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Governor's Newsletter, Fall 1999

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

Please Vote

Every four years our Chapter has the opportunity to select its new Governor and the year 2000 is our Chapter's election time. Our Chapter has enjoyed, in my opinion, an excellent track record as far as our annual meetings, Internist participation (highest in the College), establishment of CBT, a journal club and now establishment of an active Council. We are in the best financial shape of our history. The Chapter has won the College's Chapter Management award annually for the last seven years and two Evergreen awards for Chapter projects. At the National meetings when our Chapter talks, people listen.

I therefore urge all members to read the Vision statements of our candidates and to think carefully when your ballot arrives in November about who you think will continue this tradition of excellence. Your vote is essential to the future of the Chapter's success. Please vote for the candidate who you think will best carry out the Chapter's mission.

Biographical Sketches For Governor-Elect Candidates

Richard Neubauer, MD, FACP

It is a privilege to be a candidate for Governor of the Alaska Chapter ACP. I graduated from Yale University Medical School in 1976 and did my residency in internal medicine at the University of Michigan 1976-1979. Subsequently, I spent two years in the Indian Health Service in Fort Washakie, Wyoming. After a brief stay in Juneau, I have been in private practice in Anchorage since 1982. I am a general internist and have active staff privileges at Alaska Regional Hospital and Providence Alaska Medical Center.

I have been Chairman of the Internal Medicine Department at Alaska Regional Hospital for a total of four years, and have served as Chief of Staff at Alaska Regional Hospital as well. I am currently on the Board of Trustees at Alaska Regional Hospital. I have served on the executive committees at both Alaska Regional Hospital and Providence Alaska Medical Center.

Early in my private practice career, I established an interest in continuing medical education. In 1988, I became CME director at Alaska Regional Hospital and over the ensuing years have organized and executed over forty CME conferences directed toward Alaskan physicians. As part of this activity, I have been director of the Alaska Chapter ACP annual meeting and have had a continued commitment to making this annual meeting a hallmark on the Chapter's activities.

In addition, I have implemented the Chapter Web site and have continued to help maintain the site since its inception. I currently serve on the Chapter Council. I have had the privilege to work closely with the last four Governors of the Chapter, and have a good working knowledge of the Chapter history and functions.

Over the years, I have been particularly attracted to the ACP because of its commitment to the ideal of life-long learning, and its focus on what is best for patients. In these turbulent times, the College has been able to keep to its high ideals while also trying to expand its political/ policy representation of physicians. If elected Governor, it would be an honor to expand my service to the College and to represent my fellow Alaskan internists on a national level.

My goals as Governor would include maintaining the continued success of our annual meeting and other Chapter activities. I would also try to build upon the solid foundation set by our recent Governors who have successfully expanded our membership. Specifically, I would work to increase participation by internists throughout the state.

Jeanne R. Bonar, MD

Steve Tucker asked the candidates for Governor to write about our goals for the Alaska Chapter of the ACP. I immediately thought about when I first came to Alaska and how impressed I was with the high quality of physicians (especially internists) and the care they delivered. I started my medical practice here in 1980, and we had exceptionally talented internists in practice. That number has increased, and the same quality of excellence has continued. The newer internists (general and subspecialists) have added significantly to the outstanding quality of care in this community and throughout our state. They bought with them quality education and an array of newer techniques.

My goal in the Alaska College Chapter will be to recruit all of our physicians who are not already members. As soon as their two-year time limit is met, they will be promoted to Fellowship. We can develop our Chapter into a statewide organization with 100% Fellowship, because of our highly qualified internists.

Education and continued exposure to new advances are gained not only by excellent courses and invited speakers, but also by sharing mutual and individual opinions on medical subjects. A journal club is one example of an excellent format for teaching, sharing views and understanding the latest developments in subspecialties and general internal medicine. Regular and more frequent open meetings of a journal club or information exchange will be a useful and instructional forum, preferably at central, public locations, e.g., one of the new gourmet restaurants. Pharmaceutical representatives I have polled have strongly indicated that they will support these medical exchange meetings. With so much local talent and ability in our state, we benefit most from local participation. This will extend not only to education, but to social aspects of practice in internal medicine.

With the changes in the social structure of medical practice in the United States and attitudes of the public toward our profession, our united efforts in continued quality practice and education will benefit us and our patients.

