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Governor's Newsletter, Fall 2000

Governor's Column

Chester Choi FACP Governor, Southern California Region 1

Greetings to our members, and for those who do not know me, let me provide just a few words of introduction. I am newly elected as Governor of our region, and I'm the Program Director and Academic Chief of Medicine at St. Mary Medical Center in Long Beach. I have been involved in our Chapter's activities, especially with our Associate members and with our regional meetings. I am very proud to be a member of the ACP-ASIM, and I look forward to working with and for you.

Keeping in touch
Many changes have occurred in the first months of the new millenium and many challenges face all of us in medicine. We are a large Chapter with over 3500 members, but our geographic size makes communication and sharing of ideas very difficult. Our best approach lies in embracing communication technology. For those who are Internet-savvy, our Chapter web site, reached through www.acponline.org and the link to chapter web sites, can keep us all in touch. For those with ideas, frustrations, information, or complaints that you want to share, our list serve is now active. Just send email to me at cchoi@chw.edu and I can get you started. In the list serve, I'll ask you to categorize your comments and questions into Health and Public Policy or HPP (all the issues that involve our lawmakers and related regulatory agencies), Medical Services (those issues that impact on our patient care such as managed care formularies, E&M coding, denials of service, etc.), Associate Members and Medical Students, Membership and Advancement, and Miscellaneous in the subject line. Then, I'll be able to refer your question or comment to our Council members with particular interest and expertise in that area. The list serve and the web site are the best ways to link us so that we can respond and act with some immediacy. Of course, there's snail mail (my address is 1050 Linden Ave., Long Beach, CA 90813) and the telephone (562-491-9350), but I would encourage everyone to try the electronic methodsthey really do work.

The Council
Our Chapter's Council has been reorganized under new bylaws, and some members have assumed leadership roles in the following areas:

Secretary/Treasurer
Carole Warde FACP
Health and Public Policy
Susan Sprau
Medical Services
Glenn Littenberg FACP
Medical Student Activities
James Louie FACP
Associate Activities
Ronald Oudiz
Membership
Sharon Adler FACP
ex officio members
Kouichi Tanaka MACP
Donald Feinstein MACP
Edward Crandall FACP
Alan Fogelman FACP

We do need to fill 7 remaining Council seats through a ballot election; please send nominations to me (be sure the individual is willing to serve) so that they can be presented to the nominations committee.

Recent Events
December 1999 saw the untimely passing of our Governor, James Klinenberg, who had ably served the College and its members, helping to orchestrate the formation of our statewide California Chapter and the merger with the ASIM. We miss him greatly.

Several of our members represented us in ACP-ASIM organized visits to our state legislators and our Congressional representatives. Susan Sprau, Kouichi Tanaka MACP, Glenn Littenberg FACP, Jose Perez FACP, and I lobbied for a number of issues, and our Chapter continues to investigate problems and push for remedies.

The national ACP-ASIM and Board of Governors meetings were in Philadelphia and blessed with brisk, but pleasant weather (you were there weren't you?). A number of resolutions were discussed, including:

  • Mechanisms for ABIM recertification (referred to the Education Committee)
  • Internet prescribing (should occur only in the context of an established physician-patient relationship)
  • Prohibiting all or nothing insurance product requirements (referred to Medical Services Committee)
  • Excessive documentation requirements (referred to Medical Services Committee), one standard credentialing and recredentialing form (adopted)
  • Restore funding to Medicare to provide relief to healthcare providers and beneficiaries (adopted)
  • Managed Care and Restrictive Drug Formularies (referred to Medical Services Committee)

The Board of Regents decided not to establish a political action committee (PAC) based on mixed membership feedback, the effectiveness of the College's current efforts without a PAC, and concerns about possible decreased access and influence with legislators who might view the ACP-ASIM in a different light if a PAC were formed.

The scientific meetings were diverse and comprehensive as usual. Whitney Addington delivered the convocation speech and spoke of many of the problems facing medicine. Two themes particularly struck me. He urged us to find ways to provide universal access to healthcare, and he also urged us all to "get a life," to find our time for our families, our personal pursuits, and our friendships. My wife was taking notes.

Fellowships
Congratulations to the new Fellows from our region who were inducted in Philadelphia, Glenn Littenberg FACP, Haytham Albizem FACP, Michelle Eslami FACP, Yehuda Handelsman FACP, Marc Harwitt FACP, Stephanus Ong FACP, Erin Stone FACP, and Edmund Tse FACP. And congratulations are in order to our newly elected fellows, Janet Au FACP, David Bloom FACP, Ashwin Kashyap FACP, and Sushil Ojha FACP. I would like to personally encourage our members to apply for advancement to Fellowship. The criteria have been expanded (publications are now only one of several pathways), and I know there are many qualified individuals out there who should seek this honor. The criteria and pathways are posted on the ACP-ASIM web site, or I would happy to send them to you.

