strong>
</p>
<p>
"Medical school is a bit of a tasting menu where you have the opportunity to watch what happens in a variety of clinical settings and then absorb your feelings. Probably because of my experience of working in big technical research labs embedded in large academic systems, I found a natural affinity for the operating room—filled with equipment and very team-based—gravitating to anesthesiology as likely to be an enjoyable career choice.
</p>
<p>
"I was attracted to the way in which clinical anesthesiology practice had been refined and taught at Virginia Mason and so I applied for residency in Seattle. At that time, Virginia Mason was a center of excellence in regional anesthesia, and the training was almost exclusively based on physical anatomy. The attendings were enthusiastic, the little hospital was cheerful, and the teaching ur-text was by Andreas Vesalius! I thought it was all rather esoteric, and I was delighted when they accepted me into their program.
</p>
<p>
"I recall being very happy to have got into my chosen program, but I do think it was useful for me to be more than a little open, emotionally, to the possibility of only getting into one of my lower-ranked locations. I do, also, remember that my faculty advisor at UCSD was vaguely disappointed that I had chosen anesthesiology over 'real medicine' that he thought I would be 'good at,' so having to turn to an alternative cognitive specialty would have at least made him happy, and I liked him, so possibly I would have been happy too!</p>
<p>"I have no advice, other than the obvious—don't apply for anything that you predict will make you miserable!"
</p>
<p>
<strong>Bindu Nayak, MD, WSMA vice president:</strong>
</p>
<p>
"When your whole life seems to be building up to this moment that will decide the next step in your journey, emotions are high as you anticipate receiving that news that will change everything. This pivotal moment is something I hope you will treasure and look back on with joy. Whatever path you land on will take you to amazing places, life experiences and the reality of finally making it to your goal of being a physician. Enjoy every minute and know that wherever you go, you will do amazing things.
</p>
<p>
"Growing up in Louisiana, I put all my hopes and dreams into matching in internal medicine in Washington D.C. to follow my heart and my dreams. My fiancé (now husband) had already been in residency there for two years. Match day would determine if we would actually live in the same place. I loved D.C. and when I received the news that I did get my top choice, Georgetown University Medical Center, for my residency, I was overjoyed and it felt like so much more than just a residency falling into place. It felt like the first day of my dreams coming true."
</p>
<p>
<strong>John Scott, MD, WSMA secretary-treasurer:</strong>
</p>
<p>
"My advice to students is: be open and be present. There is this uncertainty that it's a little maddening, and even if you don't get top choices, there are so many excellent programs. I have friends who had an unexpected match day that in the long run worked out very well for them. Be there for your friends and classmates and their range of emotions that they will be feeling. Oh, and enjoy the last few months of 4th year because you’re going to work harder than you ever have for the next 3-7 years. Good luck!
</p>
<p>
"I matched into internal medicine at Stanford back in 1998. I was very happy because it was my #1 choice and I would be going back to where I grew up. I did the couple's match with my wife so we had applied to 20 different places all over the country, and we really had no idea where we were going to end up. She matched into the primary care pediatrics program at University of California, San Francisco, and made some amazing friends and got excellent training. I remember feeling relief that we were going to be in same city, and I was blown away by my classmates and the amazing places they were going to. And also, a little bit sad because I probably wouldn’t see some of these folks again or at least for many years."
</p>
<p>
Happy Match Day, graduates!
</p>
<p><em>Graham Short is WSMA's director of communications.</em></p>
</div> | 3/19/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| 2026-session-recap-key-policy-wins-for-physicians-patients | 2026 Session Recap: Key Policy Wins for Physicians, Patients | Latest_News | Shared_Content/News/advocacy-report/2026/March 16/2026-session-recap-key-policy-wins-for-physicians-patients | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/advocacy-report/2026/february/2026-Leg-Session-Graphic.png" class="pull-right" alt="WSMA 2026 Legislative Session Updates" /></div>
<h5>Mar. 16, 2026</h5>
<h2>2026 Session Recap: Key Policy Wins for Physicians, Patients</h2>
<p>
The 60-day, 2026 legislative session adjourned as scheduled on March 12. It was a successful session for the WSMA and physician community, with passage of key policy bills to ensure access to vaccines, reform prior authorization, and require insurance carriers to pay claims in a timely fashion. We also successfully defeated all bills we opposed this year.
</p>
<p>
Legislators worked against the backdrop of a state budget dynamic that continues to be challenging. Updates to the state budget were approved on the final day of session with a combination of cuts and new spending, the latter driven by rising state tort claims and increased utilization of state programs such as Medicaid.
</p>
<p>
In the budget space, the WSMA successfully advocated for priority funding items to maintain the state's Apple Health Expansion immigrant coverage program, promote insurance affordability though subsidies for plans on the Washington Health Benefit Exchange, and fully fund Foundational Public Health Services. We also advocated against a proposed cut to Medicaid coverage for physical, occupational, and speech therapy services, which was restored in the final budget.
</p>
<p>
Budget negotiations in the coming years will likely continue to be challenging, particularly as cuts to federal health care funding from H.R. 1 are implemented. In spite of this, we will continue to advocate for Medicaid rate increases for professional service delivery and business and occupation tax reform for independent practices. While we were disappointed to not see more progress on those issues this year, given the state of the state's budget, we were also grateful that the final spending plan did not include cuts to Medicaid rates or tax increases on physician practices.
</p>
<h3 id="TheMillionairesTax">The Millionaires Tax</h3>
<p>
While the final state budget did not rely on tax increases on physician organizations, much of session was dominated by tax talk, specifically on <a href="https://app.leg.wa.gov/billsummary/?BillNumber=6346&amp;Year=2025&amp;Initiative=false" target="_blank">Senate Bill 6346</a>, which establishes a state income tax on individuals and spouses with annual income over $1 million.
</p>
<p>
Through the course of session, the WSMA advocated for dedicated revenue from the millionaires tax to support Medicaid rate increases and broad B&amp;O tax mitigation for physician groups and health care professionals - both intended to help promote health care access and affordability, as well as the viability of independent physician practice.
</p>
<p>
Negotiations over the bill culminated in a debate in the House of Representatives that ran more than 24 hours, with majority-party Democrats rejecting numerous amendments before taking a final vote on the bill.
</p>
<p>
The WSMA worked in collaboration with physician groups to develop one of the few amendments that was accepted. Our amendment eliminates the 0.5% B&amp;O tax surcharge on large medical groups that gross over $250 million annually one year earlier than directed under current law, saving physician groups an estimated $22 million and aligning with a similar policy in the bill for hospitals. Other noteworthy tax mitigation in the bill includes elimination of sales tax on certain services beginning in 2029, such as temporary staffing services, continuing education, custom IT projects, hygiene products, and diapers.
</p>
<p>
While Gov. Bob Ferguson has signaled that he will sign the millionaires tax into law, that won't be the last hurdle before it's implemented. Opponents of the law have signaled they will attempt to gather sufficient signatures to force ratification by voters in November. The bill will also face legal action challenging its constitutionality. If it withstands scrutiny, the tax will be assessed beginning in 2029.
</p>
<h3 id="WSMAPolicyPriorityWins">WSMA Policy Priority Wins</h3>
<p>
The millionaires tax grabbed most of the headlines from Olympia this year, but it was far from the only issue on the table. Between bills that were introduced in the 2026 session and those from 2025 that didn't pass and were automatically reintroduced, there were more than 3,500 bills eligible for consideration this session. The WSMA tracked and engaged on more than 600 of those bills, seeing wins on our following priority issues:
</p>
<p>
</p>
<ul>
<li>
Prior authorization reform | <a href="https://app.leg.wa.gov/billsummary/?BillNumber=5395&amp;Year=2025&amp;Initiative=false" target="_blank">Senate Bill 5395</a>
<ul>
<li>Continues recent efforts to modernize insurance carrier prior authorization processes, including prohibiting carriers from solely using AI to deny prior authorization and clarifying an existing prohibition on retroactive denials of prior authorization. This bill was developed by the WSMA in partnership with the Washington State Hospital Association and Proliance Surgeons.
</li>
</ul>
</li>
<li>
Timely insurance payments | <a href="https://app.leg.wa.gov/BillSummary/?BillNumber=5845&amp;Year=2025&amp;Initiative=false" target="_blank">Senate Bill 5845</a>
<ul>
<li>Generally requires insurance carriers to pay "clean claims" within 30 days and reduces the time period in which reimbursement for claims can be retroactively clawed back by a carrier to 12 months.
</li>
</ul>
</li>
<li>
Vaccine and preventive service access | <a href="https://app.leg.wa.gov/BillSummary/?BillNumber=2242&amp;Year=2025&amp;Initiative=false" target="_blank">House Bill 2242</a>
<ul>
<li>Modifies state policy to preserve access to preventive services, including vaccines, on a covered basis through health insurance plans and the state's Childhood Vaccine Program.