Fellowship in the College is easily within grasp of all our members. I am committed to the promotion of all our excellent, qualified physicians within a unified state organization.

Advancement From Membership To Fellowship

"How do I advance from Membership to Fellowship?" is a question frequently asked by you, the ACP members. Below, is a summary of the requirements and pathways that a candidate must fulfill and/or meet in order to become a Fellow of the College. Please contact me if you have any questions or problems.

Requirements:

  • be certified by the American Board of Internal Medicine, the Royal College of Physicians and Surgeons of Canada or the American Osteopathic Board of Internal Medicine;
  • have been a member in good standing for two years in either ACP or ASIM and have held a position in practice or in academia for at least two years since completion of training;
  • have an active medical license in good standing (if in clinical practice);
  • have confined professional activity to internal medicine or a subspecialty of internal medicine;
  • be proposed and seconded with detailed letters of support from two current Masters or Fellows with reference to character, ethics and medical activities, and outlining professional contributions and accomplishments;
  • be endorsed by the appropriate ACP Governor;
  • have shown continuing scholarship and professional accomplishments; and
  • document continuing professional activities, including teaching (both institutional and community-based); hospital committee work; public service and community activities; and participation in continuing medical education activities as both a student and teacher.

Pathways

The College has established four Pathways that serve as guidelines to qualify for Fellowship. For each of the following pathways, the candidates must meet the basic requirements listed above.

Pathway 1: Members must have demonstrated skill in written medical communication.

Pathway 2: Members must have significant and continuing certification activities and/or teaching (both institutional and community-based), and/or community activities that indicate professional achievement and scholarship; they must have undergone recertification, or they must have participated in the Medical Knowledge Self-Assessment Program (MKSAP) with a passing score. In addition, subspecialty certification or certificates of special competence in adolescent medicine, critical care medicine, clinical cardiac electrophysiology, geriatrics, or sports medicine can qualify a candidate for this pathway, but are not adequate by themselves.

Pathway 3: Members must have been active members in ACP or ASIM for at least 10 years, with substantial participation in programs and activities, as well as demonstration of other professional accomplishments.

Note: Outstanding candidates who have been active Members for fewer than 10 years may qualify by combining Pathways 1 and/or 2 with Pathway 3.

Pathway 4: Members must have distinguished professional activity in teaching, patient care or professional service over many years.

Candidates must document each pathway; however, a candidate may be accepted without fulfilling one pathway if his/her work in other pathways is deemed outstanding by the Credentials Committee. For a complete copy of the "Requirements for Advancement from Membership to Fellowship" and/or an advancement to Fellowship proposal, contact your local College Governor or call ACP Customer Service at (800) 523-1546, ext. 2600. The "Requirements for Advancement from Membership to Fellowship" can also be found on the College's web site at: www.acponline.org/college/membership/required.htm

Fall Board Of Governors Meeting Highlights

The BOG of the College held its Fall meeting in Asheville, NC. Highlights of the meeting included:

  1. College Health Initiatives

    a) Universal insurance
    The College continues to lobby for universal insurance to help cover the ever increasing number of uninsured Americans. The College along with other health organizations, has successfully returned health care reform to the National agenda—witness the current attention given to this topic by both GOP and Dem candidates.

    b) Patients Bill of Rights
    The College has been active in articulating its view in what's important to include in this debate. Although the conference meeting on this topic still looms, the initial House vote carried the elements felt important by the College.

    c) Emerging infectious diseases
    The College has identified this area as its first clinical theme. As a result, there will be a public awareness campaign alerting the public as well as physicians about the downside of inappropriate use of antibiotics. Data and guidelines will be forthcoming soon.

  2. Merger Update

    The CEO of the College Walt McDonald, reported that the staff mergers of the two organizations has achieved a grade of A+ in his estimation. Chapter merger activity continues to proceed well. Our Alaska Chapter, as a result of this process, is in the final phases of revising its bylaws.

  3. PAC (Political Action Committee) Update

    The BOR is in the process of studying the recommendation of the BOG that the College establish a PAC. A decision will be made February 2000.

  4. Resolutions

    Six resolutions were heard this time out, down from the 53 heard at the time of initial merger. Key resolutions addressed: 1) the College condemning the use of Internet prescribing in the absence of an established patient-physician relationship; and 2) reevaluating the recertification process (the College however has only an advisory not decision capacity.)

