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Southern California Region III - Governor's Newsletter - Summer 2002

Kenneth D. Herbst, MD, FACP
Governor, Southern California Region III

Governor's Message

Greetings! This promises to be a great fall season for the Region III chapter of the ACP-ASIM. Our Annual Scientific Meeting is scheduled for the 11th through 13th of October at our usual site at Indian Wells. The topic will be Current Concepts in Common Thrombotic Diseases. Dr. Tim Morris will be updating us on deep venous thrombosis. Dr. Brett Meyer will help update us on the diagnosis and treatment of stroke. Dr. Sammy Mahmud will provide insight into the newer antiplatelet therapies of acute myelocardial ischemia. And yours truly will attempt to reacquaint you with all that you've forgotten about hemostasis! Dr. Joel Levine, FACP, College Regent who hails from Denver, Colorado, and who's known for being able to stimulate discussion and controversy, would like to help us discuss how we interest young physicians in the specialty of Internal Medicine. Hope to see you there!

The California Chapter of the ACP-ASIM has been building on the foundation that was laid for us by the California Society of Internal Medicine. Our new California Chapter President is Glenn Littenberg, MD, and Kathy Matikonis continues to be the contact person of the California Chapter. Please see the All-Cal Meeting article inside this newsletter.

Our associates have been busy under the leadership of Richard Keating. We look forward to an exciting Associate's Poster Session at the scientific meeting.

There has been considerable discussion by the council regarding the dues to the California Chapter. A survey was suggested, but the cost might be considerable. The issue is this: Would members be willing to pay more dues to the California Chapter? We need your input on this. And we welcome your comments either via direct mail or email to our secretary Susan Chadwell.

Again, we look forward to this fall, and most of all to seeing you at the regional scientific meeting!

Chapter Meeting

The Southern California Region III Fall Meeting will convene at the Indian Wells Resort beginning October 11 and concluding October 13. Adventures in Medicine will be presented Friday evening with Saturday and Sunday topics focusing on Current Concepts of Common Thrombotic Diseases.

Come and participate in your Southern California Chapter. You will find excellent CME, good food and pleasant surroundings. Please call (619) 543-6061 for reservations or refer to the registration form enclosed on page seven. Hope to see you there!

All-Cal Meeting

The Northern California Chapter of ACP-ASIM will hold its Annual Scientific Meeting November 1-3, 2002 at the Doubletree Hotel, Monterey. The preliminary program includes clinical updates, clinical skills and concurrent sessions on medical economics. For further information, please contact Kathy Matikonis at (800) 576-2747.

New Requirements for Interpreters in Medical Facilities

The Office of Civil Rights (OCR) published a policy guidance on February 1, 2002, that would require all physicians who receive any federal financial assistance to hire, train and assure the competency of clinical interpreters for all of their patients, even those not insured by Medicare or Medicaid. ACP-ASIM strenuously objected to the requirement that could result in interpreter expenses of $400 for a visit reimbursed by Medicaid an average of only $30 to $50. A physician could conceivably have to hire, train and pay several interpreters if his/her patient population were ethnically diverse.

ACP-ASIM recognizes the conceptual basis for the requirement, but urged the OCR to rescind this policy until alternate approaches were discussed. While the OCR's intention was to increase access to care for non-English speaking patients, ACP-ASIM believes the unfounded expense of hiring interpreters would force physicians to abandon the Medicare and Medicaid programs in order to avoid these costs.

The College's comments to the OCR are available online.

New Member Benefit: Online CME Transcripts

The College is pleased to announce a new member benefit: online CME transcripts. ACP-ASIM members may view and point a transcript of their CME credit earned for participation in activities sponsored by the College. The transcript provides a six year listing and includes credit earned for:

  • Annual Session
  • Postgraduate Courses
  • Chapter/Regional Meetings Accredited by the College (starting November 1999)
  • MKSAP and Related MKSAP Enhancements
  • MKSAP Audio Companion
  • Clinical Problem Solving Cases
  • Audio and Video Products

Work is underway to include credit earned for The Medical Laboratory Evaluation Program and the educational component of the ABIM recertification program.

Members can also print documentation of their participation in sessions related to state specific CME requirements. If you have any questions, please contact ACP-ASIM's Customer Service Department at (800-523-1546 ext. 2600).