</li>
</ul>
</li>
<li>
Medicaid Access Program date extension | <a href="https://app.leg.wa.gov/BillSummary/?BillNumber=2385&amp;Year=2025&amp;Initiative=false" target="_blank">House Bill 2385</a>
<ul>
<li>Maintains the Medicaid Access Program in statute until 2030 to allow the state to revisit seeking federal approval of the program in the future when feasible.
</li>
</ul>
</li>
</ul>
<p>
Other bills supported by the WSMA that were passed by the Legislature this year include <a href="https://app.leg.wa.gov/BillSummary/?BillNumber=6025&amp;Year=2025&amp;Initiative=false" target="_blank">Senate Bill 6025</a> from the Washington Chapter of the American College of Obstetricians and Gynecologists to update the state's definition of fetal death, <a href="https://app.leg.wa.gov/BillSummary/?BillNumber=1155&amp;Year=2025&amp;Initiative=false" target="_blank">House Bill 1155</a> to prohibit noncompetition agreements, <a href="https://app.leg.wa.gov/BillSummary/?BillNumber=6182&amp;Year=2025&amp;Initiative=false" target="_blank">Senate Bill 6182</a> to fund direct patient abortion clinical care services, <a href="https://app.leg.wa.gov/BillSummary/?BillNumber=2225&amp;Year=2025&amp;Initiative=false" target="_blank">House Bill 2225</a> to regulate AI chatbots, and <a href="https://app.leg.wa.gov/BillSummary/?BillNumber=2320&amp;Year=2025&amp;Initiative=false" target="_blank">House Bill 2320</a> to prohibit the manufacture of 3D-printed firearms.
</p>
<p>
As is always the case, scope of practice proposals consumed a substantial portion of our lobbying capacity this session. Along with the reintroduction of bills to grant prescriptive authority to psychologists and expand it for naturopaths, a new proposal was considered to permit pharmacists to independently diagnose and prescribe. Guided by our policy to analyze whether scope proposals entail adequate education and training to ensure patient safety, the WSMA successfully opposed these bills. At the direction of key legislators, we will be working with the pharmacists over the interim to try to find common ground on an appropriate update to their scope of practice.
</p>
<p>
Another topic of extensive discussion in recent months is the practice of international medical graduates. Upon negotiation with legislators and advocates for the IMG community, the WSMA was able to work to compromise on <a href="https://app.leg.wa.gov/BillSummary/?BillNumber=5185&amp;Year=2025&amp;Initiative=false" target="_blank">Senate Bill 5185</a>, which creates a pilot program under which IMGs who are currently working in structured settings in the state can work toward licensure as primary care physicians upon attainment of extensive, stipulated education and training.
</p>
<p>
The WSMA was successful in amending or defeating all bills we opposed this session. Those that died include <a href="https://app.leg.wa.gov/BillSummary/?BillNumber=2613&amp;Year=2025&amp;Initiative=false" target="_blank">House Bill 2613</a> imposing restrictions on drug compounding, <a href="https://app.leg.wa.gov/BillSummary/?BillNumber=5921&amp;Year=2025&amp;Initiative=false" target="_blank">Senate Bill 5921</a> legalizing psilocybin, and <a href="https://app.leg.wa.gov/BillSummary/?BillNumber=5990&amp;Year=2025&amp;Initiative=false" target="_blank">Senate Bill 5990</a> permitting advance practice providers to work as local health officers.
</p>
<p>
Legislative advocacy is a team sport. Through the course of session we partnered on these bills and others with the physician organizations that advocate in Olympia, as well as patient groups, the public health community, hospitals, community health centers, and other stakeholders. We’re grateful for these partnerships and the ongoing advocacy efforts of our physician members.
</p>
<h3 id="WhatsNextPromotingPreserving">What's Next : Promoting Patient Access and Preserving Independent Practice</h3>
<p>
At the top of the WSMA's legislative agenda this year were two ongoing priorities: mitigating recent B&amp;O tax increases on independent practices and across-the-board rate increases for Medicaid professional services. Both come with steep price tags and uphill climbs given the state's budget shortfall. But both are also essential for promoting the viability of independent practice, as well as health care affordability and access to care.
</p>
<p>
As we move into the legislative interim, we'll carry these issues and other priorities into conversations with legislative candidates in the 2026 midterm elections. We’ll also be discussing next steps around medical title transparency, as <a href="https://app.leg.wa.gov/billsummary/?BillNumber=2261&amp;Year=2025&amp;Initiative=false" target="_blank">the bill</a> the WSMA developed with physician specialty partners was considered but not passed in the 2026 session.
</p>
<p>
WAMPAC is the nonpartisan campaign arm of the WSMA which works to identify and support candidates for political office whose priorities align with the house of medicine. If you want to support the WSMA's advocacy efforts, consider joining the <a href="https://www.wsma.org/wsma/advocacy/wampac/give_to_wampac/wsma/advocacy/wampac/give_to_wampac.aspx">WAMPAC Diamond Club</a>. Or keep an eye on WSMA communications as we'll be visiting communities across the state in the coming months, creating opportunities for physicians to connect with area candidates.
</p>
<p>
In the meantime, thank you for your support of WSMA's advocacy efforts. This year saw the launch of our Medical Student and Resident Advocacy Program, with more than 70 participants from across the state. We also held a sold-out WSMA Legislative Summit at the Capitol, and numerous physicians took time this session to meet with legislators and testify on bills. We're grateful to all of you who take time out of your busy schedules to advocate for your profession and your patients.
</p>
</div> | 3/16/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| 2026-legislative-session-update-week-of-mar-9 | 2026 Legislative Session Update: Week of Mar. 9 | Latest_News | Shared_Content/News/Latest_News/2026/2026-legislative-session-update-week-of-mar-9 | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><a href="https://vimeo.com/1171173151"><img src="/images/Newsletters/latest-news/2026/march/leg-update-video-3-9-26.png" alt="WSMA Legislative Update: Week of Mar. 9, 2026" /></a></div>
<h5>March 9, 2026</h5>
<h2>2026 Legislative Session Update: Week of Mar. 9 - As Session Winds Down, Bill to Preserve Access to Preventive Services and Vaccines Passes</h2>
<p>SMA Lobbyist Malorie Toman on a big win for WSMA's legislative priorities as we head into the last week of session, and a recap of our first medical student and resident advocacy day at the Capitol. <a href="https://vimeo.com/1171173151">Watch the video here</a>.</p>
<p>To get caught up on previous weekly updates from this session, these videos can also be accessed as audio podcasts on <a href="https://podcasts.apple.com/us/podcast/wsma-podcasts/id1702920307">Apple Podcasts</a> or <a href="https://open.spotify.com/show/0PBMBLgHr6e0X3OaMjyJON?si=cece76253c2e4888&amp;nd=1&amp;dlsi=0029b8db89544fb4">Spotify</a>.
</p>
<p>
<strong>Post-Session Webinar, March 13 at noon</strong>
<br />
Join us March 13 for a post-session wrap-up webinar, where WSMA's government affairs team will review the outcomes of session. And as always, we want to hear your feedback and any concerns or issues you or your practice are facing, so we will hold time during the meeting for questions. <a href="https://us06web.zoom.us/meeting/register/BcBz1F42TMu-gikCAcPKlA#/registration">Register for the webinar</a>.
</p>
</div> | 3/9/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| doctors-making-a-difference-matthew-grierson-md | Doctors Making a Difference: Matthew Grierson, MD | Latest_News | Shared_Content/News/Latest_News/2026/doctors-making-a-difference-matthew-grierson-md | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img alt="WSMA Reports Doctors Making a Difference: Matthew Grierson, MD graphic" src="/images/Newsletters/Reports/2026/march-april/DMD-Website-Image-Grierson-645x425px.png" class="pull-right" /></div>
<h5>Mar. 6, 2026</h5>
<h2>Doctors Making a Difference: Matthew Grierson, MD</h2>
<p>For Matthew Grierson, MD, what began as a small journal club with fellow physicians and clinicians focused on dance medicine evolved into Seattle Dance and Performing Arts Medicine, a free clinic for those in the performing arts with a deeply collaborative and integrated approach to care. His own history in dance and the challenges of finding specialized care helped shape his medical career and, in turn, this unique resource for the Seattle-area performing arts community. Dr. Grierson spoke with <em>WSMA Reports</em> about SeaPAM's history and mission.
</p>
<p>
<strong><em>WSMA Reports: </em>How did the SeaPAM free clinic get started?</strong>
</p>
<p>
<em>Dr. Grierson:</em> Seattle Dance and Performing Arts Medicine grew out of a very organic community effort. As a physical medicine and rehabilitation resident, I sought out Dr. Nancy Kadel—an internationally recognized orthopedic surgeon and leader in dance medicine—after learning she had returned to Seattle. She was initially surprised that a physiatry resident wanted to work with dancers, but she welcomed me, and that rotation became foundational for my career.
</p>
<p>
Afterward, a small group of us—physicians, physical therapists, and other clinicians—began meeting monthly for a journal club in Nancy's living room. She cooked dinner, we invited colleagues from across Seattle, and we talked about dance medicine. It was genuinely magical. Attendance quickly grew to 20–30 people each month, and the conversations kept circling back to the same frustration: Dancers were profoundly underserved, and many of us worked in systems that actively made it difficult to care for them.