  5. Practice Tumult

    The BOG spent a fair amount of time discussing our current practice conditions and MD satisfaction. A record 31% of surveyed Internists reported they would not go into Medicine if they had it to do over again, a statistic that contrasts with the stability of students choosing IM as a career. It is felt perhaps differing expectations is the reason for this phenomenon. Nonetheless, the College is actively studying the issues involved with the seeds of the problem and hopes to find ways to improve MD "happiness" without appearing to be motivated by self-interest.

  6. On Being a Doctor

    This as you know is a feature in the Annals. At this meeting, selected pieces were presented to the audience. They were powerful and moving and reminded all listeners of the real reasons we went into Medicine. I like it so much I will be looking into getting a session devoted to this at our Regional Meeting, June 22-24, 2000.

  7. Collective Bargaining

    It's fair to say that this topic generated the most passionate of opinions. Although not as present an issue here in Alaska, this debate centers around the controversy of whether MD's should be allowed to discuss as a group with Managed care plans issues that affect patient care.

  8. The First Annual Spoon Award

    The Chair of the BOG created a new annual award to honor those Governors who he felt kept the College's nose to the grindstone and as he put it "kept the pot stirred." I am proud to say that I was runner-up and received a personally engraved wooden spoon. Larry Lehrner Governor of Nevada was the winner and received a larger spoon.

Your Council At Work

The current Council of your Chapter met on Wednesday September 22, 1999. FYI the current Council consists of Drs. Tucker, Wilder, Neubauer, Wood, Herndon, Southworth, Peach and Bundtzen.

  1. We are in the final stages of updating our bylaws, bringing them into compliance with the new organization and current State laws.
  2. We approved, in concept, the formation of a new AK ACP Committee, which will help PAMC, ARH and ANMC improve the quality of out of town CME speakers at our local medical department meetings. Burt Janis, MD, FACP, will head the Committee and the CME directors of the three institutions will also be members this will be Rich Neubauer, MD, FACP (ARH), Mark Agnew, MD (PAMC) and Brian McMahon, MD, FACP (ANMC).

    The Council requested that this Committee report back to the Council with a detailed proposal on how it will be structured before November 30th. Look for more information in upcoming newsletter issues. It is the goal of this Committee to insure quality speakers for our ongoing CME talks. The College Chapter is honored to have been asked by these institutions to help in this area.

  3. Treasurers Report (as of 9/13/99)
    • Card Project Balance—$1,350.00
    • Checking account—$7,090.15
    • CD's—$56,287.81
  4. Reviewed upcoming resolutions to be voted on at the Fall Governors meeting. These resolutions can be found on the College web site at www.acponline.org.
  5. Accepted the reports of the Nominations and Community Based Teaching (CBT) Committees.

Gender Bias Not Found

At our recent June townhall meeting, concerns were raised about possible gender bias in our Chapter. I have explored this and wish to assure our Chapter members that this allegation has no factual basis— here's the data.

  • In the US, the male/female percentage ratio of Internists is 74.6%/25.4% (ACP headquarters).
  • In Alaska, the male/female percentage ratio is 76%/24% (ASMA).
  • The College membership is 74.8% male/25.2% female (ACP headquarters).
  • The Alaska Chapter membership is 70.5% men/29.5% women (ACP headquarters).
  • The ASMA membership is 77.2% men/22.8% women (ASMA).
  • In regards to Fellows, our Chapter has 2% more women Fellows than the College average (ACP headquarters).
  • Two of the last four Presidents of the College (includes President-elect) have been women. The current Chair-Elect of the Board of Governors is Donna Sweet (ACP Headquarters).
  • I and my previous Governors have had a policy of trying to encourage (some would say cajoling/begging) ALL Internists in the State to join the College and our Chapter. We have also encouraged (some would say badgered/pleaded) ALL eligible members to pursue Fellowship. I'm sure our next Governor and future Governors will also pursue similar goals.

Group Insurance Administrator

By Jack Finnegan, GIA, Vice President of Insurance and Financial Planning

Who are these people? Oh, they are the folks that set up the College Display at Chapter Regional Meetings. Yes they do that, but let's look at Group Insurance Administrators' (GIA) principal responsibilities in providing benefits of membership for ACP members.