College Works to Eliminate Undue Burdens on Physicians

ACP-ASIM and other medical associations have expressed serious concerns regarding the Business Associates provisions in the final privacy rule promulgated by the Department of Health and Human Services (HHS) pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA).The Business Associates provisions unreasonably hold physicians and other covered entities responsible for actions of their business associates and impose an affirmative obligation to mitigate any harmful effects of unauthorized uses or disclosures of patient information by business associates.

In a letter to HHS Secretary Tommy Thompson, the organizations said that the provisions in the final privacy rule fail to successfully extend privacy protections to entities that are not subject to HIPAA, and impose an unfair and unwieldy burden on physicians and other covered entities. The letter called upon Congress to enact privacy legislation that applies to all entities that maintain protected health information in order to adequately protect the privacy of personal health information and strengthen safeguards for confidentiality of patient information.

PIER is Here—The Physicians' Information and Education Resource

What Pier Is - PIER is The Physicians' Information and Education Resource. Integrated with the College's other medical information and education resources, PIER is ACP-ASIM's new, electronic, Web-based, decision support tool designed for rapid point-of-care delivery of up-to-date, evidence-based guidance for physicians. PIER contains modules focusing on the diagnosis and treatment of diseases, and will eventually include sections on prevention and screening, procedures, ethical and legal issues, complementary and alternative medicine, and patient education. ACP-ASIM members can visit the PIER web site by going to http://pier.acponline.org.

Why PIER is the Best Choice- All information in PIER has gone through a rigorous review process, so you can be sure that the information found in PIER is credible, up to date, and accurate.

How PIER Can Help You -

  • Get answers to clinical questions fast.
  • Rapidly review diagnostic and therapeutic strategies.
  • Find focused drug information.
  • Provide clear information to patients in print or electronic format.
  • Have ready access to the evidence and related literature.
  • Be up to date on the newest data.

What to Expect From PIER in the Future -

  • Ongoing coverage of the newest data.
  • Integrated links to electronic medical records.
  • Customizable patient information.
  • Clinical question archiving.

Independent Medical Review - A New Tool for Health Care Dispute Resolution

The Department of Managed Health Care, launched in July 2000, has made protecting the patient our top priority. Protecting the patient means ensuring they have access to high quality health care, the right doctors and specialists and making sure that the doctor-patient relationship is always secure.

One of the Department's new programs, Independent Medical Review, allows patients who have been denied treatment or medical care to have those decisions reviewed by physicians or other appropriate medical professionals who have no affiliation with their health plans.

The Independent Medical Review program provides patients with an impartial review of:

  • Health plan denials, delays, or modifications of services based upon the finding that they are not medically necessary.
  • Health plan denials of experimental or investigational treatment.
  • Health plan denials of reimbursement for emergency or urgent medical services.

The Department contracts with several Independent Medical Review Organizations to conduct Independent Medical Reviews. The reviewer(s) consider patients' medical records, health plan denial and grievance letters, supporting documentation from the patient and treating physician(s), and other appropriate documents when making a decision.The decision of the Review Organization is sent to the Department, the patient, the treating physician, and the health plan. The health plan must comply with the decision of the Independent Medical Review Organization. The Department will enforce the decision when necessary.

If there is an imminent and serious threat to their health, patients may request an expedited Independent Medical Review. These requests are referred to a nurse at the Department who determines whether the medical condition meets the expedited review criteria.

Patients pay no application or processing fees for an Independent Medical Review. However, in most circumstances, patients are required to participate in the health plan's grievance process prior to requesting an Independent Medical Review.

The Department has developed an on-line database of Independent Medical Review decisions (excluding patient, provider or facility information) since the program was put into effect on January 1, 2001. Searches can be conducted by diagnosis or treatment category.

The Department's HMO Help Center administers the Independent Medical Review program. The HMO Help Center also assists patients who have other problems with their health plan, including issues regarding medical coverage or benefits, denials of payment, access to care, and termination of coverage.

If a patient has a problem with a health plan that cannot be resolved through the Independent Medical Review program, the issue will be referred to the HMO Help Center's Complaint process for resolution.