Medical Students
Our Chapter has always been very active in Medical Student activities. With Jim Louie's able assistance, we were able to provide ACP-ASIM Student Internist Awards to Rachel Ann Scheuring in honor of Shaul Massry FACP at USC and to Albert Kim and Tanya Barauskas in honor of the memory of James Klinenberg FACP at UCLA. Lynn Klinenberg, who accompanied her husband and was such a vital participant at many ACP-ASIM activities, kindly assisted in the presentation of the awards at UCLA.

We also continued the student intern program where medical students spend a 2 week preceptorship with a practicing internist. Some of the student comments included "my experience with Dr. (Peter) Guzy over the past two weeks has been wonderful...I have learned about the doctor-patient relationship, the business side of health care and a little about cardiology" and "I have had a wonderful two weeks precepting with Dr. (Jane) Spiegel (FACP). She is a rare doctor nowadays. Her solo private clinic is a warm and comforting place where treatments and answers are given. Her patients are a diverse group of people, from young to old, healthy to ill, and interestingly Medicare or private-paying. However, she treats them all with the same degree of respect and the same excellent care, although the changes in medical management have clearly caused her frustration. She also inspires me because she is working to change the establishment." These preceptorships really help the students with career choices and give them exposure to internists, "doctors for adults."

Upcoming Events
Our next regional meeting is being planned for February 2001. We're actively seeking input for key topics and educational needs; if you have some burning issues, please let me know. Ron Oudiz and several Associates from our region's 12 Internal Medicine residency programs are actively planning an Associates' meeting for November 2000. Career planning seems to be high on the agenda.

Statewide Chapter Dues
Some of you have already received your dues statements and may have noticed the increase of $20 directed to the Statewide Chapter. I would like to encourage everyone to include these funds. It's not that much money and it is vital to the health and public policy efforts, the medical services lobbying and advice, and the other member services of the newly formed statewide Chapter. Remember, this is the group with the 501C6 charter that can and should take a very active role on behalf of all of the California members of ACP-ASIM, especially when it comes to dealing with the Legislature, the regulatory agencies, the managed care groups, and on and on. They are our voice!

Current Issues
I'm sure there are far more issues to tackle than I can list here, but some major foci of the ACP-ASIM include:

  • Access to Care
  • Decreasing medical errors
  • Medicare Pharmacy Benefit
  • Relief from the Balanced Budget Act so negatively impacted medicine
  • Antibiotic resistance
  • Evaluation and Management coding reform
  • End of Life Care

If you have input about these or other areas, please let me know through the list serve or other mechanisms.

Tidbits

  • Did you know that Medicare recipients (who do not have a prescription benefit) can obtain prescription drugs at MediCal rates (plus 15cents per prescription) at the over 5000 MediCal pharmacies in California?
  • Proposed Senate bill 1875 on Medication Errors in hospitals has been changed to remove the provision that required reporting. It now, appropriately, deals with reducing medication errors.
  • The CMA Leadership Academy will be held Oct. 16-18 in LaQuinta. For more information see www.cmanet.org/leadership
  • The Health Care Decisions Law related to Advance Directives and DNR orders took effect July 1. There's a nice summary on the CMA website www.cmanet.org.

Best regards to all,
Chester Choi FACP
Governor, Southern California Region 1


ACP-ASIM Student Internist Awards Presentation at UCLA School of Medicine From left: David Solomon MACP, Kouichi Tanaka MACP, Lynn Klinenberg, Chester Choi FACP, and Senior Associate Dean Neil Parker FACP.


James R. Klinenberg FACP (1934-1999)

Governor, ACP-ASIM Southern California Region 1

It is with great sadness that we acknowledge the untimely passing of James Klinenberg, a man of great stature in the academic, administrative, research, and clinical practice communities. His career encompassed research and teaching in rheumatology where he was particularly known for his application of plasmapheresis to help many afflicted patients. He served as Chief of Medicine and later as Senior Vice President for Academic Affairs at Cedars-Sinai Medical Center and as an Assistant Dean at the UCLA School of Medicine. As ACP-ASIM Governor, he assisted in the merger of the two organizations and in the formation of the statewide Chapter. Not only was he a physician role model for his many colleagues, trainees, and students, but he also taught us that family and friends give our professional lives special meaning. It was no coincidence that there was an overflow crowd of mourners at his services despite the fact that they occurred on New Year's eve on a rainy and blustery day. He is survived by his devoted wife, Lynn, and his many children and grandchildren. In honor of his memory, the ACP-ASIM Student Internist Awards were presented this year at the UCLA School of Medicine to 2 students judged to be the best graduates entering the field of Internal Medicine.