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Governor's Newsletter, Spring 2001

William E. Dismukes, MD, MACP
Governor, Alabama Chapter

Annual Scientific Meeting Of Alabama Chapter

Bill Dismukes, MD, MACP

Our upcoming annual meeting will be held once again at Perdido Beach Resort, Orange Beach, AL, on May 31-June 2, 2001. An outstanding program and group of speakers have been assembled by James Bonner, MD, Program Chairman.

Clinical topics will be:

  • Sports Medicine for Internists
  • Evaluation of Chest Pain
  • What a Primary Care Internist Should Know about HIV
  • Erectile Dysfunction
  • Topics in Geriatric Psychiatry
  • GI Potpourri

Other features will include 1) Six Clinical Vignettes by Associate members, 2) Report from Washington, 3) Update from the College, and 4) two 1.5 hour clinical skills workshops on Joint Arthrocentesis and Injection.

Special activities are also planned:

  • Two receptions, one on Thursday evening and another on Friday evening to honor our Laureate awardees
  • A Town Hall meeting and a Business Meeting
  • Golf tournament for attendees

Please join us for an informative meeting as well as fun, relaxation and visits with friends.

For more information on registration and hotel reservations, please call Charlotte at 205-934-5191.


Ninth Annual Literature And Medicine Retreat

Thanks to co-chairs, Bob Lokey, MD, and John Bass, MD, as well as Dr. Randy Davis, Facilitator, this Retreat, held on January 27-28, 2001 in Montgomery, was again a huge success. There were 32 participants who enthusiastically discussed the works of Tolstoy (Anna Karenina), Garcia Marquez (Collected Stories), Heaney (Opened Ground: Selected Poems 1966-1996), and Albee (A Delicate Balance). All attendees reported an enjoyable and exciting exchange/dialogue and invite new participants to the winter 2002 retreat.


ACP-ASIM'S Advocacy Agenda for 2001

  • Access to Care for the Uninsured
  • Regulatory Relief (Reduce Red Tape)
  • Physician Payment
  • Medical Errors
  • Confidentiality of Medical Data (HIPPA)
  • Medicare Prescription Drug Coverage
  • Patient Bill of Rights
  • Graduate Medical Education

ACP-ASIM
Division of Governmental Affairs and Public Policy
2011 Pennsylvania Avenue, NW
Suite 800, Washington, D.C., 20006-1834
Tele: 202-261-4500/800-338-2746


Activities of the Alabama Chapter ACP-ASIM

University of Alabama School of Medicine Internal Medicine Student Interest Group (IMSIG)

Lisa Howard, 4th Year Medical Student, President, IMSIG

First meeting - November 2000

  • Introduced first and second year medical students to the IMSIG at a noon meeting with lunch provided

  • Several internal medicine faculty members spoke briefly about internal medicine and answered questions from the students

  • Showed the 20-minute ACP-ASIM video, Internal Medicine: Imagine the Possibilities

  • Informed students about benefits of membership in the ACP-ASIM

Second meeting - March 2001

  • Held another lunchtime meeting with food provided

  • Dr. John Canto, a UAB cardiologist, spoke to students about recent exciting developments in cardiology and about the advantages of residency training in internal medicine as a platform to various career options

  • Measured interest in the development of an internal medicine summer mentorship program

  • Dr. Canto and Dr. William Dismukes, AL Governor, answered questions from students

  • Encouraged student membership in the ACP-ASIM and attendance at the annual meeting in Atlanta

Third event - April 2001

  • Held an evening reception honoring the 50 UASOM students who matched in various Internal Medicine Residency Training Programs across the country (13 matched at UAB)


Alabama Chapter Associates Activities

David Ennis, MD, FACP, Chair, Associates Committee

The Associates Program of the Alabama ACP-ASIM has continued to be very active. On February 24, 2001, a seminar on real estate basics was held at The McWane Center in Birmingham, AL. This session, which was supported by Glaxo-SmithKline, provided in-depth information for residents who are buying or selling homes, and also provided their families with an opportunity to explore the museum and to view the IMAX film. The meeting was well attended and well received. A final Associates meeting will be held in May of this year.

