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Governor's Newsletter, August 1997

Governor's Corner

As I watch a torrent of water washing on my windows (panes of glass separating me from our monsoon, not a soft-ware program), I am struck that we are in the midst of a tide of change in our specialty that holds great promise for the future. Increasingly, institutions such as the College are taking pro-active steps in a number of public forums to represent the true interests of our profession, our specialty, and our patients. Our organizations have come to understand that their power to affect change is severely limited when they speak with multiple, and at times discordant, voices. The Board of Regents has heard its membership, as translated through the voices of its Governors, ask that the Board forget historical enmities with sister societies; that a successful future needs to be a collective future. Important, serious, discussions have been underway that hold the promise of significant change. I will be involved in discussions at the upcoming Board of Governors meeting in September, and will keep you informed of progress as it becomes publicly available.

As I spoke about in previous newsletters, this Chapter needs to provide more effective representation of the professional interests of all Internists, both specialists and sub-specialists, who live in Colorado. To do so will require substantial organizational change that allows more complete communication between the membership, the standing committees of the Chapter, and the Governor. I believe a substantial step in that direction occurred during the Governor's Advisory Council of June 27, 1997. Rather than reprinting the minutes, I have summarized on the next page the important conceptual and practical outcomes that I took from the meeting. Some of the process outcomes will require changes in our By-laws, some will require a new way of working, and all hold the promise of making this a more effective component of the ACP. This initiative will fail, however, unless the membership considers the changes valuable enough to become involved in the process.

I will need a little of your time, your thoughts, your creativity, and your involvement if this is going to work. It should be a lot of fun.

The Governor's Advisory Council - June 1997 - Concepts and Outcomes

Concept I. The Colorado Chapter should reorganize its Committee structure to allow greater participation of its membership.

Outcome: With the help of the Advisory Committee I will be writing a revised 'charge' for each committee. Committees will be encouraged to think broadly about their mission, suggest improvements, and propose a budget to the Advisory Committee for its activities.

Outcome: To translate this concept effectively, each Chair of a standing committee will automatically become a member of the Governor's Advisory Council.

Outcome: Mechanisms to allow members from outside the Denver metro area to fully participate in Chapter activities will be a high priority.

Outcome: A concerted effort will be undertaken to engage more members in active participation.

Outcome: Membership, involvement, and advancement for all interested students, house officers, and internists in Colorado will be a high priority.

Concept II. The Colorado Chapter should prioritize its resources, so as to permit more effective function as a Member driven organization.

Outcome: A Finance Committee will be reconstituted with the responsibility of a) evaluating and prioritizing requests from committees for resources, b) evaluating current dues structure, including what services will not be available to members who do not submit Chapter dues, and c) seeking increased resources for Chapter professional and educational initiatives from industry and foundations.

Outcome: To encourage accountability and trust, the source and use of all Chapter resources and expenditures will be open to the general membership.

Concept III. The Colorado Chapter should participate more directly in the great issues that confront our patients, our specialty, and our profession.

Outcome: The Health and Public Policy Committee will include members of the CSIM and SGIM. A goal will be to develop policy positions that are seamless as to parent organization and provide one image of the Internist for the public and policy making bodies; including those that control the corporate/financial side of health care. The Chapter will participate in the State legislative and rule making process as well as at the national level.

Outcome: The Chapter will actively support any initiatives that define internists and internist sub-specialists to be the preferred providers for adult Coloradans.

Outcome: The Committee chair will be seeking new members with commitment to advocacy, analysis, and understanding of the policy issues confronting our profession.

Outcome: Statewide projects that involve our membership in improving the health of the public will be considered and fostered.

Outcome: The Chapter will be involved in the process by which policy is formulated at the national level for the ACP.

  • An immediate outcome was the construction of a Resolution that is being submitted to the Board of Governors meeting (see next page) that came from and idea suggested by Karla Demby, MD, FACP from Durango.

Resolution Submitted By Colorado Chapter

Title: To Direct the Health and Public Policy Committee to Create a Strategic Plan that Enunciates, Clarifies, and Defines the Components and Resource Needs of a Grassroots Initiative Within the American College of Physicians.

Whereas: The American College of Physicians has developed into a large organization representing the educational, professional, and public policy aims of a diverse group of over 100,000 trainees, general internists and sub-specialists, both in practice and in academia, and ...

Whereas: The American College of Physicians has demonstrated an increasing interest and capacity to understand and represent the needs of our patients, our specialty, and our profession at the national level, and ...

Whereas: The capability of any organization to effect the course of health policy is structurally limited by an inability to rapidly communicate, get feedback from, and politically mobilize its membership, and ...