</p>
<p>
Even leaders in the field were blocked by institutional silos. Dancers with work-related injuries couldn't see the most qualified clinicians because they didn't fit neatly into "occupational medicine" categories. Several of us worked on and published a study where we found that very few dancers had access to competent medical teams. For many of us, this was devastating — this was exactly why we went into medicine.
</p>
<p>
Eventually, someone suggested we simply start a free clinic. That idea took on a life of its own. We formed a nonprofit, built a board, and began operating monthly clinics using donated space. Today, SeaPAM brings together physicians, physical therapists, massage therapists, chiropractors, acupuncturists, Pilates instructors, dance educators, and primary care clinicians. It's the model of care we all wish existed in everyday practice—but payment structures don't allow.
</p>
<p>
Each clinic is deeply collaborative. One clinician may lead the visit, but everyone in the room participates. Trainees observe. Questions are encouraged—not just about the patient, but about clinical reasoning itself. Honestly, many of the most useful physical exam techniques I use today I learned from colleagues in this clinic.
</p>
<p>
Twelve years later, SeaPAM is still thriving. Many of us now serve as clinicians for major performing arts organizations in Seattle. We collaborate on research, trust one another professionally, and function as a true community. I only wish more cities had access to a model like this.
</p>
<p>
<strong>What made you want to get involved with providing care for those in the performing arts specifically?</strong>
</p>
<p>
I earned a Bachelor of Fine Arts in modern dance from the University of Utah and performed in the opening ceremonies of the 2002 Salt Lake City Olympics. As a dancer, I was injured constantly—but I never saw physicians as people I could turn to.
</p>
<p>
I remember breaking a rib during rehearsal and being told in the emergency department to "stop dancing." Technically, that advice wasn't wrong—but it was completely disconnected from my reality. Dance wasn't optional. It was my first major performance, and stopping wasn't feasible. What I needed was context, guidance, and a plan—not dismissal.
</p>
<p>
Those experiences stayed with me. Over time, I realized dancers and musicians often believe pain is inevitable, and they dont' realize there are clinicians who understand their bodies and goals. Dance, quite literally, gave me my life back during a very difficult period. That perspective has shaped my entire medical career.
</p>
<p>
While I love working with professional dancers, my philosophy applies broadly. One of my favorite patients was an 80-year-old man who wanted his knee pain treated so he could keep swing dancing all night. Movement matters—to everyone. That's why PM&amp;R is such a natural fit for this work.
</p>
<p>
<strong>Are there certain health needs that are unique to this community?</strong>
</p>
<p>
Absolutely. Dancers experience dramatic fluctuations in training volume, which places them at high risk for stress injuries. Learning to recognize early warning signs can mean the difference between brief modification and months away from dance.
</p>
<p>
Hypermobility is also common, requiring focused attention on proprioception, strength, and cross-training. Concussion awareness is another major gap. Unlike athletes in organized sports, dancers often return to performance immediately after head injuries. Education is improving, and organizations like the Dance/USA Task Force on Dancer Health have been instrumental in pushing for concussion action plans.
</p>
<p>
<strong>Does this organization provide other services for performing artists besides medical care?</strong>
</p>
<p>
Yes. We host a monthly journal club, conduct and present research nationally and internationally, and help connect artists with other nonprofits—such as the Entertainment Community Fund—for financial support during difficult periods. Our impact is small in scale but meaningful.
</p>
<p>
<strong>Do you have any goals for the future of the clinic?</strong>
</p>
<p>
We'd love to reach more volunteers and more patients, particularly musicians. Expansion would require funding and administrative support, and we're careful not to grow in ways that dilute the clinic's core mission. Preserving the spirit of what makes SeaPAM special matters just as much as growth.
</p>
<p>
Anyone who wishes to learn more about our group can sign up for our email announcements at <a href="https://www.seapam.com">www.seapam.com</a>.
</p>
<p>
<em>This article was featured in the March/April 2026 issue of WSMA Reports, WSMA's print magazine.</em>
</p>
</div> | 3/6/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| legislature-passes-wsma-priority-legislation-to-preserve-access-to-preventive-services-and-vaccines | Legislature Passes WSMA Priority Legislation to Preserve Access to Preventive Services and Vaccines | Latest_News | Shared_Content/News/advocacy-report/2026/March 6/legislature-passes-wsma-priority-legislation-to-preserve-access-to-preventive-services-and-vaccines | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/advocacy-report/2026/march/getty-images-c2PPCDPMB-A-unsplash-for-web.jpg" class="pull-right" alt="WSMA 2026 Legislative Session Updates" /></div>
<h5>Mar. 6, 2026</h5>
<h2>Legislature Passes WSMA Priority Legislation to Preserve Access to Preventive Services and Vaccines</h2>
<p><a href="https://app.leg.wa.gov/billsummary/?BillNumber=2242&amp;Year=2025&amp;Initiative=false">House Bill 2242</a>, sponsored by Rep. Dan Bronoske (D - Lakewood), which preserves access on a covered basis to preventive services, including vaccines, was passed by the Legislature last week with bipartisan support. The legislation, which was requested jointly by Gov. Bob Ferguson and the Office of the Insurance Commissioner, now heads to the governor's desk, where it is presumed to be signed into law in the coming weeks.</p>
<p>This WSMA priority legislation allows the Washington State Department of Health to make recommendations on vaccines in consultation with expert organizations, including professional medical organizations and local health organizations. The law also preserves Washingtonians' access to preventive services without cost-sharing for residents enrolled in commercial health plans who choose to utilize these services.</p>
<p>As leadership at the Centers for Disease Control and Prevention is shaken up and recommendations from the Advisory Committee on Immunization Practices continue to shift away from evidence-based practices, this vital legislation will ensure Washingtonians can continue to access important preventive health services, including vaccines, on a covered basis.</p>
</div> | 3/6/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| member-spotlight-elizabeth-westling-md | Member Spotlight: Elizabeth Westling, MD | Latest_News | Shared_Content/News/Latest_News/2026/member-spotlight-elizabeth-westling-md | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Reports/2026/march-april/Member-Spotlight-Website-Image-Westling-645x425px.png" class="pull-right" alt="WSMA Reports Member Spotlight: Elizabeth Westling, MD" /></div>
<h5>Mar. 6, 2026</h5>
<h2>Member Spotlight: Elizabeth Westling, MD</h2>
<p>
<strong>Works at:</strong> Providence-Washington State University Internal Medicine Center, Everett.
</p>
<p>
<strong>How long in practice:</strong> Five years.
</p>
<p>
<strong>Specialty:</strong> Internal medicine.
</p>
<p>
<strong>Why WSMA:</strong> My first introduction to the WSMA was in residency when I attended the WSMA Legislative Summit. Up to that point, I hadn't realized how much impact physician organizations could have on local legislation and I was inspired by the respect that legislators have for the WSMA. I aspire to have a positive impact on the health of the community where I practice beyond the provision of direct clinical care and my involvement with the WSMA has provided an avenue to support tangible change.
</p>
<p>
<strong>Inspired by:</strong> I love the relationships that medicine allows me to build with my colleagues and patients. It is motivating to feel that we are all part of a bigger team working toward the great shared goal of improved health and quality of life for those we care for. I learn something new from my patients or colleagues every day, and getting to know my patients provides insight into many other ways of living that I would never know about if I worked in another field.
</p>
<p>
<strong>Why WSMA's Your Care Is at Our Core campaign matters:</strong> My role as a healer and ally to my patients is one of the most important parts of my identity as a physician. Our medical system is complicated and hard for patients to navigate and, whether it is intended or not, many people experience trauma during their health care journey. To me, embracing the role of healer means taking patients' experiences seriously, walking alongside them on what can be a difficult journey, and helping them recover from medical trauma and rebuild their trust in the medical system. This feels particularly salient right now as public trust in medicine is being undermined. I hope that my patients feel that I am a safe source of information and reassurance.
</p>
<p>
<strong>Best advice:</strong> The purpose of the first visit is to earn the second visit.
</p>
<p>
<strong>Spare time:</strong> Hanging out with my husband, 2-year-old son, and two cats. We love going for walks on the Everett waterfront and checking out the Imagine Children's Museum.
</p>
<p>
<strong>Hobbies:</strong> Cooking for friends and family, crocheting, and gardening. My son loves tomatoes and we're looking forward to growing cherry tomatoes this summer. We just finished sowing shallot seeds to get a head start on the growing season.
</p>
<p>
<strong>Recommended reading:</strong> "Prophet Song" by Paul Lynch is a book that I read over a year ago and still think about all the time. I highly recommend it but be prepared to be emotionally devastated. For a lighter read, I got "The Secret Keeper" by Kate Morton for Christmas and read it over one weekend! It's a historical mystery with great pacing.
