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Governor's Newsletter, Fall 2000

Steven B. Tucker, MD, FACP
Governor, Alaska Chapter

Laureate of the Alaska Chapter

Alaska has its 4th Chapter Laureate – Norman J. Wilder, MD, FACP. Norm was born in Corvallis, Oregon on January 20, 1945. He attended Oregon State University and received a Bachelor of Arts Degree in General Science. He then received his medical training and degree at University of Oregon Medical School in 1970 followed by his internship and residency at UC Davis in Sacramento. Norm went on to complete his Pulmonary Fellowship at USAF Scott Hospital and Washington University in St Louis and is boarded in both Internal Medicine and Pulmonary Diseases as well as voluntarily recertifying in Internal Medicine in 1980. Following his Fellowship, Norm served in the Air Force and was Chief of Medicine at both Eilson and Elmendorf Air Force Bases.

Norm entered private practice in Anchorage in 1979 as a pulmonologist and rapidly became an acknowledged local "guru." From then until now he has served the Anchorage private and medical communities well. He has been President of his multispecialty group as well as Alaska Regional Hospital and has served on innumerable committees such as respiratory care, patient care, critical care, and the city-wide pulmonary care committees.

Norm is married and has two children both pursuing careers in medicine. Outside of he career in medicine, Norm was a pilot extraordinaire lecturing on aviation issues, acting as Consultant to the FAA, and was medical director of an airline company. He has traveled far and wide in the Alaskan Bush performing FAA physicals as well as participating in the lecture circuit.

Norm remains energetic in his educational pursuits. In addition to his recertification in Internal Medicine, he has studied sleep medicine and is co-director of the Sleep Lab and is currently in a Master of Business Administration Course at the University of Alaska.

Norm's contributions to the College both locally and nationally are particularly noteworthy. He has always supported the local chapter and became its fifth Governor in 1993. Under his guidance membership dramatically increased, many members advanced to Fellowship, and the Chapter prospered financially. He was active nationally on the Credentials Committee, Nominations Committee, and ACP Online advisory Board.

On a personal level he remains a good friend and my personal physician. The Alaska Chapter is proud to present Norman J. Wilder with our 2000 Laureate Award.

Respectfully,

Steven B. Tucker, MD, FACP, Governor, Alaska Chapter

Member Congratulations

New Fellow
Please join me in congratulating San Gan, MD, FACP, an Internist at the VAH to the ranks of Fellow.

New Member
Please welcome Dr. Dale Webb (at long last... who says nagging doesn't work!)

New Council Members

  • Carol Juergens (Kenai/Kodiak)
    Carol is a private practice Internist in Kodiak.
  • David Rudolph (Mat-Su)
    Dave is a private practice Internist in Palmer.
  • Jon Starr (Fairbanks and the Northern Tier)
    Jon is an Internist in Fairbanks at the Andrew Isaac Medical Center.
  • Jean Glossa (Southeast)
    Jean is in private practice as an Internist in Sitka.

New Council Treasurer
Congratulations to our new Treasurer - Dave Peach. As an officer, Dave is also a member of the Chapter Council.

Newest Member of the Council of Student Members - Julie Ake
Congrats to Julie Ake, who was elected to the Council of Student Members. Julie Ake is a member of the Alaska WWAMI class of 2003 at the University of Washington School of Medicine. Beginning this summer, she is the Pacific Region representative on the ACP Council of Student Members (CSM). The Pacific Region encompasses the states of Alaska, California, Hawaii, Idaho, Montana, Oregon, Washington and Wyoming. In addition, Julie serves as the CSM's representative to the AMA Medical Student Section.

The Council of Student Members is comprised of ten members - a chair and nine regional representatives. Its purpose is to address issues of concern to the medical student members of the ACP, of which there are over 16,000, and to promote internal medicine in medical schools. In 1999-2000, the CSM attracted over 1,500 new members, helped to found 15 internal medicine interest groups, published 6 editions of the student newsletter - IMpact, and established student positions on 17 Governors' Councils. For the year 2000-2001, the annual theme of the CSM is "E-learning" and it is working to create an e-learning resource guide for medical students on the College Web site. The CSM also aims to further increase membership, to strengthen its contacts with interest groups and with Governors, and to enhance student related activities at Annual Session and chapter meetings.