For more information about the Department of Managed Heath Care, the HMO Help Center or the Independent Medical Review Program, please contact www.hmohelp.ca.gov or (888) HMO-2219. The Pending Regulations section of the website has been updated. You may also contact Kathy Matikonis, ACP-ASIM California Chapter, P.O. Box 591687, San Francisco, CA 94159-1687, acpasimcal@aol.com or (800- 576-2747).

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 at a recent meeting. Since the College leadership realizes the needs of it 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 this list to Kenneth D. Herbst, MD, Governor, ACP-ASIM Southern California Region III, 200 West Arbor Drive, San Diego, CA 92103-8421.

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
Internal medicine recertification preparation course
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 (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 awareness campaign
Ethics case studies
ACP Ethics Manual
Legislative Action Center
"Membership Enhancement" programs
Access to legislative and regulatory information
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 on Associates & Student Members Council Video/slides on 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
Involvement with ISIM

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

Southern California III Region - Newly Elected Fellows and Members since July 2002

Fellows

Joel I Bernstein, MD, FACP
Wun-Ling Chang, MD, FACP
Philip A Lobue, MD, FACP
John D Pauls, MD, FACP
Xing J Ren, MD, FACP
Karl T Sun, MD, FACP
Daniel G Wallace, MD, FACP

Members

Emelya M Ahadian, MD
Patrick S Alix, MD
Hiroshi Ashikaga, MD
Miki Aurang, MD
Colleen L Bailey, MD
Rahil A Bandukwala, DO
J David Beckes, DO
Thomas J Byrne, MD
Sanjana Chaturvedi, MBBS
Larry C Chiang, MD
Shagun Chopra-Sonthalia, MD
Timothy J Corbin, MD
Kerry J Corboy, MD
Jill S Cottel, MD
Brent D Culver, MD
Sandip K Datta, MD
Luan K Do, MD
Richard R Dobhan, MD
Adrian W Dollarhide, MD
Brent C Drouin, MD
Mark M Fuster, MD
Denise Gomez, MD
Eduardo L Grunvald, MD
Kimberly L Harper, MD
Krista A Hartman, MD
Dalia A Hunt, MD
Hong B Huynh, MD
Joel S Isackson, MD
Simerjot K Jassal, MD
Dipul M Kansagara, MD
Nyingi M Kemmer, MBBS
Poornima Khanna, MD
Bhupinder S Khehar, MD
Ildong Kim, MD
Donald M Kimes, DO
Tung N Lai, MD
Thomas E Lawrie, MD
Daniel Lee, MD
Wayne I Levin, MD
Osvaldo A Lopez, MD
Martha Lozano, MD
Daniel A Manring, MD
Emily A Marton, MD
Steven Mosher, MD
Glenn P Murphy, MD
Aarthi Shenoy Musci, MD
Jennifer D Neely, MD
Christine M Perry, MD
Raymond G Pigeon, MD
Samuel I Poniachik, MD
John D Ponsiglione, MD
Kelly A Portnoff, MD
Sumati Rawat, MBBS
Shannon Rose, MD
LCDR Michael B Russo, MC USN
Dana A Ryan, MD
Arvin B Saluta, MD
Roopa Sathyaprakash, MBBS
Bret R Scher, MD
Timothy T Shack, MD
Kara R Shay, MD
Edward L Singer, MD
Renee I Smilde, MD
David D Smith, MD
Steve S Song, MD
Michele M Spolyar, MD
Victor A Stewart, MD
Ryan W Stewart, MD
Wynnshang C Sun, MD
Charles S Taft, MD
William T C Tseng, MD
Neil M Vidwans, MD
Matthew E Viernes, MD
James C Warenski, MD
Lisa J Wastila, MD
Izabela Witczak, MD
Beni Wolf, MD
Clifford Wong, MD
Gene W Yang, MD

Bioterrorism Resource Web Site Updated

The College's Bioterrorism Web site has been revised for easier navigation, and features new clinical information, images, and support tools. The site has received praise from the Centers for Disease Control and Prevention and other viewers for its comprehensiveness and content.

Recent additions include new support tools on cutaneous and inhalation anthrax, self-assessment questions on biological and chemical agents, and new information about biotoxins, nerve agents, and toxic gasses. Physicians are urged to visit the site to increase their knowledge of bioterrorism agents and to learn how to deal with a suspected bioterroristic attack.