</p>
<p>
<em>This article was featured in the March/April 2026 issue of WSMA Reports, WSMA's print magazine.</em>
</p>
</div> | 3/6/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| rfk-jr-has-made-a-shambles-of-national-vaccine-policy | RFK Jr. Has Made a Shambles of National Vaccine Policy | Latest_News | Shared_Content/News/Latest_News/2026/rfk-jr-has-made-a-shambles-of-national-vaccine-policy | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img alt="" src="/images/Newsletters/Reports/2026/march-april/Heartbeat-Website-Image-Wheeler-645x425px.png" class="pull-right" /></div>
<h5>Mar. 6, 2026</h5>
<h2>RFK Jr. Has Made a Shambles of National Vaccine Policies</h2>
<p>
By Cathrine Wheeler
</p>
<p>
Each October, my elderly parents ask me for recommendations on which vaccines they need. They have trusted my advice as both their daughter and an internal medicine physician. Vaccine recommendations can be confusing in the best of times. Now is not the best of times.
</p>
<p>
My advice to my parents remained the same — I encouraged them to get the yearly flu and COVID vaccines. Vaccines don't totally prevent either illness, but they can make a significant difference in how sick they might get.
</p>
<p>
However, our vaccine conversation was more fraught than ever this year. Recent national regulatory changes have created new complexities and barriers — to the point that vaccine access now varies by state. I wasn't sure they would be able to easily receive the vaccines. My parents aren't the only ones caught in this quagmire. Patients are confused and skeptical; doctors are frustrated and worried.
</p>
<p>
This was intentional.
</p>
<p>
Over the last several months, Secretary of Health and Human Services Robert F. Kennedy Jr. has significantly weakened the vaccine infrastructure that has saved countless lives. This has included changes in vaccine approval and vaccine schedules that have had no basis in new research. Lifelong vaccine experts have been fired from important advisory committees, and their inexperienced replacements have created mayhem at vaccine advisory meetings. Secretary Kennedy has canceled $500 million in vaccine research, leaving us unprepared for future outbreaks. He has demonstrated none of the knowledge and leadership necessary to respond to our worst measles outbreak(s) in decades. He has fired or driven out trusted experts from the Centers for Disease Control and Prevention because they thought and acted independently and professionally, thereby eroding trust in the CDC by front-line doctors who have long relied on the organization for vaccine guidance.
</p>
<p>
Recently, he instructed the CDC to add a statement to its website asserting "the claim that vaccines do not cause autism is not an evidence-based claim." This statement is blatantly untrue — there is a strong collection of research evidence accumulated over decades showing that vaccines do not cause autism.
</p>
<p>
The whole situation is a mess.
</p>
<p>
Chaos and confusion sow mistrust in vaccines and the doctors who recommend them, which puts people and communities at greater risk. Changing government policy also changes insurance coverage and pharmacies' abilities to order and administer vaccines. Last fall, some pharmacies delayed ordering vaccines due to this pandemonium. For now, most insurance companies have agreed to pay for vaccines through the end of 2026 — but coverage beyond that is unclear. Should things continue in this direction, patients will face increasing difficulty finding and paying for vaccines in the future. I am grateful to live in a state that promptly responded by allowing pharmacists to keep giving vaccines. My parents aren't so lucky — where they live, people need to get a medical order to get the vaccine.
</p>
<p>
Vaccine policy should be a dynamic process; over time there are regular changes in vaccine recommendations based on new research. Change can be confusing. What's new this year is the onslaught of changes that are not based on research. The public has had understandable questions about the safety and effectiveness of vaccines; the current administration is cherry-picking studies to inflame these concerns. While vaccines can occasionally cause side effects and complications, the consensus among experts is that the tiny risk from vaccines is eclipsed by the much larger risks that come with having the illness while unvaccinated. Yet this nuanced understanding was ignored by the authorities enacting Secretary Kennedy's vaccine philosophy.
</p>
<p>
Eighty-eight percent of Americans believe the benefits of childhood vaccines outweigh the risks. Many are worried about future access to vaccines. The fear, as we have seen, has been warranted.
</p>
<p>
Yet there is hope. People and organizations have been standing up to preserve vaccine integrity and availability. Some CDC experts have shown great courage in resisting unscientific vaccine policy. Washington state has taken steps to ensure vaccine availability to its citizens and has aligned with a number of states to create a regional health care authority. Medical professional organizations including the American College of Physicians, American Academy of Family Physicians and American Academy of Pediatrics have acted with other organizations to preserve vaccine availability and called for the removal of Secretary Kennedy.
</p>
<p>
That's a good start, but it is not enough to confidently ensure broad access to vaccines in the future. There are other things we can do in the short term:
</p>
<ul>
<li>People can choose to be vaccinated. Not just for one's own health, but for the good of the community. Vaccination remains one of the best tools we have to reduce serious illness and death (especially in infants and young children).</li>
<li>Patients can speak with trusted health care providers about concerns and confusion about vaccine recommendations.</li>
<li>Medical professionals can look beyond the current CDC for supplemental guidance on vaccine recommendations. The Infectious Disease Society of America and the Center for Infectious Disease Research and Policy are two entities working to consolidate and communicate reliable vaccine information.</li>
<li>Doctors can join their respective medical organizations (American College of Physicians, American Academy of Family Physicians, etc.). These nonprofit organizations include doctors across the political spectrum and are working to create guidelines and advocate for the health of patients.</li>
</ul>
<p>
I remain optimistic that my parents will still be able to get their vaccines, even if it takes extra effort. I hope that people will always have easy access to current and future vaccines, to protect their own well-being and the health of our communities. I want that for my parents. I want that for my patients. I want that for all of us.
</p>
<p>
<em>Cathrine Wheeler, MD, is a general internal medicine physician practicing in Seattle. Originally published in The Seattle Times on Dec. 7, 2025.</em>
</p>
<p>
<em>This article was featured in the March/April 2026 issue of WSMA Reports, WSMA's print magazine.</em>
</p>
</div> | 3/6/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| standing-up-for-evidence-based-medicine | Standing Up for Evidence-based Medicine | Latest_News | Shared_Content/News/Latest_News/2026/standing-up-for-evidence-based-medicine | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img alt="" src="/images/Newsletters/Reports/2026/march-april/Cover-WSMA_Reports_MarchApril-2026-645x425px.jpg" class="pull-right" /></div>
<h5>Mar. 6, 2026</h5>
<h2>Standing Up for Evidence-based Medicine</h2>
<p>
By John Gallagher
</p>
<h5>
<em>Members only; sign-in required.</em>
</h5>
<p>
A year ago, federal vaccination policy was the result of careful consideration from the Advisory Committee on Immunization Practices, a panel convened by the U.S. Centers for Disease Control and Prevention made up of experts recognized as leaders in their fields. Scientific rigor was the hallmark of their decision-making and U.S. vaccination policy was considered the global standard.
</p>
<p>
"The ACIP and the nationalization of vaccine policy led us to a place where we were considered world leaders," says Helen Chu, MD, an immunologist and professor of epidemiology and medicine at the University of Washington and, until June 2025, an ACIP panelist. "It was policy decided on the basis of safety data, efficacy data, cost, and equity."
</p>
<p>
Not anymore. Since Robert F. Kennedy Jr. assumed the role of the nation's top health officer, the Secretary of Health and Human Services, he has discarded long-standing policies in favor of hurried decisions conforming to non-mainstream theories and based on long-discredited misinformation, especially the disproven link between vaccines and autism. He fired all 17 members of ACIP, including Dr. Chu, as well as the newly appointed CDC director, prompting the resignations of four top CDC officials, all physicians with decades of experience, who stepped down in protest of the firings.
</p>
<p>
Thanks to a new ACIP reconstituted with Sec. Kennedy's handpicked choices, recommendations for routine childhood vaccines have shrunk from 17 to just 11, deviating from the American Academy of Pediatrics Recommended Child and Adolescent Immunization Schedule, which is based on vaccine safety and effectiveness evidence, and marking a dramatic break from the established procedure for vaccine policy recommendations. While the vaccines removed from the list will still be available, they will not be routinely administered. Instead, they are only recommended for high-risk children or after consultation with a doctor.
</p>
<p>
"We are no longer making decisions for the good of the people," says Dr. Chu. "They are being made on complete falsehoods. In the past several months, we’ve seen a complete dissolution of the national progress that we’ve made."
</p>
<p>
Those changes to federal immunization policy—based on junk science—jeopardize the health of patients. "When guidelines change without the data to support the change, it puts patients at risk," says WSMA President Bridget Bush, MD. "We cannot say we are doing our best patient care when data doesn't support our actions."
</p>
<p>
Alan Melnick, MD, public health director for Clark County and a member of the WSMA board of trustees, is blunt. "The recommendations from the CDC are dangerous," he says. "They will kill people."
</p>
<p>
</p>
<p>
</p>
<h3>Addressing patient concerns</h3>
<p>&nbsp;</p>
<p>
Now that the federal government says some pediatric vaccines are no longer routine, some physicians report that parents are concerned that their children can't get them. "So many people are scared that their baby won't get the hepatitis B vaccination at birth," reports Jennifer Chin, MD, an OB-GYN at the University of Washington Medical Center. "They say they still want it, but they worry that it no longer being recommended nationally means that UW will no longer offer it to babies. I see fear in my patients' eyes when they are asking for that." (The UW Medicine system follows standard evidence-based guidelines and continues to provide the hepatitis B vaccine, which has been shown to reduce infections by 95% in infants.)