The appointed administrator of ACP sponsored Insurance and Financial Planning Services, GIA has been providing its expertise in these services for over 45 years. Currently over 28,000 ACP members benefit through participation in insurance plans, which are designed exclusively for them and administered by the staff of GIA. An added benefit is that GIA devotes all of its skills to ACP members only!

GIA understands your needs for protection in the event of death, disability, medical expense and financial planning. They also recognize that members of the College are preferred risks and this is reflected in the low premium rates charged for benefits selected.

GIA's insurance and financial planning services are monitored by the Board of Regents' Member Insurance and Financial Services Subcommittee. The members of the subcommittee include ACP's Executive Vice President and Treasurer, as well as one member of the Board of Regents and four members of the Board of Governors. For more information, contact GIA at 1-800-GIA-PLAN. Also, if you wish to set up an Insurance or Financial Planning Seminar in your community, hospital or University, call Jack Finnegan, Vice President of Insurance and Financial Planning, and GIA will take care of the arrangements.

New Legislative Action Center

Ever wanted to zip off a letter to your representatives but just don't seem to get around to it? Well, the College's new LAC is the solution. This makes it a snap to simply access our rep via e-mail and zip off a letter before the "passion" fades. Check it out. We also have these and the Governor and Mayor's e-mails on our web site as well.

ACP Launches Legislative Action Center

To make participation in grassroots advocacy easier for its members, ACP launched in August the new Legislative Action Center (LAC), which may be accessed from ACP Online. The LAC allows you as an ACP member to view the most current ACP Legislative Alerts, find out who your federal legislators are, and send e-mails or faxes to your members of Congress. It also provides you with the status of key legislative issues of concern to ACP, Congress' schedule, and tips on communicating with your legislators. ACP encourages you to try the LAC by sending an e-mail to your members of Congress in response to the current Legislative Alert posted on ACP Online.

You can access the Legislative Action Center through the "Where We Stand" section of ACP Online at http://www.acponline.org/advocacy/, or by going straight to the LAC at http://congress.nw.dc.us/acp/. To send a message to Congress, you are prompted for your zip code and are zip-matched to your federal legislators. You will then be asked for your name and address (so that congressional offices can identify you as a constituent). ACP encourages you to send a message based on the sample points posted for you, with your own personal anecdotes added. If you have any questions about the LAC or contacting your federal legislators, please contact Jenn Jenkins, Associate for Grassroots Advocacy, at jjenkins@acponline.org.

Chapter Meeting 1999

Well the reviews are in and the June Meeting, "Emerging Infectious Diseases" got 5 stars out of a possible 5!!

In keeping with Rich Neubauer's great track record, the consensus suggested the quality of the speakers was at an all-time high. The topic selected by Rich also happens to be the College's National theme as well. Our attendance also was at record levels up 11% from last year!!

The Anchorage Museum's Sydney Laurence room was a big hit and the dinner provided by Ultimate Catering continued to be superb. Judging from the number of attendees the Friday night change seemed popular.

Dr. Sandra Fryhofer, FACP, President-Elect for the College, ran our townhall meeting and presented the Chapter with a management award and an Evergreen award for our donation card project. Her CR report gave our meeting a glowing review.

Special thanks to our hosts for speakers and out of town guests including Drs Wilder, Peach, Janis, Brownsberger, Kramer and Demers.

Mark your calendars for next years meeting June 22-24, 2000, "Immunology for the Millennium." So far, the meeting's speakers will include: Dr Anthony Fauci from the NIH, Christine Grady, PhD, John Gallin, MD, Eric Sasso, MD and Dr. Cliff Lane from Michigan.

The College said, "the Alaska Chapter meeting continues to have one of the highest percentage of member attendance." I say "bravo" AK ACP members and let's continue this tradition into the next millennium.

Our Flattop trek (third annual) had thirty hikers twice our previous high and 29 summitted. The summiteers were rewarded with gift certificates to REI.

Reminders

  • Still need those e-mails!! While my list is growing, its not totally complete. Let me know your new address by e-mailing me at sbtucker@alaska.net.
  • We still have plenty of those Evergreen Award winning donation cards—place your order now.
  • If you are not yet a Fellow, please review the article which outlines the pathways by which you may be elected to Fellowship in the College.