Whereas: The current structure of most, if not all, of the College's Chapters has the potential for such grassroots activities, but the Chapters do not actually function in such a manner, and ...

Whereas: The Chapters have not received the strategic direction from the College that such a grassroots capability is of a level of importance to make the required changes in their infrastructure and commit the increased resources that would enable such activities.

Therefore, let it be resolved,

That the Health and Public Policy Committee of the American College of Physicians will be charged with examining the current organizational structure of the College and its Chapters; and make recommendations to the Board of Regents of the potential strategic value, structure, and resource requirements of an ongoing grassroots advocacy capability within the College.

I'll let you know how this was received at the Board of Governors meeting.

Advancement to Fellowship

In the past few years, the College has changed the requirements for advancement to Fellowship. It now includes four pathways, and individuals may be eligible on the basis of one or a combination of several tracks.

Pathway 1: Skill in written medical communication

This is basically the older track for publication in peer reviewed journals but also includes unpublished case reports, expanded consultations with discussion and references, written patient education materials, quality improvement programs, and other written materials.

Pathway 2: Continuing certification activities or teaching

Recertification, participation in MKSAP with a passing score, or subspecialty certification are usually required but by themselves are not adequate. Would add weight to another category that is weaker.

Pathway 3: Active membership in the College for at least ten years with participation in College programs and activities

This includes participation at annual sessions of the College, regional meetings or other scientific meetings sponsored by the College. Outstanding candidates who are members for less than ten years may qualify by combining Pathway 1 and/or 2 with Pathway 3.

Pathway 4: Distinguished professional activity in teaching, patient care, or professional service over many years

This category is designed for senior practitioners, not previously active in the College who have gained respect and prominence in their communities for professional contributions over many years. Weight is given to the education of other physicians, medical students, or allied health professionals through either institutional or community based teaching.

These pathways are not mutually exclusive. Detailed guidelines and applications are available through my office or from Philadelphia. You need to be proposed by 2 current Fellows. If you have any questions about whether you are currently a candidate for advancement please call me directly.

My goal is that every member fulfilling these criteria will be advanced to fellowship during my tenure. If you need help or advise please call me.

Chapter News

Cara Dawson, MD - Winner of the American College of Physicians Award

I am pleased to announce that Cara Dawson, MD, a recent graduate of the University of Colorado School of Medicine was this year's winner of the Colorado Chapter's American College of Physicians Award. The award is presented to a graduating senior for "Exemplary Performance and Outstanding Promise in Medicine." Cara is also a member of AOA, and we have been fortunate to keep her in the University of Colorado Internal Medicine Primary Care residency. The award carries a $200 prize as well as an expense paid visit to our February meeting. We wish Cara great success in her career in Internal Medicine.

Do You Have a Patient Who Has Been Turned Down for Health Insurance?

The Colorado Uninsurable Health Insurance Plan (CUHIP) offers comprehensive, individual major medical insurance to Colorado residents who cannot buy insurance in the commercial market because of a pre-existing medical condition or who are paying exorbitant premium rates. Despite the fact that CUHIP participants pay premiums which are higher than standard rates, claim losses exceed premium collected. The cost of CUHIP coverage is subsidized by the State of Colorado. CUHIP is a statewide PPO plan that uses the Sloans Lake Provider Network. Examples of persons covered by CUHIP are:

  • Those who are employed or are the dependent of someone employed in a company that does not offer health insurance;
  • Persons who are retired before age 65 and are not yet eligible for Medicare.

The most frequent medical diagnoses for persons needing health coverage through CUHIP are diseases of the circulatory system, diabetes, cancer, and mental illness.

If you would like additional information about CUHIP please call (303) 863-1960 or 1-800-672-8447.

Annual Chapter Meeting - February 5-7, 1998 at the Broadmoor

The Program Committee, under the leadership of our new College educational liaison Robert Swaney, MD (with the much appreciated help of outgoing liaison Kelly O'Brien-Falls, MD, FACP) has put together another outstanding program for our annual meeting in Colorado Springs. The focus of the meeting will be New Developments in Drug Therapy. Again, the speakers have been asked to create presentations that will have immediate impact on your practice. As a sub-specialist I can say in all honesty that last year's meeting was the best concentrated update on a broad spectrum of Internal Medicine topics that I have attended.

I fully expect that some of the content of this meeting will involve a discussion of the collective future of, and the issues confronting, all Colorado internists. You may want to plan on staying for the business meeting at which time I will be presenting a number of By-laws changes.

Please mark your calendars.