</p>
<p>
While vaccine policy has borne the brunt of Sec. Kennedy's changes, it is not the only misinformation coming out of the CDC. Last September, with President Donald Trump at his side, Kennedy warned doctors not to give pregnant women Tylenol, claiming that it could lead their unborn children to develop autism. A review published last January in The Lancet Obstetrics, Gynaecology, &amp; Women's Health of existing studies found no correlation between the painkiller and autism.
</p>
<p>
"There's no evidence that it will cause autism in your baby," says Dr. Chin. "There are very limited options for pain medicine in pregnancy, and if we eliminate that, it will leave patients needlessly suffering with very normal parts of pregnancy, like headaches and joint aches."
</p>
<p>
Yet, says Dr. Chin, the steady stream of misinformation has led patients to ask questions. "Even patients that I have a long-term relationship with and whom I consider to have high health literacy and the ability to differentiate myth from fact are saying, 'I just wanted to double check because I don't want to cause any harm.' "
</p>
<p>
Sara Cate, MD, a family physician in Yakima, says that patients have forgotten how vaccines save lives and now are more apt to respond accordingly when offered them. She recalls a mother and child who were offered a flu vaccine booster. Instead of making a decision for him, the mother asked her son if he wanted the shot, and unsurprisingly the boy said he didn't.
</p>
<p>
"That child can't make that decision for himself. I juxtapose my 101-year-old mother's experience with what is happening now," says Dr. Cate. "In her day, she would go back to school in September and there would be empty chairs" from schoolmates who had died.
</p>
<p>
</p>
<p>
</p>
<h3>Exacerbating existing problems</h3>
<p>&nbsp;</p>
<p>
Dr. Chu notes that vaccine skepticism that led to the current policies had been growing long before last year. "The tearing down has been gradual," she says. "It's not just that a switch was flipped in January 2025." Indeed, childhood vaccination rates in Washington had already been on the decline before the latest moves by HHS. For example, in 2023, 78% of two-year-olds received all four doses of the DTaP vaccine. In 2020, the number was 86%.
</p>
<p>
A strong doctor-patient relationship is essential to combatting misinformation and helping keep patients safe. "Patients are coming to us scared and confused and hopefully we have the language and the skills not only to provide the standard-of-evidence care but also treat them with compassion and develop therapeutic relationships with them so that they know to come to us for trusted, true information," says Dr. Chin.
</p>
<p>
Providing tools to combat misinformation and hesitancy will help. "The different medical societies have to come together as one voice and share resources to take over the role the CDC played," says Dr. Cate. Even before the current administration took office, work was underway to bolster trust in the medical profession. The WSMA, in partnership with the American Medical Association, launched the Your Care Is at Our Core social media campaign in October of 2024 to highlight the importance of the patient-physician relationship and to begin restoring trust.
</p>
<p>
But strong relationships with patients have also been declining, driven by the response to the COVID-19 pandemic. "Trust in our profession has eroded in the past years because people have lost sight of the importance of data," says Dr. Bush. "We saw this during COVID where people questioned when masking guidance changed. They accused the physician community of reversing course, when really we were working with the data and best evidence we had at the time. As we gained more experience with the disease and more data was collected, guidance evolved. Now we have to work hard to repair that trust."
</p>
<p>
Dr. Chu says that in retrospect medical leaders bear some responsibility for inadvertently feeding people's fears. "It makes us think about an acknowledgement of some of the things we didn’t do right in COVID and have a little more humility around that." For example, she expresses concern that scientists downplayed the reports of myocarditis in young men as a rare adverse event from the vaccine. "We should have taken that a little more seriously," she says. She also says that scientists should have recommended opening schools sooner.
</p>
<p>
The ongoing backlash from decisions made during the pandemic obscures the fact that in key ways the response was largely a success. "The real win from COVID was that we were able to get a vaccine together so quickly and save so many lives," says Dr. Chu. "Five years later, we've forgotten how many people died and how extraordinary an achievement the vaccine was. That's what's shocking."
</p>
<p>
In the meantime, Sec. Kennedy has accused doctors of being motivated by greed, adding yet another layer of distrust in the physician community. The lie infuriates Dr. Melnick.
</p>
<p>
"That's the biggest bunch of bullshit," he says. "My god, you're not getting a deal from Big Pharma each time you give a shot."
</p>
<p>
In addition to rebuilding trust with patients, doctors also have to deal with everyday pressures, especially time and billing. Conversations take time, which is in short supply and isn't generally reimbursable. (It is also not a metric upon which physicians have their performance evaluated.)
</p>
<p>
"It just takes longer and longer to have those conversations because of the amount of general skepticism and the fact that there is now a national platform for discussions that used to be in the shadows," says Dr. Chu.
</p>
<p>
That adds to the stresses that physicians are already under. "We have very limited time with patients, and often it is hard for patients to access care," says Dr. Chin. "If half the visit is taken up talking about misinformation, that leaves us little time to do routine medically necessary care. We either need to delay that counseling until our next visit, or we need to cut into time that we should be spending with another patient."
</p>
<p>
While health plans continue to offer coverage for all the childhood vaccines regardless of the CDC's recommendations, Dr. Chu wonders how long that will last. "Right now, America's Health Insurance Plans [AHIP, the trade organization for the industry] will follow the pre-Trump vaccination policy, at least in terms of payment," she says. "But at some point, that will have to be discussed."
</p>
<p>
Meanwhile, the country is bearing unnecessary costs that are likely to grow, says Dr. Melnick.
</p>
<p>
"People shouldn't be getting measles in the U.S." he says. "We are spending all our time on things that are completely preventable and that shouldn't require major intervention from us when we could be spending time on other areas with our communities and our patients."
</p>
<p>
It's not just suffering and mortality that could have been avoided. The potential for more outbreaks of preventable disease is going to be expensive and a drain on already limited resources.
</p>
<p>
"It cost our health department more than $800,000 for the measles outbreak in 2019," says Dr. Melnick, adding that the total cost, including time from volunteer physicians and lost productivity, was in the millions. "Those are opportunity costs that are lost in terms of providing other services to our patients."
</p>
<p>
</p>
<h3>Standing for science</h3>
<p>&nbsp;</p>
<p>
Faced with the threat to public health and, more broadly, to evidence-based medicine, physician organizations, including the WSMA, are responding with extraordinary efforts to counter the federal government's actions. Physician groups have been leaders in rebutting the misinformation coming out of HHS and in condemning the dismantling of public health infrastructure. Last September, the WSMA joined more than 50 specialty societies and nonprofits in publicly calling for Sec. Kennedy's resignation, the only state medical association to do so. The WSMA also successfully sued HHS last year to stop discriminatory federal deletions of taxpayer-funded health data.
</p>
<p>
"Our medical partners, including WSMA, are rising to the occasion," says Dr. Melnick. "If we didn't have the WSMA, the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Physicians, and the American College of Obstetricians and Gynecologists, it would be a lonely position to advocate for this. It shouldn't have been necessary, but it is nice to know that we are all working on this together."
</p>
<p>
States have also joined the battle. Washington, Oregon, California, and Hawaii have formed the West Coast Health Alliance, which was created "to uphold the integrity of effective public health strategies that protect the health of our communities," including vaccine recommendations. In many ways, decisions are returning to the way things were before ACIP was formed more than 60 years ago to harmonize a patchwork of vaccination recommendations across the nation. (At the time of this writing, the AMA announced the Vaccine Integrity Project, a collaborative effort to reinstate a structured, evidence-based process to assess vaccine safety and effectiveness for the 2026–27 respiratory virus season.)
</p>
<p>
A bill being considered in the state Legislature would clarify state authority, allowing the state Department of Health to make recommendations for immunizations and, more broadly, preventive services using evidence-based recommendations from outside experts. "The goal is to ensure that anyone who wants to get vaccinated can still access them and is covered by their health insurance," says Malorie Toman, lobbyist for the WSMA, which is part of the coalition to help to shape and support the measure. The measure echoes language in a resolution passed by the WSMA House of Delegates at its meeting last September.
</p>
<p>
Dr. Bush says that the WSMA must be at the forefront of the current battle over medical standards.
</p>
<p>
"The WSMA as an arm of organized medicine exists to protect evidence-based practice," she says. "We exist to protect our physicians from threats against them giving the best possible care to our patients. Medicine changes not because of trends and personal philosophies but because science is rigorous in its effort to continue to improve. When guidelines change without the data to support the change, it puts patients at risk. We cannot say we are doing our best patient care when data doesn't support our actions."
