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Governor's Newsletter, Summer 2001

Robert W. Bradsher Jr., MD, FACP
Governor, Arkansas Chapter

Letter From the Governor

I went to an exhibit on medicine during the Civil War era at the ACP-ASIM Annual Session in Atlanta in April. I read in another Governor's newsletter (Dr. Fieselmann from Iowa) how he was struck by how isolated those physicians must have felt and I thought that his words were appropriate and he had a nice point so I repeat them here.

The [civil war physician's] education and training lacked basic standards and requirements; the information about basic medical conditions was severely lacking. Their opportunities to network and learn from each other were limited in the field and the rural areas. The American College of Physicians was the organization that could, and did, provide the opportunity and environment for physicians to meet.

The environment of medical care continues to experience rapid changes. Our forefathers in medicine did not have to deal with government regulations, HMO's, and practice management issues such as coding and billing. The role of the physician has been forced to expand to include many activities unrelated to patient care.

The American College of Physicians-American Society of Internal Medicine continues this tradition. The ACP-ASIM Mission Statement, "To enhance the quality and effectiveness of health care by fostering excellence and professionalism in the practice of medicine," speaks for itself. The educational opportunities through ACP-ASIM are exceptional for experienced and new physicians. Opportunities for medical students to learn about Internal Medicine and to enhance their clinical skills are outstanding. There are many opportunities for advocacy that will play a major role in how the environment will progress through the next several years. The ACP-ASIM provides the forum to look after and care about each other, both as a human society and as a medical society.

I think there is a lot the ACP-ASIM can do for us here in Arkansas. I have listed the meeting agenda for our Annual Session to be held in October in Little Rock at the University of Arkansas for Medical Sciences Campus. The College has prepared a list of items that the ACP-ASIM sponsors or carries. Finally, there is the opportunity to do something for the College as well. This is the year that we elect a Governor-elect. Please vote when you get your ballot. Other opportunities include advancement to Fellowship or participation as a Key Congressional Contact.

See you at the Annual Meeting in Little Rock on October 19 and 20 at UAMS. Mark your calendar (or Palm Pilot) today!!

Meeting Program


Friday, October 19, 2001


8:15 a.m. - Welcome and Introductions
Dr. Robert Bradsher

8:30 - Leading Health Indicators - Healthy People 2010
Dr. Joe Bates

9:00 - Basic Mechanisms Regarding Obesity
Dr. Philip Kern

9:45 - Physicians' Role in Reduction of Firearm Death and Injury
Dr. Clark Fincher

10:15 - Break

10:35 - Racial/Ethnic Disparities in Health: What We Know, What Can We Do
Dr. Richard Cooper

11:20 - Clinical Aspects of Obesity
Dr. Philip Kern

12:00 p.m. - Lunch with College Representative

1:30 - Integrating Genetics into Preventive Medicine
Dr. Marta Gwinn, Centers for Diseases Control

2:15 - Health Insurance Coverage in Arkansas Fact, Fiction and Future
Dr. Joe Thompson

3:00 - Break

3:20 - Screening for Cancer of the Prostate
Dr. Creshelle Nash

4:05 - Osteoporosis Prevention & Pathogenesis
Dr. Stavros Manolagas

4:50 - Adjourn

Saturday, October 20, 2001

8:30 a.m. - Screening for Cancer of the Lung
Dr. John Shultz

9:15 - Screening for Colorectal Cancer
Dr. Jean-Pierre Raufman

10:00 - Break

10:20 - Clinical Case Presentations by ACP-ASIM Associates
(Internal Medicine Residents)

12:20 p.m. Lunch

1:30 - Defining, Measuring and Responding to Medical Errors
Dr. William Golden

2:15 - Towards the End of Vascular Disease in the 21st Century
Dr. Richard Cooper

3:00 - Town Hall Meeting
Dr.Bradsher and College Visitor

4:00 - Adjourn

7:00 - Abernathy Award Banquet and Closing Session

What ACP-ASIM is Doing for You Today

"What have you done for me lately?" is a question that ACP-ASIM strives to answer before it is asked, by making membership needs an integral part of its strategic planning process.

As such, the following is a comprehensive list of products and services that ACP-ASIM offers to its members, which was compiled by the Board of Regents. Since the College leadership realizes the needs of its membership are ever-changing, they will continue to re-evaluate this list and add new products and services when appropriate. In addition, the College encourages you, the members, to submit your ideas for changes/additions to the list to Dr. Bradsher at BradsherRobertW@exchange.uams.edu.