The Alabama Associates Program is also active at the national level. Dr. Bill Summers of the Baptist Health System Internal Medicine Residency Training Program was chosen at our 2000 state meeting to represent our chapter at the April national ACP-ASIM meeting in Atlanta, GA. His abstract described an unusual presentation of blastomycosis. In addition, Dr. Steven Rowe of the UAB Internal Medicine Residency Training Program submitted an abstract on pneumococcal disease to the national Associates competition; his abstract was also selected for presentation in Atlanta. We are very proud of these young physicians and wish them well.

Finally, The Associates Program has promoted a recent legislative proposal, which, if passed, would greatly reduce the financial burden upon residents who have educational loans. At the urging of our Associates, a letter writing campaign to our state senators and representatives was undertaken. We hope that these letters, in conjunction with those generated from MASA, will result in a favorable vote. The Associates Program is committed to acting on behalf of its resident and fellow members.


Congratulations to New Alabama Chapter

Fellows Invited to Participate in March 29, 2001 ACP-ASIM Convocation in Atlanta

Laurence C. Carmichael
Sheffield

Benjamin S. Citrin
Mobile

Osemwegie E. Emovon
Mobile

Charis E. Eng
Birmingham

Brijendra Gupta
Huntsville

David L. Hinton
Tuscaloosa

Michael P. Houston
Foley

Cora E. Lewis
Birmingham

Ivan D. Maya
Montgomery

John C. McDuff
Point Clear

Stuart J. Padove Birmingham

James K. Simpson, III
Mobile

Thomas E. Stevens, Jr.
Mobile

Jefferson Underwood, III
Montgomery

G. Scott Warner
Cullman

Ayman A. Zayed
Anniston


Alabama Chapter Receives National ACP-ASIM Chapter Excellence Award

This award was based on the following activities of our chapter during the 1999/2000 fiscal year:

  • Active participation by your Governor in the national Governors Information Center Website.
  • An active Board of Directors (Advisory Council).
  • An active Internal Medicine Student Interest Group.
  • An active Associates Program.
  • At least two other active committees — examples in our chapter, the Health and Public Policy Committee and Literature and Medicine Committee.
  • Publication of at least two Governor's Newsletters per year.
  • An annual Chapter sponsored, CME accredited state scientific and educational meeting.
  • Initiatives to recruit new members to ACP-ASIM and advance Members to Fellowship.
  • A staff person to handle chapter-related activities. Our Chapter is fortunate to have two part-time persons:
    Charlotte Brown in the Governor's Birmingham office,
    and Teri Dingler in the MASA Montgomery office to work with AL Health Services.

Our Chapter was one of 36 national and international chapters to receive the Chapter Excellence Award.


Report from Washington

Richard H. Esham, MD, FACP, President, AL ACP-ASIM HS

Alabama ACP-ASIM Health Services was represented at the 2001 Medical Association of the State of Alabama (MASA) Washington Government Affairs meeting by Richard H. Esham, MD, Mobile, and Peter W. Morris, MD, Birmingham. The meeting was held in February 2001, at the Willard Hotel and was well attended by a large number of physicians representing most specialty organizations from Alabama. The Sunday afternoon meeting of the Interspecialty Council stimulated lively discussion regarding the Prompt Payment Bill currently under consideration by the Alabama legislature as well as perceived and/or actual inequities of payment for physician services between rural and urban practice locations. Governor Don Siegelman visited briefly with the group and indicated his willingness to listen to physician concerns and work with us on important health care issues.

During the four-hour Monday morning session, Richard A. Deem, Vice-President, Government Affairs for the American Medical Association (AMA), highlighted the AMA's perspective on an assortment of Federal issues. Priority items for the AMA this legislative year are similar to the priority issues of ACP-ASIM and include: securing medical insurance coverage for the uninsured, addressing patient safety and medical privacy of patients, as well as a strong patient bill of rights which provides patient protections while enhancing access to needed healthcare services. On behalf of physicians, the AMA is working to obtain regulatory relief, equitably balance the Medicare payment formula, and assist medical students and residents with the onerous debt incurred during training years.

Carolyn M. Clancy, MD, Director, Center for Outcomes and Effectiveness Research, Agency for Healthcare Research and Quality (AHRQ), Department of Health and Human Services, outlined the government's analysis of medical errors, and reviewed several studies documenting estimates of adverse events in hospitals and the frequency of preventability. The Leapfrog Group (an independent work group) is evaluating evidence based practices and computerization with feedback to reduce systemic medical errors. Dr. Clancy strongly advocates the use of medical computer technology to both reduce errors and foster best practices. She also contends there continues to be an underestimate of outpatient complications and errors.