</p>
<p>
</p>
<h3>An uncertain future</h3>
<p>&nbsp;</p>
<p>
Despite the best efforts of medical societies and physician leaders, the damage caused by the federal government seems likely to continue. The U.S. Preventive Services Task Force, which makes recommendations for screenings, counseling, and preventive medications, has not met since shortly after Sec. Kennedy took office amid rumors that he wants to shut it down. Like ACIP, the task force is supposed to be an independent panel of experts who study the evidence to make recommendations, which in turn are included by health plans in their insurance policies.
</p>
<p>
Despite everything, Dr. Chu remains cautiously optimistic that at some point the federal government will return to relying on evidence as the basis for decisions. "I'm pretty hopeful that this isn't permanent," she says. "I don't think the way decisions are being made now is going to be long term. I do think there's a sense of 'let's wait this out.' I don't think it's so destroyed that it can't be rebuilt."
</p>
<p>
While Dr. Cate, who also holds a master of public health, believes that the current situation is temporary, as well, she laments the damage that continues to be done. "I am concerned about the loss of lives," she said. "We had one of the most wonderful public systems in the world. It's just heartbreaking." Yet, she says she will continue to do what she's always done: "I'll keep teaching and providing evidence-based care and develop relationships with patients so that they trust me."
</p>
<p>
<em>John Gallagher is a freelance writer specializing in health care.</em>
</p>
<p>
<em>This article was featured in the March/April 2026 issue of WSMA Reports, WSMA's print magazine.</em>
</p>
</div> | 3/6/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| upholding-trust-in-health-and-science | Upholding Trust in Health and Science | Latest_News | Shared_Content/News/Latest_News/2026/upholding-trust-in-health-and-science | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img alt="" src="/images/Newsletters/Reports/2026/march-april/Cover-WSMA_Reports_MarchApril-2026-645x425px.jpg" class="pull-right" /></div>
<h5>Mar. 6, 2026</h5>
<h2>Upholding Trust in Health and Science</h2>
<p>
By Rita Colorito
</p>
<h5>
<em>Members only; sign-in required.</em>
</h5>
<p>
Turn on the news or scroll through social media and you're bound to come across inaccurate or even blatant lies around health and science. With the assault on evidence-based information now underway at the highest levels of what were once bastions of truth and trust in medicine, physicians and clinicians can use all the help they can get to combat misinformation and disinformation.
</p>
<p>
To that end, <em>WSMA Reports</em> spoke with Helen Burstin, MD, MPH, MACP, to learn how the Coalition for Trust in Health and Science, a nonpartisan nonprofit founded in March 2023, is creating and using an evidence-based knowledge infrastructure to benefit physicians and their patients. The coalition brings together more than 90 diverse leading health, health care, and scientific organizations to promote trust in health and science and challenge false information. Dr. Burstin serves on the coalition's board of directors. She's also the CEO of the Council of Medical Specialty Societies.
</p>
<p>
</p>
<h5><em>WSMA Reports:</em> What was the impetus for the coalition?</h5>
<p>
<em>Dr. Burstin:</em> It was very much in response to what happened during the pandemic. We saw a profound impact on the nation's trust in health and science. There were a lot of differences across different populations.
</p>
<p>
Reed Tuckson, MD, one of the co-founders of the coalition, had done a lot of work understanding the impact of lack of trust in the African-American community around vaccination. There was a sense that we need to do what we can to ensure that experts who really bring the best evidence-based information to the table know how to get that information out and appropriately shared.
</p>
<p>
There was an opportunity to say, "How do we tackle this?" It was clear there's no one group who could take this on. The idea was, could the coalition be built in such a way that we pulled in the whole ecosystem that could make a difference? Whether that's medicine, science, nursing, even industry, we all have a role to play in thinking about how we can address this erosion of trust in health and science.
</p>
<h5>What are some of the coalition’s goals?</h5>
<p>
Our overall mission is to make sure that those seeking information, whether that's an individual, a family, or a community, have the information they need to make appropriate health decisions. In the short term, to do whatever we can to keep the conversations open and flowing across different groups ... to understand what's driving some of this catalyzing dialogue. For example, Dr. Tuckson literally engaging with "Make America Healthy Again" moms to better understand where they're coming from. We can't figure out how to counter some of this if we don't really understand the genesis for it.
</p>
<p>
There's a lot of interest in us serving as thought partners, providing conferences, podcasts, and tools for the field. My group, the Council of Medical Specialty Societies, works with the coalition and its founding member—the NewCourtland Center for Transitions and Health at the University of Pennsylvania School of Nursing—to go through all the known strategies that physicians and others could employ with their patients to counter disinformation. What's interesting here is there is a real science to how to communicate.
</p>
<h5>What tools does the coalition offer for physicians to empower them to build trust?</h5>
<p>
The coalition has many resources on its website, including evidence-based reviews of different strategies that help us move the needle on both fighting misinformation and improving trust. Some strategies have been around for quite a long time. For example, serving as a trusted messenger, where you gently explain to the patient that part of the information they're hearing may not be correct.
</p>
<p>
Coalition members have access to a biweekly lunch learning series where we feature experts. They're often 15- to 20-minute discussions. They provide quick, digestible strategies you can use on your own or with everyone else in your practice.
</p>
<p>
We encourage members of the WSMA to sign up for our mailing list for content-rich newsletters and information about events open to nonmembers (see sidebar).
</p>
<p>
On our website, we also have resources pulled from across our 100 members on what works—strategies on pre-bunking or debunking—or how you can serve as a trusted messenger with your patients. For example, the Council of Medical Specialty Societies and the National Academy of Medicine worked with YouTube and came up with a set of criteria to help viewers identify which sources are credible. Some of these things really work. The evidence is strong. A lot of them haven't been fully tested in health care yet, but there are real opportunities for us to think about how they might.
</p>
<h5>What strategies do you find work?</h5>
<p>
Learning what patients are reading, what they're concerned about. Listening and reviewing the sources that they're seeing. Even saying something like, "Can you share your sources with me? Can we have a follow-up conversation to review some of what you're seeing? Perhaps I can share some of what I know in terms of the science."
</p>
<p>
A lot of this is doing what we all know well, which is building relationships with our patients. It's using strategies proven in terms of good clinical care—being an active listener and thinking about how we can use motivational interviewing to keep the dialogue open, rather than having a patient go down a pathway where they're just like, "He's just not listening to me. I'm not going back."
</p>
<h5>You mentioned pre-bunking and debunking. Can you explain those?</h5>
<p>
With pre-bunking, it's the idea of being proactive and helping inoculate patients and people to understand when they're being exposed to falsehoods. How are you being manipulated? How do you have them recognize it, think about it, and use examples to refute it? That's the parallel tool to debunking, which is the idea of correcting lies, to say what you're seeing is not necessarily the truth or maybe isn't based on the best possible information.
</p>
<h5>What strategies simply don't work or should be avoided?</h5>
<p>
One of the cautions is any attempt to push back on a patient in a way that closes the dialogue. We know a lot from the literature on how to communicate effectively, including the work of professor Julia Minson at the Harvard Kennedy School, for example, about disagreeing better. She makes the case that the more you can keep the dialogue open, even if the patient disagrees with you at first, the better off we'll be. We have to be very careful about not coming across as just disagreeing with you. That tends to close the conversation.
</p>
<h5>Is there something that physician organizations can do to further the dialogue?</h5>
<p>
Some of it is being open to having those conversations. Put things on your walls that say things like, "Have a question about vaccines? Ask me."
</p>
<p>
Encourage being personal in the way physicians talk to a patient about vaccination, not just saying, "I really think you should get the flu shot," but also, "All of my family has been vaccinated for flu." Patients respect that level of interpersonal dialogue. The beauty is this is very much a team sport. I don't think all this has to be done by the physician. There are opportunities for the clinic, the health system, and all the different health care practitioners within a clinic to play their role.
</p>
<h5>What role does social media play in the erosion of trust and the efforts to counter it?</h5>
<p>
There's no question that social media has played a very large role, providing patients information sometimes that may not be fully credible. There have been some efforts, for example, on the part of YouTube, where they will now bring up the most trusted, credible source of health information first, rather than the viral source.
</p>
<p>
Physicians can also use social media to teach patients where they can go for credible sources. The WSMA and your specialty societies all have resources that you could recommend. There's a real opportunity for physicians to be positive forces in the social media environment. Whether you're comfortable doing videos like Dr. Mike or just pushing back on your community and Facebook page, those are all important opportunities. Dr. Todd Wolynn and his team at The Trusted Messenger Program are great resources (see "Key Resources", below).
</p>
<p>
Engage in your community. Go to those school board hearings, go to health department hearings. Lending your voice as a credible source of health information is probably one of the most important things we can do. Counter what might be happening by providing what you know is evidence-based, accessible, and understandable information.
</p>
<h5>What's your best advice for physicians and clinicians who feel overwhelmed by lack of trust in science and health care?</h5>
<p>
Despite all the concerns about what's happening in terms of trust in medicine and science, patients continue to trust their physician more than anyone.