Education
Annual Session
Chapter/regional meetings
Clinical skills teaching modules
In-training examination
Post-graduate review courses
Recertification courses
Programs for community-based teachers

Self-study
Internal medicine board review course (audio and video versions)
Internal medicine recertification preparation course (audio and video versions)
MKSAP 12 update
Annual session audiocassettes
Best Evidence (CD-ROM)
Bioterrorism resource center online
Clinical practice guidelines
Clinical problem-solving cases
Clinical skills videotapes
Firearm injury prevention resource center
MKSAP for students
MKSAP Prep for Boards
Subspecialty MKSAPs
Telemedicine resource center
Virtual Annual Session

Practice Assistance
Professional liability insurance
Center for a Competitive Advantage
Medical informatics program (Annual Session)
Medical Laboratory Evaluation Proficiency Testing Program
Qnet
Quality 101

Publications
Annals of Internal Medicine
ACP Journal Club
Effective Clinical Practice
ACP-ASIM Observer
Books and expert guides

Advocacy and Professionalism
Online membership directory
Grassroots hotline
Career opportunities
Decision 2000 campaign
Doctors for Adults public awareness campaign
Ethics case studies
ACP Ethics Manual
Legislative Action Center
Access to legislative and regulatory information, national and state
"Membership Enhancement" programs
Position and policy papers
Volunteerism project

For Associates and Medical Student Members
Residency information
Career counseling information and Web links
Career counseling brochures
Community-based teaching program support
Impact newsletter
Mentoring database
MKSAP for students
Representation through Council of Associates and Council of Student Members
Video and slides about internal medicine careers
Support for internal medicine clubs
Annual Session workshops

International Programs
Clinical skills teaching modules
Internal medicine overseas
Action in internal medicine
International speakers program
Eurasian Medical Education Project
Annual Session workshops
Representation in the International Society of Internal Medicine

Recognition Program
Fellowship credentialing process
Associate and Medical Student competitions
Convocation
Chapter awards program
Laureate awards
Mastership awards
Community-based teaching awards

Personal Benefits
College accessories and gifts
Doctors for Adults accessories and gifts
Affinity credit card
Car rental discounts
Financial planning service
Group insurance plans
Loan programs

Educational Goals of ACP-ASIM

One of the goals supporting the ACP-ASIM mission statement is an educational goal "To be the foremost comprehensive education and information resource for all internists." Traditionally, the organization has promoted education through didactic lectures at its Annual Session and Chapter/regional meeting, development of clinical skills teaching modules, in-training examination, post-graduate review course, re-certification course, programs for community-based teachers and development of a number of self-study programs. More recently the ACP-ASIM has focused on a new aspect of education teaching in the ambulatory setting. The organization has sponsored the development of a new textbook, Teaching in Your Office: A Guide to Teaching Medical Students and Residents, and a 20 minute videotape entitled, Teaching in the Ambulatory Setting.

The textbook is an ACP-ASIM resource for physicians interested in improving their skills in office-based teaching. The reason that we need such a book is the very nature of ambulatory teaching. Ambulatory medical education takes place in a fast-paced, chaotic environment in which there is little opportunity for teaching, observation and feedback. The office practice, in particular, offers little time for reflection and collaborative learning or teaching. Office-based preceptors often believe they have no occasion to observe others teach and to receive feedback on their own teaching skills. Consequently, preceptors mistakenly consider the opportunity for self-improvement to be limited.

This eight chapter, 145 page soft-cover book intends to help office-based physicians improve their own teaching while maintaining the efficiency of their practice. The design allows busy clinicians to identify and read only those chapters that address their specific needs. In other words, Teaching in Your Office does not need to be read cover to cover, rather it can be read selectively. Additionally, summaries of the major topic areas provide a quick review in the appendices. Similarly, if summaries are read first, the page locations of the associated text are indicated after the summary headings.

The videotape is intended to help office-based physicians responsible for precepting medical students and residents improve their teaching skills. The videotape presents nine different teaching scenes, each illustrating a different teaching strategy or problem. Illustrated in the videotape are examples of setting goals and expectations, modeling problem-solving, use of the precepting "microskills," priming and focusing, and providing feedback, as well as examples of common teaching errors. The videotape is accompanied by an 8-page companion text that briefly describes the teaching skill or error being demonstrated.

For new, young physicians, the Young Physicians Subcommittee of the ACP-ASIM has developed two new products its Young Physician Practice Management Survival Packet and the Evaluation and Management Coding Card.

Aimed at the young physician who is beginning his/her practice, the Young Physician Practice Management Survival Packet provides information about the resources that the College has to offer the young physician in the early stage of his/her career. In addition, the booklet contains information from a variety of sources that can help you successfully launch a career. The information provided contains references to Internet sites and telephone numbers. It also contains a checklist for getting started.