Cynthia Grubbs, RN, JD and John Heyob from the Division of Quality Assurance, Bureau of Health Professions, Health Resources and Services Administration, reviewed the present status and operation of the National Practitioner Data Bank (NPDB), which opened September 1990. The NPDB functions as a flagging system and contains clinical privilege actions, medical malpractice payments, and licensure actions on physicians, dentists and other health professionals. The NPDB is self-sustaining and does not receive support from taxpayer funds. Efforts to date to breach the confidentially of the NPDB have failed. Detailed information can be obtained at www.npdb-hipdb.com.

On Monday afternoon at the Rayburn House Office Building, Congressman Charlie Norwood (R-Georgia) described his efforts to pass meaningful Patient Bill of Rights legislation (see following article by Peter Morris, MD). The MASA group was joined at the Willard Hotel for dinner that evening by many of our congressmen and key staff from each office. This annual MASA meeting provides a wonderful opportunity for our members to become active participants in healthcare-related policy issues. I urge you to attend this meeting next year, or to attend the annual May ACP-ASIM Leadership Day in Washington, DC.


Patient Bill of Rights

Peter Morris, MD, AL ACP-ASIM HS

The first piece of major healthcare legislation to be passed by the 107th Congress this year and signed into law by President Bush may well be a "Patient Bill of Rights", according to Rep. Charles Norwood, R-GA. Congressman Norwood, a dentist from Georgia and long time sponsor of Patient Bill of Rights legislation, explained that there appears to be a spirit of cooperation (at least in the early few weeks of Congress) and willingness to work together in a bipartisan fashion to pass the Norwood-Dingell (also known as the Norwood-Ganske-Dingell) Bill in both the House and Senate and signed by the President. This same bill easily passed the House in 2000 but failed to be acted upon by the Senate. ACP-ASIM, the AMA and many other medical organizations are committed to working with Congress and the President to reach agreement on a bipartisan patient protection bill.

The key features of such a bill would:

  • Guarantee that "medical necessity" decisions are made by physicians, not health plan bureaucrats.

  • Ensure patient access to an independent, timely and binding external appeals process when he or she has been improperly denied benefits.

  • Hold health plans accountable for their decisions, and protect employers who do not make medical treatment decisions.

  • Permit patients the opportunity to choose, at their own added expense, a point of service option in which they have appropriate access to specialists. Women should be permitted to obtain gynecology/pregnancy care from an OB/GYN and children to obtain pediatric care without a referral.

  • Apply a "prudent layperson standard" for determining when a patient may obtain and a plan must cover emergency medical services.

  • Require health plans to provide enrollees with important, basic information about their medicalcoverage and be prohibited from including gag clauses in their contracts or implementing gag practices under their plan policies.

In March, President Bush addressed the American College of Cardiology and outlined his version of a Patients' Protection Bill that he could support and sign. Although his bill differs from the bills supported by ACP-ASIM, AMA, etc., the differences could well be resolved. Maybe so, maybe not. Stay tuned.


Appeal to Internists

Pink Folmar, Jr., MD, Immediate Past President, MASA

Internists have traditionally been viewed as leaders and have assumed leadership roles in hospital staff and medical society organizations. Over the past fifteen years, the Board of Censors of the Medical Association of the State of Alabama has had representation by the following internists—Dr. Peter Morris, Dr. Richard Esham, Dr. Bill Curry, and myself—all have served either as chairman of the Board or as President. This is my last year on the MASA Board, and I am the only internist currently on the Board. I urge any of you interested in running for a MASA Board or committee position to contact any of us mentioned above or Ms. Teri Dingler (1-800-595-9319) at MASA. Serving in these positions or on your county medical society board are truly opportunities where you can make a difference in health care policy decisions. I will be glad to discuss this further with any of you at the ACP-ASIM Annual Meeting at Orange Beach on May 31-June 2, and also encourage you to attend the MASA Meeting at San Destin June 28-July 1.


Alabama Chapter Questionaire

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Please fax this form to Bill Dismukes, MD
Governor's Office - 205-934-5155