</p>
<p>
<em>Rita Colorito is a freelance writer specializing in health care.</em>
</p>
<p>
<em>This article was featured in the March/April 2026 issue of WSMA Reports, WSMA's print magazine.</em>
</p>
<h3>Key Resources</h3>
<h5>The Coalition for Trust in Health and Science</h5>
<em><a href="https://www.trustinhealthandscience.org">trustinhealthandscience.org</a></em>
<p>
Resources on what works in health and science messaging. Sign up for the coalition's mailing list under About, then Contact Us.
</p>
<h5>"Why Should I Trust You?" podcast, YouTube</h5>
<em><a href="https://www.whyshoulditrustyou.net">whyshoulditrustyou.net</a></em>
<p>
This weekly series, a collaboration between physicians and journalists, looks at the breakdown in trust for science and public health and how we can trust each other again.
</p>
<h5>The Trusted Messenger Program</h5>
<em><a href="https://www.trustedmessengerprogram.org">trustedmessengerprogram.org</a></em>
<p>
Recommended by the Coalition for Trust in Health and Science, this program offers comprehensive, field-tested education, delivered online or in person, designed to improve your skills and strengthen your status as a life-changing trusted messenger.
</p>
<h5>WSMA Social Media Ambassador Program</h5>
<em><a href="https://www.wsma.org/social-media">wsma.org/social-media</a></em>
<p>
If you are a social media user, you can help amplify trusted, evidence-based public and general health messages with your peers and the public online using our ready-made social media toolkits. Each toolkit features links to resources, sample posts, and graphics that can be used out of the box or edited to fit your community.
</p>
</div> | 3/6/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| vaccine-nonadherence-on-the-rise | Vaccine Nonadherence on the Rise | Latest_News | Shared_Content/News/Latest_News/2026/vaccine-nonadherence-on-the-rise | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img alt="" src="/images/Newsletters/Reports/2026/march-april/Cover-WSMA_Reports_MarchApril-2026-645x425px.jpg" class="pull-right" /></div>
<h5>Mar. 6, 2026</h5>
<h2>Vaccine Nonadherence on the Rise</h2>
<p>
By Sharon Hall, RN
</p>
<p>
Physicians and health care professionals in the U.S. are seeing a notable increase in patients refusing recommended vaccinations. Rising refusal rates, entrenched hesitancy, and declining immunization coverage have become major challenges in clinical practice.
</p>
<p>
Since a nonadherent patient may subsequently develop an illness or experience a worsening of their condition, it is important to be able to follow the patient's care in case the patient files a malpractice claim for a missed or delayed diagnosis. Lack of informed consent is an allegation in 30-35% of malpractice claims nationwide, so it is vital that the patient's decision to decline recommended care is carefully documented.
</p>
<h3>Informed consent and vaccinations</h3>
<p>
While there is no federal requirement for informed consent relating to vaccinations, the National Childhood Vaccine Injury Act requires the physician (or physician assistant or nurse practitioner) to deliver a vaccine information sheet that includes both the benefits and risks associated with certain vaccinations. As WSMA members are no doubt aware, recent federal recommendations for childhood vaccines have changed and differ from those recommended by our regional authority, the West Coast Health Alliance. The alliance, which includes Washington, California, Hawaii, and Oregon and is endorsed by physician professional organizations in those states, continues to support vaccine recommendations from the American Academy of Pediatrics. The Washington State Department of Health offers guidelines for immunizations and vaccines on its website, along with guidance for health care practitioners.
</p>
<p>
Prior to vaccine administration, provide sufficient information and obtain consent from the child, patient, or state legal representative. We recommend a well-documented informed consent, including the rationale for the vaccine, risks, and benefits for the vaccine, as well as for declining the vaccine and its alternatives. This can be done using the vaccine information sheet, unless that form does not include state requirements or has not been updated with current information on the vaccine to be given.
</p>
<p>
Recordkeeping recommendations include:
</p>
<ul>
<li>Documentation that the vaccine information sheet was distributed, including the edition date and the date the information sheet was provided.
</li>
<li>The name, address, and title of the health care worker who administered the vaccine.
</li>
<li>The date of administration.
</li>
<li>The vaccine manufacturer, along with the lot number of the vaccine used.
</li>
</ul>
<h3>Elements of informed consent</h3>
<p>
Components of a valid consent include adequate information, absence of coercion, decision-making capacity by the patient, and the patient's consent.
</p>
<p>
Informed consent typically includes the following information:
</p>
<ol>
<li>Patient condition or disease.
<ul>
<li>Whether the procedure is diagnostic or therapeutic.
</li>
<li>Expected outcome with and without treatment.
</li>
</ul>
</li>
<li>Rationale for recommended treatment or procedure.
</li>
<li>Benefits.
<ul>
<li>Evidence in favor of procedure.
</li>
<li>Prevention of deterioration of the patient’s condition.
</li>
<li>Longer survival for the patient.
</li>
<li>Further treatment recommendations.
</li>
</ul>
</li>
<li>Complications and risks.
<ul>
<li>Usual risks associated with the recommended treatment or procedure.
</li>
<li>Possible complications, taking into consideration the patient's comorbidities.
</li>
<li>Serious risks, up to and including death.
</li>
</ul>
</li>
<li>Alternatives, including nontreatment.
<ul>
<li>Risks and benefits of alternatives.
</li>
<li>Risks and benefits of nontreatment.
</li>
</ul>
</li>
</ol>
<p>
Since not all patients have the same level of literacy, it is important that explanations of care be provided in simple, plain language, using lay terminology in place of medical jargon. Requesting that a patient repeat back the information allows for opportunities to address any misunderstandings.
</p>
<p>
Discussion of treatment options should include, but not be limited to, those covered by the patient's insurance. While cost may play a factor in a patient's ultimate decision, if an available option may be in the patient's best interests, it should be included in the informed-consent discussion. We recommend reminding the patient to check with their insurer to determine what services are covered.
</p>
<p>
The patient may benefit from other information, as well, including details about recovery time, additional follow-up care, and costs. The informed-consent discussion can be supplemented with printed information that is available for many conditions and treatment options.
</p>
<h3>Shared decision-making</h3>
<p>
Shared decision-making is an approach that facilitates the highest ethical standard for the informed-consent process. The use of this process may be guided by state law or regulations. The Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services, offers a five-step shared approach to the decisionmaking process:
</p>
<ol>
<li>Enlisting the patient's participation and encouraging patient involvement.
</li>
<li>Assisting the patient in exploring treatment options while explaining the risks and benefits of each option, including no treatment.
</li>
<li>Recognizing the patient's values and preferences, taking patient priorities into consideration.
</li>
<li>Reaching a decision together.
</li>
<li>Evaluating the patient's decision, assessing whether their decision is reasonable based upon their values.
</li>
</ol>
<h3>Moving from informed refusal to informed declination</h3>
<p>
Informed refusal is a health care industry phrase used to describe a patient's decision to decline to follow the order or recommendation of a physician, physician assistant, or nurse practitioner. This phrase tends to reflect the perspective of the practitioner rather than that of the patient; in fact, even the words "informed refusal" may result, consciously or unconsciously, in negative value judgments from the practitioner's perspective, which in turn may impact the patient. On the other hand, using the term informed declination aligns with patient autonomy, is patient-centric, and will likely support an organization's mission, vision, and values, which are generally written with a focus on the patient.
</p>
<h3>Documentation of informed declination</h3>
<p>
There may be circumstances in which a patient's declination cannot be successfully addressed. In these instances, Physicians Insurance recommends that the patient be provided with information concerning the possible consequences of declining treatments, procedures, or recommendations or plans. Discuss and document the patient's reasoning. Explore alternatives and actions taken to help address the patient's thought processes, and document the patient's response. If the patient states that their declination is due to a lack of understanding, incorporate audiovisual or multimedia materials, and document this.
</p>
<h3>Documentation of the declination should state:</h3>
<ul>
<li>That the patient has declined the recommended care.
</li>
<li>The patient's reasons for declination.
</li>
<li>That the consequences of declination have been explained to the patient in plain language, and that the patient understood the risks of their decision.
</li>
<li>That the patient's signature was obtained on an informed declination form.
</li>
</ul>
<p>
In the event that the patient is uncooperative, the signature of a witness to the discussion should be obtained and documented in the medical record.
</p>
<p>
<em><strong>Sharon Hall, RN, MPH, ARM,</strong> is a senior clinical risk consultant with Physicians Insurance.</em>
</p>
<p>
<em>This article was featured in the March/April 2026 issue of WSMA Reports, WSMA's print magazine.</em>
</p>
</div> | 3/6/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| 2026-legislative-session-update-week-of-mar-2 | 2026 Legislative Session Update: Week of Mar. 2 | Latest_News | Shared_Content/News/Latest_News/2026/2026-legislative-session-update-week-of-mar-2 | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><a href="https://vimeo.com/1168963718"><img src="/images/Newsletters/latest-news/2026/march/leg-update-video-3-2-26.png" alt="WSMA Legislative Update: Week of Mar. 2, 2026" /></a></div>
<h5>March 2, 2026</h5>
<h2>2026 Legislative Session Update: Week of Mar. 2 - Senate and House Budget Proposals</h2>
<p>WSMA's Senior Director of Government Affairs and Policy Sean Graham takes a look at the positives and negatives of the Senate and House budget proposals that were released last week. <a href="https://vimeo.com/1168963718">Watch the video here</a>.</p>
<p>To get caught up on previous weekly updates from this session, these videos can also be accessed as audio podcasts on <a href="https://podcasts.apple.com/us/podcast/wsma-podcasts/id1702920307">Apple Podcasts</a> or <a href="https://open.spotify.com/show/0PBMBLgHr6e0X3OaMjyJON?si=cece76253c2e4888&amp;nd=1&amp;dlsi=203a61430bf0474d">Spotify</a>.
