Alaska Chapter Governor's Newsletter
Richard Neubauer MD, FACP
Governor, Alaska Chapter
The upcoming ACP Board of Governor's meeting in April will be extremely important for the future of ACP. As most internists know, the American Board of Internal Medicine (ABIM) concept of recertification (which they have called Continuous Professional Development or CPD) has been very controversial. Many have complained that the complex and time consuming process that ABIM cooked up is going to absorb an unreasonable time commitment from doctors already stretched thin by the demands of their busy practices. Furthermore, there is no data to validate that the CPD process yields any benefit in its expressed purpose: protecting the public from poor and outdated practices of medicine. Finally, there is concern that CPD, with its modules spread over ten years leading up to a secure exam, intrudes on the educational role that should be reserved for ACP.
While ACP is not directly responsible for the certification and recertification of internists, ABIM has sought ACP endorsement of the CPD process. Over the past year, a task force composed of ACP Leadership and representatives of the ABIM has tried to find a common ground. However, the progress has been slow, and ABIM has thus far been very resistant to fundamental changes in the CPD process. The ACP Board of Regents, which has the final say in determining whether or not ACP endorses the CPD recertification process has decided to await word from the Board of Governors at the April meeting. In the best tradition of a grass roots organization, our leadership wants to advocate for the membership in this crucial decision.
There is an interesting sidelight to this issue. The CPD process was developed in response to directives from the American Board of Medical Specialties, which outlined principles of what a recertification process should entail. Each Board came up with their own process, and while ABIM has been heavily criticized, other Boards came up with some very interesting and creative ideas that appear to be better accepted by candidates for recertification.
One outstanding example is the American Board of Obstetrics and Gynecology (ABOG). They offer candidates a choice between a secure exam at six-year intervals or a novel process of yearly recertification based on open book questions derived from a series of seminal articles that they pick out each year. They offer CME credits for completing the yearly recertification. The more I have studied the ABOG scheme the more I like it. In my view, the goal of the recertification process should be to emphasize internists' competence in acquiring, retrieving and applying new knowledge. What better way to do this than to read seminal articles, and answer questions that can be studied in open book fashion based on these articles? Such a process would supplement existing continuing educational activities without interfering with such activities. It has been pointed out that ABIM doesn't really have a constituency, other than the vague role they perceive for themselves of protecting the public from the errors of physicians who have not kept up with knowledge in their field. On the other hand, ACP has a clear constituency - you and me. It is my hope that the Board of Governors will send a strong message to the Board of Regents that we want ACP to hold out for a recertification process that really makes sense. In turn, I hope the Board of Regents has the gumption to take a firm stand with the ABIM that our constituency finds CPD unacceptable. Finally, my hat goes off to organizations like the ABOG that have been creative in developing recertification schemes that are innovative and exciting. I hope we can follow their lead and advocate for an internal medicine and subspecialty recertification process that our membership will thank us for and live happily with for a long time to come. Stay tuned.
Alaska Chapter ACP/WWAMI dinner
On January 30 the Alaska Chapter ACP hosted a dinner gathering at Campobellos Restaurant in Anchorage for the Alaska WWAMI medical students. The gathering was organized to increase the student's awareness of internal medicine and of the benefits of joining ACP as student members.
Our Chapter Council had been studying ways to use some of the money in our scholarship fund, and had considered some type of student award. But in the end, we felt that a better way to spend the funds would be to reach all the first year WWAMI students. With the help of one of the students, Ben Westley, we were able to entice the entire class to attend our meeting!
The concept of the gathering was straightforward: get together for a nice meal, and have some of our Alaska Chapter members each stand up and present a brief vignette to illustrate what it means to be an internist.
Well, the meal was great! Even more satisfying, however, was to hear the presentations of our Chapter members. Each one had something different to say, and each presentation was truly inspiring. Particularly memorable moments included:
- Dave Peach talking about how important a role general internists play in seeing "the big picture" in caring for their patients
- Bill Mayer discussing how as a cardiologist he is able to master a field of medicine that has changed dramatically over the years and save lives that would have been lost in years past
- Peter Hulman reviewing how his ability to sort through a complex problem and assemble a team of specialists was instrumental of saving the life of a young patient with disseminated meningococcemia
- Norm Wilder, in his inimitable form, telling tales of how his mentors taught him to always be humble and listen to his patients.
In attendance was the ENTIRE first year WWAMI class: Jon Anderson, Aric Christal, Allison Kelliher, Brian Kim, Hillary Moore, Maggie Nice, Chris Sahlstrom, Erica Stillner, Ben Westley, and Melissa Camille Young. Rebekah Miller, who is applying to medical school and is good friends with several of the WWAMI students also attended.
Alaska Chapter ACP members in attendance were: Tim Bateman, Bob Bundtzen, Jay Butler, Peter Hulman, Burt Janis, Steve Livingston, Bill Mayer, Julien Naylor, Rich Neubauer, Dave Peach, Molly Southworth, Latha Subramanian, and Norm Wilder.
The students were very appreciative to meet with Anchorage internists, and we distributed ACP student applications and promotional materials to each of them. The physician participants also commented that they really enjoyed the gathering, and want to make sure that we continue this activity for future WWAMI students. In summary, this first Alaska Chapter ACP/WWAMI dinner was a great success, and we will plan on making this a regular Alaska Chapter activity.
It is a pleasure to welcome cardiologist Dr. George Rhyneer to the ranks of ACP fellowship. Dr. Rhyneer had not previously been an ACP member, and because of his distinguished career he was granted "direct advancement to fellowship" upon applying last year.