If you have any questions about what the CSM is doing, Julie can be reached at julie_ake@hotmail.com. Julie will be a Chapter Council member as well.

Volunteerism Award (Chapter First!!) Announced

The College has always been and continues to be, interested in encouraging volunteer efforts. As such, it has added volunteer projects to the criterion for advancement to Fellowship, created a National Award and encouraged its Chapters to create a Volunteer of the Year Award as well.

Our Chapter's first recipient is Dr. Tom Wood. Tom was instrumental in creating the clinics at the Brother Francis Shelter. Congrats Tom - well done!

Please send suggestions for next year's award to Rich Neubauer for the Nominations Committee to review.

Chapter Scientific Meeting

WOW! At least that's what all the reviews said. The topics and speakers were met with universal enthusiasm per meeting reviews. We had record numbers of attendees at the meeting itself and the dinner. Thanks for your support.

The Alaska Native Heritage Museum was a very popular venue. It will be the site for next year as well and then will likely rotate between the Anchorage Museum and the Heritage Center. Who can forget in addition to Dr. Fauci's timely remarks, the sight of Jim Sprott and Keith Brownsberger joining the King Island Dancers on stage.

It was also a unique time in that all six Governors in Chapter history and the current Governor-Elect were present at the same time.

The Near Point climb had enthusiastic participants, but the consensus favored a return to Flattop (this will be up to Rich, who takes over in April.) Climbing were Steve Tucker; Rich Neubauer; Kathy and Norm Wilder; San Gan; Keith Brownsberger; Sue Heverling with 2 kids in tow; Carol Juergens; Dave Caternichio from Merck; Associates from Oregon Sue Henery and from Washington Mike Schatzman; Tony Fauci, his wife, Christine Grady and their two children; Eric Sasso; Whitney Addington and family; and Cliff Lane.

Thanks to all for their support/participation and to TAP/Abbott for providing refreshments and gifts.

Special thanks to the Neubauers', the Wilders', the Bundztens', the Janis', the Tuckers', the Lyons', the Herndons', and the Peachs' for hosting our gueststand speakers.

Annual Session (Philadelphia) Highlights

  1. Board of Governors Meeting
    1. Our Chapter received another Chapter Management Award - our fifth consecutive such award!!
    2. Our Chapter received a "special recognition" Evergreen Award for its innovations to improve our Annual Meeting.
    3. Drs. Mary Stewart and Jim Stragand were officially inducted as Fellows.
    4. Resolutions - The Board of Governors once again heard a number of resolutions discussed by your Council prior to the meeting. Without elaborating each resolution, approved measures included a request for further inclusion of Internists from outside the USA; strong stances against managed care clauses that restricted formularies; reimbursement and other issues important for patient care and MD independence; inclusion of an annual exam for Medicare patients; standard credentialing with paper work reduction; and a re-examination of recertification processes.

      As part of the grassroots campaign, resolutions are available for all to view at the College Web site - www.acponline.org. Send us your input. Current resolutions are now posted.

    5. Major Topics
    • The College announced its new clinical theme, "Congestive Heart Failure."
    • Decision 2000 - Last summer, ACP launched a new initiative, the Decision 2000 Campaign, to elevate the problem of the uninsured on the national agenda. Through Decision 2000, the College is working to secure commitments by presidential and congressional candidates to address the issue of the uninsured and to educate decision-makers about the impact of health insurance on health status.

      To date, the College has placed advertisements in various publications highlighting the evidence that the uninsured have worse health outcomes. Each ad featured the tag line "No Health Insurance? It's Enough to Make You Sick." Last fall, ACP sponsored a briefing for Capitol Hill staff on universal access with House Majority Leader Dick Armey (R-26-TX), and held a press conference to release a new white paper that demonstrates the link between a lack of health insurance and poor health.

      The success of ACP's Decision 2000 campaign depends on the participation of Governors and chapter members. Chapter involvement will be especially important during the 2000 congressional elections. Washington staff will be contacting chapters and asking them to participate in grassroots activities throughout the primary season. For more information on the campaign or what you can do to help, contact Jenn Jenkins, Associate for Grassroots Advocacy, in the Washington Office. You can reach her at 800-338-2746, ext. 4536.