</p>
<p><strong>Post-Session Webinar, March 13 at noon</strong></p>
<p>Join us March 13 for a post-session wrap-up webinar, where WSMA's government affairs team will review the outcomes of session. And as always, we want to hear your feedback and any concerns or issues you or your practice are facing, so we will hold time during the meeting for questions. <a href="https://us06web.zoom.us/meeting/register/BcBz1F42TMu-gikCAcPKlA#/registration">Register for the webinar</a>.</p>
</div> | 3/2/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| ceo-rounds-feb-24-2026-legislative-budget-proposals-released-what-they-mean-for-health-care | CEO Rounds: Feb. 24, 2026 - Legislative Budget Proposals Released: What They Mean for Health Care | Latest_News | Shared_Content/News/ceo-rounds/2026/ceo-rounds-feb-24-2026-legislative-budget-proposals-released-what-they-mean-for-health-care | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;">
<img src="https://wsma.org/images/Newsletters/ceo-rounds/ceo-rounds-article-graphic-sean-graham-645x425px.png" class="pull-right" alt="CEO Rounds with Sean Graham, WSMA Senior Director of Government Affairs and Policy graphic" />
</div>
<h5>
Feb. 24, 2026
</h5>
<h2>
Legislative Budget Proposals Released: What They Mean for Health Care
</h2>
<p>By Sean Graham</p>
<p>
Majority-party Democrats in the House of Representatives and Senate released their budget proposals this week, signaling the beginning of negotiations on spending plans and the homestretch of the 2026 session, which is scheduled to adjourn on March 12.
</p>
<p>
At a high level, the WSMA is grateful that both budget proposals seek to maintain access to care for state residents who are impacted by recent policy and fiscal changes from the federal government. The budgets also fully fund Foundational Public Health Services, which were slated for cuts in the governor's spending plan released in December. Importantly, neither budget relies on broad-based taxes on the physician community nor cuts to Medicaid reimbursement or coverage for physician services.
</p>
<p>
Following years of strong economic growth, state tax collections have slowed in recent years. Meanwhile, enrollment and utilization of state programs, including in the health care space, have remained strong, creating a deficit that legislators worked to bridge last session but has persisted.
</p>
<p>
Last week, budget writers got good news in the form of a positive revenue forecast, showing tax collections projected to increase by $827 million more than was forecasted in November. This helped obviate deeper cuts in the legislative budget proposals, though both budgets do make targeted reductions to state programs.
</p>
<p>
The state's fiscal challenges are exacerbated by H.R. 1, the congressional tax and spending bill signed into law by President Donald Trump last summer. Among other provisions, the federal law reduces federal funds to support our state's health care system and imposes restrictions on the ability of undocumented individuals to access health care.
</p>
<p>
The House and Senate budget proposals differ in details, but both dedicate funding intended to continue to support Medicaid coverage, aligning with one of the WSMA's fiscal priorities. One provision directs the Health Care Authority to develop a fee-for-service coverage program open to individuals ineligible for Medicaid, such as undocumented residents of the state. Another provides support for "Cascade Care Savings," which provides subsidies to make insurance coverage through the Washington Health Benefit Exchange more affordable, with the House allotting $25 million and the Senate $47.5 million to the program.
</p>
<p>
There are concerning elements of the spending plans that the WSMA will be engaging on through the course of budget negotiations. Both proposals would divert funding from the health professions account at the Washington State Department of Health, which is the repository for licensure fees from physicians and other health care practitioners. The House uses funds to backfill programs at DOH. The Senate proposes moving away from the historical paradigm of professions being required to be self-sustaining and would have physician licensure fees support other professions. Separately, the House budget proposes eliminating Medicaid coverage for physical, speech, and occupational therapy services.
</p>
<p>
On the revenue side of the ledger, both budgets presume passage of the millionaires tax proposal in <a href="https://app.leg.wa.gov/billsummary/?BillNumber=6346&amp;Year=2025&amp;Initiative=false">Senate Bill 6346</a>, as well as the elimination of tax preferences for insurance carriers and prescription drug warehousing. Like the governor's budget proposal, the legislative budgets also propose to tap around $800 million from the state's rainy day reserve account.
</p>
<p>
Looking ahead, both spending plans are expected to be approved by their respective budget committees and chambers this week. Then a conference committee will be convened, allowing negotiators from the two chambers to iron out the differences between the proposals. Assuming agreement is reached, the budget will likely be one of the last actions legislators take before adjourning session.
</p>
<p>
For questions about the budget, policy bills, or anything happening in Olympia, <a href="mailto:sean@wsma.org">email me</a> at any time. If you want to learn more about where things landed in the 2026 legislative session, <a href="https://us06web.zoom.us/meeting/register/BcBz1F42TMu-gikCAcPKlA#/registration">register for our post-session webinar</a>, being held at noon on Friday, March 13.
</p>
<p>Sean Graham is WSMA's senior director of government affairs and policy</p>
</div> | 2/24/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| 2026-legislative-session-update-week-of-feb-23 | 2026 Legislative Session Update: Week of Feb. 23 | Latest_News | Shared_Content/News/Latest_News/2026/2026-legislative-session-update-week-of-feb-23 | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><a href="https://vimeo.com/1166772001"><img src="/images/Newsletters/latest-news/2026/february/leg-update-video-2-23-26.png" alt="WSMA Legislative Update: Week of Feb. 23, 2026" /></a></div>
<h5>February 23, 2026</h5>
<h2>2026 Legislative Session Update: Week of Feb. 23 - Budget Takes Center Stage in Olympia</h2>
<p>WSMA Lobbyist Malorie Toman tees up the negotiations set to begin on the state budget and gives an update on WSMA priority bills that continue to advance through the legislative process. <a href="https://vimeo.com/1166772001">Watch the video here</a>.</p>
</div> | 2/23/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |
| 2026-ampac-candidate-workshop-returns-april-17-19 | 2026 AMPAC Candidate Workshop Returns April 17-19 | Latest_News | Shared_Content/News/advocacy-report/2026/February 20/2026-ampac-candidate-workshop-returns-april-17-19 | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/advocacy-report/2026/february/US-Capitol-1024px.jpg" class="pull-right" alt="Image of US Capitol highlighting the 2026 AMPAC Candidate Workshop" /></div>
<h5>Feb. 20, 2026</h5>
<h2>2026 AMPAC Candidate Workshop Returns April 17-19</h2>
<p>Ever wonder how physicians get elected to Congress or your state Legislature? Considering a run for office yourself? The <a href="https://ampaconline.org/political-education/ampac-candidate-workshop">AMPAC Candidate Workshop</a> will teach you how to run a winning political campaign because it is designed to help you make the leap from the exam room to the campaign trail and give you the skills and strategic approach you will need to make a run for public office.</p>
<p>At the Candidate Workshop, Republican and Democratic political veterans work together to give you expert advice about being a successful candidate and how to run a winning campaign. You will learn the importance of a disciplined campaign plan and message; the secrets of effective fundraising; what kinds of advertising may be right for your campaign; how to work with the media; and how to build your campaign team and a successful grassroots organization. </p>
<p>Attendees include physicians, spouses of physicians, residents, medical students, and state medical society staff interested in becoming more involved in politics.</p>
<p>Please note the following:</p>
<ul>
<li>The Candidate Workshop is open to American Medical Association physician members, member spouses, residents, medical students, and state medical society staff.</li>
<li>Registration fee is $250 for AMA members/spouses and $1,000 for non-AMA members. This fee is waived for AMA-member residents and students; however, space is limited and the AMPAC board will review and select four participants from the pool of qualified resident and student applicants.</li>
<li>Faculty, materials, and all meals during the meeting are covered by the AMA. Participants are responsible for their registration fee, travel to and from Washington, DC, and hotel accommodations (the AMA will provide you with a list of nearby hotels within walking distance of the AMA offices).</li>
<li>Participants will be required to bring a laptop or Wi-Fi-enabled tablet with them.</li>
</ul>
<p><a href="https://ampaconline.org/political-education/ampac-candidate-workshop">Registration for the 2026 AMPAC Candidate Workshop is now open</a>. Space is limited and the deadline for registering is March 20, or sooner if maximum capacity is reached. For more information contact <a href="mailto:Politicaleducation@ama-assn.org">Politicaleducation@ama-assn.org</a>.</p>
</div> | 2/19/2026 12:00:00 AM | 1/1/0001 12:00:00 AM |