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Governor's Newsletter June 2001

Richard W. Carlson, MD, PhD, FACP
Governor, Arizona Chapter

Greetings From Your New Governor

I am pleased and honored to have the opportunity to serve and represent the ACP-ASIM members of Arizona. The excellent work by your immediate past Governor, Dr. Michael Grossman, and previously, Dr. Morton Fuchs, will be a guide to my tenure as Governor. I hope to be able to call on many of you to help with the work of the College and to make it relevant and helpful to you. Please contact me if you have ideas and suggestions for the Arizona Chapter, or if you would like to be involved in specific projects or activities.

The merger of ACP and ASIM is now mature, and the combined organization is poised to be an advocate and voice for Internal Medicine. The College is the bridge between generalists and subspecialists and can represent all internists; fostering interdisciplinary collegiality and advocating common interests and needs. Our Chapter can be a vital force to those ends.

One of the projects which I plan to enthusiastically support is the ACP-ASIM medical student community-based teaching preceptorship. In addition, I would like to make Associate involvement in the Chapter a high priority. We are currently finalizing the program for the fall Chapter meeting to be held in Tucson this November. I am pleased that the planning committee has included a special Associates agenda for that meeting, as well as the popular poster and vignette presentations/competition. Medical students and Associates represent the future of the College. In addition to representing the members, the Chapter must reach out to emerging internists. I hope that within a year we can develop a separate Associates' meeting in addition to the fall Chapter meeting.

For members, a current concern of internists is recertification with the American Board of Internal Medicine. In this newsletter, you will learn more about the College's position on recertification and how it is representing you in this matter. We will also have a special session on this topic at the fall meeting.

Let us work to build on the fine programs set in motion by Drs. Grossman, Fuchs and other former Governors. I look forward to your support!

Dr. Michael Grossman

On behalf of the Arizona Chapter, I would like to thank Dr. Grossman for the outstanding job he did as Governor for our chapter. His commitment and dedication to ACP-ASIM contributed to the stability of the Arizona chapter and its growth. I look forward to his continued support ­ thank you, Mike!

Highlights of the ACP-ASIM Annual Session in Atlanta, March 29-april 1, 2001

The ACP-ASIM Annual Session in Atlanta was a great success. The multiple pre-courses were well attended, as were the educational and scientific sessions which attracted more than 5,400 registrants. Associates also participated in poster competitions ­ Dr. Grossman served as a judge for these competitions. Associate representatives from Arizona, who attended the Atlanta meeting and presented posters, included Drs. Adriane Budavari and Sheila Sudhakar. In addition to the educational sessions, there were more than l00 exhibits on display.

During the Annual Session the Board of Governors and Board of Regents held meetings. There were a number of "hot topics" discussed by the Governors and Regents. One of the most lively discussions involved recertification. The Regents also held meetings with representatives of the American Board of Internal Medicine (ABIM), and the ABIM presented a program on recertification within the Annual Session. That meeting was well attended and also stimulated considerable discussion. As outlined in a letter to internists in January, the College indicated that it is important to distinguish that the ABIM and the ACP-ASIM are separate organizations, and the College neither appoints members to the ABIM nor has any say about policies developed by the ABIM. The College has enunciated three broad goals as it entered into dialogue with the ABIM regarding recertification: l) the process should be clinically relevant, cost and time effective and not redundant; 2) the responsibility of the ABIM should be limited to evaluation; and 3) there should be requirements for continuing medical education to assure maintenance of competency; although there should be flexibility in how this requirement is met. There is ongoing discussion between the College and the ABIM, and a consensus on these and other issues is sought. For an update, and to make your views known, please attend the fall Chapter meeting in Tucson.

Another important topic at the Board of Governors meeting was Doctor Kenneth Shine's report from the Institute of Medicine, summarizing the Institute's report, Crossing the Quality Chasm. The Institute has been studying errors in medicine and health quality and safety for several years. In l998 the Committee on Quality of Health Care in America was formed. The Committee was charged with developing a strategy to improve health care over the next decade. The report concludes that tens of thousands of Americans die each year from errors in their management, and hundreds of thousands barely escape from nonfatal injuries that could be prevented in a different, high-quality care system. The report makes several recommendations. Other groups have also taken up the cause of quality and errors, such as the Leapfroggroup.org. The College will be studying the Institute's report and the implications for internists, as this topic will have profound effects for all practitioners.

The Convocation ceremony of the College was held Thursday, March 29, and 499 physicians received Fellowship in the College, with four new Fellows representing Arizona ­ Drs. Mark I. Feldman (Tucson), Thomas D. Kummet (Phoenix), Raymond Taetle (Green Valley), and Robert N. Wong (Scottsdale).

Many other physicians were honored with other awards, including Dr. Pasquale J. Palumbo, Chair of Medicine at Mayo Clinic Scottsdale, who received his Mastership in the College.

The Arizona Chapter hosted a reception at the Atlanta Marriott Marquis Hotel on Friday March 30. We were pleased to see and meet with the many physicians who dropped by to chat with Dr. Grossman, Dorie Anne Ory and myself.