    • Patient safety report from the Institute of Medicine was presented by Dr. John Eisenberg, MACP. I had the privilege to be present on the panel discussing the impact of this report. Patient safety concerns will be a dominant issue in the future.
    • We heard a spectacular presentation regarding the human genome project and discussed potential implications for Internal Medicine.
    • Practice hassle factor reduction again got its just time.
  2. Scientific Session

    The following attended the Scientific Sessions, Norm Wilder and his daughters, Steve Tucker, Rich Neubauer, Keith Brownsberger, Dave Rudolph, Dave Peach, Jean Glossa, Owen Hanley, Rod Wilson, Mary Stewart and Jim Stragand. We continued our traditional annual Chapter dinner, held this year at Sansome Street Oyster House.

    I have heard very positive feedback regarding the high quality of the Scientific Sessions this year. Please mark your calendars for the 2001 Annual Session in Atlanta, Georgia, March 29-April 1.

Governor-Elect Message

Richard Neubauer, MD, FACP

I look forward with enthusiasm to serving as Governor of the ACP Alaska Chapter. These are interesting times for medicine. Many amazing advances in medical science that have been accomplished in the last twenty years have placed us in the unique position to help our patients in ways that have never before been possible. The research effort that has enabled the decoding of the human genome also places us on the threshold of a new era in medicine. We can now envision therapeutic and diagnostic interventions for the future that will vastly improve on our current capabilities. Yet, in our day to day practice of medicine, many of us sense that all is not well and that the American system for delivery of medical care is sorely lacking in many ways.

Over the years, I have been impressed with the American College of Physicians-American Society of Internal Medicine as an organization that has provided important educational activities for its members, and also has provided a venue for its members to collectively express the ideals of professionalism and patient advocacy. I personally feel that in our current political and social climate, these activities are more important than ever. I am thus proud to be a part of an organization such as the American College of Physicians-American Society of Internal Medicine.

On a local level, I have had the privilege to be involved in local chapter activities that I hope and feel are in concert with the national organization. It is my goal to continue these activities which include:

  • Annual chapter meetings that explore in depth areas of medicine that are of current interest from a scientific, clinical, and/or historical perspective.
  • Participation in other educational activities that further the chapters educational mission. An example is the newly formed chapter CME Committee that has helped to revolutionize the internal medicine grand rounds activities available in Anchorage over the past year.
  • Conservative management of our monetary funds for future educational activities of our chapter. It will reflect well on all of us here now to leave a legacy of good management for future generations of internists that will come after us.

I am not so naíve as to ignore the problems that face us, even here in our remote corner of the country. Some of these include:

  • Concerns that some of you have already voiced to me that the political stands taken by the College may in some instances conflict with some individual political beliefs. We have lost a few members over perceived differences on national positions that the College has taken on payment issues, and issues such as gun control and tobacco. I will try to represent our common interests with as much wisdom as I can.
  • A lack of active participation in chapter activities from internists outside of the greater Anchorage area. A pathway to enhance the participation and representation of internists outside the Anchorage area has been laid out in the structure of our new Chapter Council.
  • Continued practice challenges that threaten to erode the time and energy that we have to devote to our continuing education and growth as individuals and as physicians. These same forces of change threaten to damage the delicate balance of power between hospitals, physicians, insurance companies, and patients, even in Alaska where we have been relatively isolated from managed care.

While I certainly don't have an answer to these problems, our chapter can help us to at least be educated and aware, and thus perhaps better prepared for whatever lays before us.

I hope to continue the growth and development of our chapter on a pathway that has been skillfully laid out by our former Governors, and to try to look out for the interests of all of our membership - specialists and sub-specialists alike. I look forward to working with all of you in the coming years.

The Alaska Chapter ACP CME Committee

Richard Neubauer, MD, FACP

Starting January 1, 2000 a committee of our chapter took over the role of overseeing the content of the grand rounds programs at Alaska Native Medical Center, Providence Hospital, and Alaska Regional Hospital - CME Committee. This venture was undertaken at the request of the participating hospitals CME directors. This has been an exciting innovation that we feel has greatly expanded the scope of grand rounds activities in the Anchorage area.