The Evaluation and Management Coding Card is a laminated, pocket sized sheet designed to help the young physician select appropriate levels of service for history, exam and medical decision making. It presents a great deal of information from a variety of sources in one easy to read card.

Finally, an organizational framework has been developed for preception and learning entitled, "Tips for Preceptors: How to Organize the Ambulatory Visit." These materials can help a student or first year resident organize an efficient and effective visit with the patient and construct a concise follow up presentation to the preceptor.

Practicing quality medicine is a commitment to education and re-education. The ACP-ASIM is trying to make that process easier for its members. These are quality products. So get involved, participate, discuss common problems and problem solve. We need your participation.

Become an ACP-ASIM Key Congressional Contact

After hearing on the evening news about a proposed change to Medicare or a problem in the healthcare system, have you ever wanted to put your two cents in on the issues? Do you care how legislation coming through Congress affects your patients and the practice of internal medicine? Is one of your friends, family members, patients, church members or civic organization members a legislator?

If you answered "yes" to one of these questions, you would make a valuable addition to the ACP-ASIM Key Congressional Contact Program.

The College's success on Capitol Hill depends on grassroots advocacy by Key Contacts across the country who communicate with their members of Congress on issues of importance to internists and their patients. Key Contacts usually do not have established relationships with their members of Congress. ACP-ASIM gives them the tools necessary to develop and maintain relationships.

Key Contacts receive a periodic newsletter, the Capitol Key, updating them on important legislative issues. Then, as key issues approach the decision-making stage on Capitol Hill, the College sends Legislative Alerts to Key Contacts that include all the necessary information to make informative contacts with legislators. ACP-ASIM staff is always available to provide support and answer legislative questions. Key Contacts report their contacts back to staff in the Washington, DC office of ACP-ASIM via fax, phone, e-mail or mail.

The College offers a Grassroots Hotline that Key Contacts can call to hear a legislative update and be matched-with and patched-through to their members of Congress at no cost. The Grassroots Hotline number is 1-888-218-7770. ACP-ASIM also offers the Legislative Action Center (LAC) website, which allows ACP-ASIM members to view the most current ACP-ASIM Legislative Alerts, find out who their legislators are, and send an e-mail, compose a letter or a fax to their members of Congress. It provides the status of key legislative issues of concern to ACP-ASIM, Congress' schedule, and tips on communicating with legislators. The Legislative Action Center can be accessed through the "Advocacy" section of ACP-ASIM Online, or at http://capwiz.com/acp/home/.

The College implemented a Key Contact Awards Program to recognize the hard work of members who go above and beyond the call of duty to contact their members of Congress. Each year, ACP-ASIM selects a Key Contact of the Year and a Top Ten Key Contact Special Recognition winner based on the quality and quantity of responses to Legislative Alerts. The awards are presented each spring at Leadership Day in Washington, DC.

If you would like to be updated on the legislation affecting internists and their patients and are interested in corresponding with your legislators a few times a year on these issues, contact Jenn Jenkins at 800-338-2746, ext. 4536, and join the College's Key Contact Program.

Fellowship Advancement Made Easy (FAME)

By Marc Shabot, Texas Southern Governor

Prerequisites

  • ABIM, RCPSC, or AOBIM certified *
  • Licensed practitioner
  • Formal training completed, Member at least 2 years, in practice or teaching for at least 2 years
  • Proposed/seconded by 2 Masters/Fellows
  • Commitment to lifelong learning and professional development

* May be waived in extraordinary circumstances

Then, Qualify by 1 of the 4 Pathways*

Pathway 1- Academician

  • Holds academic appointment as teacher, researcher, administrator, writes scientific papers, scholarly reviews, book chapters, etc.

Pathway 2- The Scholar/Teacher/ Multiple Certification

  • Active in community as teacher in Continuing Education and Professional Development activities
  • Re-certified or dual boarded, or MKSAP for score

Pathway 3- The Active ACP-ASIM Member

  • 10 years membership in the ACP-ASIM
  • Active in ACP-ASIM meetings and Committees at local and national level

Pathway 4- The Senior Physician

  • May have been a longstanding Member or have joined ACP-ASIM later in life
  • Has demonstrated longstanding professional activity in the community, in teaching, in patient care or in service; acts as a role model for other physicians and health professionals

Note: Community service, especially the voluntary provision of medical care, and ACP-ASIM activities significantly enhance the likelihood of advancement, under all four pathways.

*Pathways are not mutually exclusive; "combinations" are permissible

ACP-ASIM Arkansas Chapter Annual Session

Little Rock, Arkansas
Dr. Joe Bates, Program Director
October 19-20, 2001
UAMS Campus