It is a particular pleasure to welcome Dr. Rhyneer to The Alaska Chapter ACP for two reasons. One, at a time when some are questioning the benefit of belonging to organizations like ACP that have a wide ranging constituency versus more focused specialty organizations, Dr. Rhyneer recognized the value of ACP membership. Second, Dr. Rhyneer has a particular talent in the political arena. In recent years, he has cultivated a native ability for effective political advocacy by his activities in the PA, Alaska Physicians and Surgeons, and has also recently applied for a Robert Wood Johnson Grant that might lead to a year stint in Washington, DC sometime soon. Because of his talents in this area, I have appointed Dr. Rhyneer to chair our Alaska Chapter ACP Health and Public Policy Committee.
Dr. Rhyneer has impeccable credentials and has an uncanny ability to "find the correct path" when dealing with difficult medical issues as well as political issues. He will be a tremendous asset to our chapter, and to the national ACP organization.
Anchorage cardiologist Dick Anschuetz had let his ACP membership lapse recently due to doubts about whether ACP was representing his interests as an internal medicine sub-specialist. This very area, of representing the interests of all internists regardless of their area of sub-specialization, has been a major ACP concern.
After hearing about the efforts of ACP to work for ALL internists and reviewing the activities of our Alaska Chapter, Dr. Anschuetz has renewed his ACP membership, and is now in the process of applying for fellowship.
It is gratifying to have Dr. Anschuetz back as a member of ACP. On the local level, activities such as our Annual Alaska Chapter scientific meeting, and the dinner meeting with our Alaskan WWAMI students are activities that benefit all internists including sub-specialists. On the national level, ACP is devoted to working closely with sub-specialty organizations and also to representing the interests of all internists regardless of their specialty.
ACP Announces Bioterrorism Response Recommendations
At a press conference held in Washington in late November, ACP President William J. Hall, MD, FACP, announced that the College is initiating steps to help primary care physicians respond to a biological or chemical attack. Those steps are outlined in a new position paper on bioterrorism.
In addition to expanding ACP's Bioterrorism Resource Center, Dr. Hall said that the College is making a series of recommendations to procure more resources for physicians from federal, state and local governments and public health departments.
The College's recommendations call for increased funding for health departments and hospitals to help them develop crisis management strategies, stock adequate supplies and expand training for medical personnel. The full text of the College's bioterrorism position paper is online.
The College has also added new information to its Bioterrorism Resource Center to help physicians distinguish diseases caused by biological agents from other conditions. Images include cutaneous anthrax, smallpox and an inhalation anthrax chest X-ray. The Bioterrorism Resource Center is available on the College's website.
History of Medicine: A Look Back and a Look Ahead- Alaska Chapter ACP Annual Meeting
Alaska Chapter ACP Annual Meeting
June 27-29, 2002
Alaska Regional Hospital
Plaza Medical Building
1200 Airport Heights
There is no sure way of predicting the future. However, it has been clear for a long time to students of history that much can be learned from past events, and that "history has a way of repeating itself." Many have also felt that the practice of medicine is at a crossroads right now. We are able to diagnose and prognosticate at a level unprecedented in the past. Likewise, we have the ability to treat illnesses that in the past were incurable. Yet, at the same time, public faith in the healing arts seems to have suffered, and "unscientific" alternative medicinals have flourished. This meeting brings together a faculty that will try to put these issues in perspective. Our target audience is physicians, but other health practitioners may find the material interesting and appropriate. We look forward to your participation in this meeting.
Thursday June 27, 2002
|9:00-10:00 AM||Registration and Refreshments|
|10:00-11:00 AM||The Keepers of the Covenant; Dr. Fitzgerald|
|11:00 AM-Noon||Public Attitudes Toward Physicians: From Chaucer to the Present; Dr. Murray|
|Noon-1:30 PM||Lunch (Provided)|
|1:30-2:30 PM||From medical ethics to bioethics: celebrate or commiserate? Dr. d'Oronzio|
|2:30-3:30 PM||How did we get where we are? Dr. Loriaux|
|3:30-4:00 PM||Break and Refreshments|
|4:00-5:00 PM||History of Politics in Medicine; Mr. Doherty|
|5:00-6:00 PM||ACP Update: CR Report; Dr. Herald|
Friday June 28, 2002
|9:00-10:00 AM||Registration and Refreshments|
|10:00-11:00 AM||How do we know what we know? Dr. Murray|
|11:00 AM-Noon||How do we know where we are going? Dr. Loriaux|
|Noon-1:30 PM||Lunch (Provided)|
|1:30-2:30 PM||The History of Medical Education; Dr. Fitzgerald|
|2:30-3:30 PM||Diabetes Care 2002: A Glance Back As We Surge Ahead; Dr. Herald|
|3:30-4:00 PM||Break and Refreshments|
|4:00-5:00 PM||ACP Washington Update; Mr. Doherty|
|6:30 PM||Banquet - Alaska Native Heritage Center
Dinner Address: Jock Murray MD, MACP
Dinner Address: "Experiencing Illness: The view of an Artist"
Saturday June 29, 2002
|10:00-11:00 AM||The origins of the real "patients' rights" movement, 1969-70; Dr. d'Oronzio|
|11:00 AM-Noon||Idealized office design- incorporating proven error-reduction strategies into the workplace to support safety; Dr. Wilder|
|Noon-1:30 PM||Lunch and Townhall Meeting|
|5:00 PM||Annual Flattop climb|