Briefly, each of the participating institutions had their own unique but overlapping problems. The physician audience at each institution had called for a change. The CME directors at each institution collectively approached the Alaska Chapter to act as an "independent third party" that could help the three institutions come together to build a stronger educational program.

We decided on several major guiding principles:

  • The program would need to adhere to guidelines set forth for CME by the Accreditation Council for Continuing Medical Education (ACCME).
  • The program should be based on a curriculum set forth by the departments of medicine at the participating institutions. The role of the committee would be partly to ensure that speakers would be identified to address ALL the topics, not just the ones that would be attractive to pharmaceutical firms wishing to educate physicians about topics relevant to their products.
  • The committee should be composed of representatives of all the participating institutions, but there should be one "point of contact" - a member of the committee who would be available to coordinate contact with speakers, industry representatives, and others wishing to interface with the grand rounds program.
  • Novel financing arrangements would be sought after to underwrite speakers who might not otherwise garner industry support for topics on our curriculum.

Our first order of business was to write policies and procedures, which were scrutinized and approved by each participating department of medicine. Once approved, we set a target date to start our program - January 1, 2000.

Now in operation for seven months, we have not yet tried to formally evaluate the impact of the new program. However, the informal audience response has been very favorable. We plan on soliciting formal evaluation from our audience after the program has been in effect for one year. Here is a brief synopsis of what we have seen thus far as a result of this program:

l It has definitely been gratifying to those of us involved in arranging CME to have a curriculum driven system. Here are a few examples of recent and upcoming speakers that demonstrate the diversity we've been able to achieve: Tom Welty, MD, "Implementation of Programs for Prevention of Mother to Child HIV Transmission in Africa;" Marty Cetron, MD, "Quarantine: Past Present and Future;" Paul Cassella, "Writing and Speaking for Excellence;" David Cook, MD, "Diagnosis and Therapy of the Adult Patient with Growth Hormone Disorders;" Scott Smith, MD, "Organizational Cultures: Implications for Medical Education;" and Kathleen Neuzil, MD, "Update on the Use of Vaccines in Adult Patients." Most of these speakers and topics would have been difficult or impossible to arrange in our past grand rounds system.

  • As a surprising outcome of this program, we have identified a novel way to raise funds to pay speakers - holding "industry fairs." For a fee, industry representatives can display their wares to our physicians, unassociated with any CME program, thus going a long way to achieving a long sought after goal: true separation of industry support from the content of our CME programs. This has been a real "win-win" situation. Our industry supporters have been pleased with the opportunity to meet with physicians (many of whom were largely inaccessible to them in the past) while we have been able to bank enough funds to actively seek out speakers that would otherwise be difficult or impossible to invite to Anchorage.
  • While so far the program has been implemented only in Anchorage, there is no reason why we could not make a similar service available to other Alaska medical communities if there was any interest in doing so.
  • While this program has involved a lot of work, the liberal use of e-mail has greatly facilitated its operation. We have a bookkeeper who has maintained the checkbook, and our committee structure has worked smoothly thus far - minimal meetings have been needed as most of our contact with each other has been via e-mail services.

This has been a very exciting venture so far. We look forward to formally surveying our audience at the end of this year. By all the indications available thus far, the program has been a great success and a great pleasure as well.

Finally, without the availability of our Alaska ACP Chapter as a "third party" respected by all other parties to this undertaking, it would have been impossible to even think about initiating such a project.

Well that's it for now.
Steve

How to Reach Us

Governor
Steven B. Tucker, MD, FACP
3300 Providence Drive, #304
Anchorage, AK 99508
Phone: (907) 261-4840
Fax: (907) 261-4820
E-mail: sbtucker@alaska.net
Governor-Elect
Richard L. Neubauer, MD, FACP
1200 Airport Heights
Suite 210
Anchorage, AK 99508
Phone: (907) 264-2030
Fax: (907) 276-0366
E-mail: stuckrik@alaska.net