Community-Based Teaching Program

The Chapter is happy to continue to sponsor and participate with the University of Arizona in the Community-Based Teaching Program again this year. The following medical students and mentors will be part of the CBT Program this summer. Many thanks to the mentors and the support of the University of Arizona for this program which allows students to work in a variety of settings throughout the state with dedicated mentors. The CBT program enables students to gain a real glimpse of practice in these settings, and has uniformly been rated as a wonderful experience by the students. The students, mentors and locations are:

Student Mentor Location

Cibecue/Whiteriver
Ben Martel
Steve Savoia, MD

Douglas
Mahmood Vahedian
Yull Arriaga,MD
Gilmer Rodriguez, MD

Lake Havasu City
Ruth Franks
Brian Sabowitz, MD

Sedona
Jessica Chodos
Devin Mikles, MD

Wickenberg
Faridy Cocco
Bill Firth, MD

Chapter Dues

Chapter dues are the backbone of local activities and vital to the success of our chapter. While we are provided some financial support from the national office, the chapter dues collected provide the majority of financial support for local activities. Educational meetings, mentoring programs for medical students, local Associates' research competitions, advocacy with state legislators, and participation by chapter leaders in Leadership Day on Capitol Hill are just some of the activities supported by your chapter dues. Your chapter dues help support the cost of our chapter staff and provide funding for new and existing chapter initiatives. When you receive your dues notice, please remember to include the chapter dues in your payment. You will be contributing to the success of many grass roots activities happening right here in Arizona.

ACP-ASIM Works To Reduce Medicare Hassles

ACP-ASIM is pleased to announce its endorsement of the "Medicare Education and Regulatory Fairness Act" (MERFA), S. 452/ H.R. 868, which directly addresses internists' concerns with Medicare red tape and hassles.

Medicare's complex regulations have created a heavy paperwork burden that significantly reduces the time doctors spend with patients, according to William Hall, MD, FACP, President-Elect of ACP-ASIM and a practicing geriatrician.

Dr. Hall represented the College and announced support for this important legislation at a March 7 press conference with the American Medical Association and the American College of Cardiology, as well as MERFA's Senate and House sponsors.

MERFA directly addresses the Medicare procedures and rules that are the source of much frustration with the program. Under Medicare regulations, physicians must comply with numerous federal rules and local contractor policies to complete claim forms, provide advance beneficiary notices, certify medical necessity, file enrollment forms and comply with code documentation guidelines. Yet, there is no single source that physicians can access to learn Medicare's rules and policies.

Introduced in the Senate by Senators Frank Murkowski (R-AK) and John Kerry (D-MA) and in the House by Representatives Shelley Berkley (D-1-NV) and Pat Toomey (R-15-PA), MERFA would allow physicians and their staff to spend more time treating patients, and less time handling needless paperwork. It would enact the following reforms:

  • Medicare rules and policies and answers to "frequently asked questions" would be made more accessible, and physicians would be given advance notice about changes in rules.
  • Medicare would be required to pay its claims, without demanding more paperwork, unless there is evidence that the bill is incorrect.
  • Medicare would be required to actually examine the records, rather than using a statistical sample, to determine that some claims were billed incorrectly.
  • Medicare's ability to investigate fraudulent claims would be preserved, while also educating physicians on how to prevent inadvertent billing mistakes that result in overpayments.

Enactment of MERFA is one of the College's highest priorities. The College strongly encourages you to ask your Senators and Representative to cosponsor this important bill if they have not already. Illustrate for your legislators your experiences with the burden of complying with regulations, and how much time it takes you and your staff to deal with complex, confusing, duplicative and unfair Medicare requirements.

E-mail, fax or compose a letter to your legislators through the ACP-ASIM Legislative Action Center at http://capwiz.com/acp/home/ (draft letter provided, please personalize), or call your Senators and Representative toll-free through the ACP-ASIM Grassroots Hotline at 1-888-218-7770. (The Hotline will prompt you for your 8-digit member number, which you can find on the mailing label of ACP-ASIM publications, such as Annals of Internal Medicine.) Report your contacts to Jenn Jenkins in the ACP-ASIM Washington Office at 800-338-2746, ext. 4536, or by blind copying e-mails to jjenkins@acponline.org. Thank you for your help.

Future Meetings

Don't miss out... mark your calendars now!

Arizona Chapter Scientific Meeting
November 16-18, 2001 Sheraton El Conquistador - Tucson

ACP-ASIM Annual Session
April 11-14, 2002
Philadelphia, PA

Resources for Renewal

We have all heard stories of "burned-out" internists who left their practices, or of young residents who chose a field other than internal medicine because they heard of the long hours, bureaucratic hassles, and declining incomes associated with our field. College Governors have listened to their members' concerns about physician burn-out and the need for renewal, and spent the last several months developing a list of resources that could be used by anyone dealing with these issues. The Board of Governors reviewed a variety of speakers, websites, organizations, books, articles, and College publications, choosing resources they would personally recommend to their colleagues. This material has been collated and posted on ACP-ASIM Online, in the Careers section at http://www.acponline.org/careers/. If someone you know is looking for a better balance or a path to renewal, there may be something on this list you can recommend.

There is a response form linked to the list. If you refer to one of the pieces, and would, in turn, recommend it to someone else, let headquarters know. If you are aware of a wonderful resource that's not listed, you can suggest it be added. All feedback will be reviewed by a working group of ACP-ASIM Governors, who will be revising the list on an ongoing basis. Visit the Careers section, check out the renewal project, and let us know what you think!

Advance to Fellowship

Would you like to receive information regarding advancement to Fellowship? Please send your mailing address to Dorie Anne Ory via e-mail at dorie.ory@tmcaz.com and you will receive an information/application packet.