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Governor's Newsletter, January 1998

Governor's Corner

I have decided to turn over the Governor's Corner this month to an unfailing supporter of the ACP, its ideals, and the new direction that our organization has been heading. At our last Governor's Advisory Council his voice was heard loud and often as we began the discussions that will lead, within this coming year, to the recreation of this Chapter to reflect its new role as a part of the ACP-ASIM. Subsequently, Charley Smyth, M.D., MACP phoned me to apologize for occupying so much of the time of the meeting. I assured him that the 'fire and brimstone' mirrored many of my own views and frustrations, and brought a refreshingly 'youthful' tone to our meeting. I asked Charley to put down a few of his thoughts on paper, and he subsequently forwarded to me the letter that follows.

I never got a chance to ask Charley's permission to publish his letter in this forum. On December 20, 1997 Charley passed away. This is not meant as an obituary or eulogy, as many will do better jobs in that regard as they struggle with our loss. Rather I view it as the clearest expression of the quality of a man, who, at the age of 88, was truly a 'Master Physician.'

Dear Joel:

The principals held over the years by the American College of Physicians have been dear to my heart since I completed my residency at the University of Michigan and became an ACP member.

As I expressed at the advisory committee meeting last Friday, perhaps with far too much emotion, there is deep concern about the drastic changes that are happening to BIG medicine and not only to Internal Medicine and the subspecialties within our group (Cardiology, Chest, Blood, Rheumatic Diseases, etc.). Never in my professional career as an internist has there been such a need for unity and action with our associates in the American Society of Internal Medicine, the various sub-specialty organizations (Cardiology, Pulmonary, Blood, Renal, etc.) the AMA).

Over the past decade the ACP has changed greatly. Over the decades prior to this change it was an organization with central control out of the national office in Philadelphia. Now we have State Chapters. Still there is no grassroots democratic structure to the local (State) organizations. If we as an ACP group with our interest in service to patients first want a shift to local control it is essential to have an elected state Board representing every segment of our membership and the necessary committee structure including Finances to accomplish local tasks with the full support of every member. As a unit this ACP Chapter can function with other units of organized medicine to preserve what is most dear to most physicians, i.e. service to our patients.

Sincerely yours,

Charley J. Smyth

May he rest in peace.

What's Happening

We have begun the formative discussions to recreate this State chapter within the newly formulated ACP-ASIM. At a rapidly convened Teleconference a group of active members of our Chapter and the CSIM tried to prioritize the issues that we will need to address as we head towards formal merger in this coming year.

Representing the Colorado Component of the ASIM were Robert McCartney, M.D., FACP (who we were delighted to find out was selected as one of the ASIM members on the newly formed ACP-ASIM Board of Regents), Christopher Unrein, D.O., FACP (President-Elect of the CSIM), and David Abbey, M.D., FACP (Secretary-Treasurer, CSIM).

Representing the Colorado Chapter of the ACP were Robert Gibbons, M.D. FACP (Former Governor from Colorado and currently 'running' for election on the Board of Regents of the ACP-ASIM), Joseph Mathews, M.D., FACP (Secretary-Treasurer of our Chapter), and Karla Demby, M.D., FACP (Member, Governor's Advisory Council). I chaired the meeting.

General guidelines were agreed to unanimously. All negotiations would be undertaken in a spirit of cooperation, with the intent of developing a unified chapter/component that would more effectively represent the full interests of all Internists and Internist sub-specialists. This will require that Internists with an historical association with the CSIM will be encouraged to join the new ACP-ASIM, become active members of the chapter/component, and participate in its committee-leadership structure. General areas of future discussion will be undertaken in ad-hoc task forces:

  1. Committee Structure/Bylaws - What are the appropriate committees? What is their appropriate function and relationship to each other and to the Governor's Advisory Council and the Governor? What organizational structure would most actively involve the membership in the decisions made by the Chapter/component? How do we create new by-laws that reflect our new mission and goals?
  2. Finances, Reserves and Assets, Consolidating Statements - What are the current assets of the Chapter and Component? What is an appropriate dues structure for statewide activities? Should Chapter/component dues be voluntary? How should a budget be constructed, and all expenditures be prioritized?
  3. Mission and Goals/Leadership - What are we about? There are many things we can do, but have limited resources to accomplish them. What is our mission, and what is the hierarchy of our goals that flow from that mission?
  4. Public Policy - How can this chapter/component most effectively represent the interests of our patients, our profession, and our professionalism?
  5. Membership/Recruitment - How can we convince the 600+ Internists who are not a member of either society to join? How can we invest the Internists on the western slope with a stronger feeling of partnership in our chapter/component?

We will be asking many members of the CSIM and Colorado Chapter to be part of this historic process. If you want to participate, and have not been contacted, please get in touch with me. What follows is our first 'joint' communication. It was sent to most Internists who are not members of the ACP.

Sent December 29, 1997

Dear Colorado Internist:

We write today to ask you to consider the value of becoming a member of the Colorado Chapter of the newly merged American College of Physicians - American Society of Internal Medicine (ACP-ASIM). The merger has created the largest physician specialty organization in the United States, and one whose future as your representative will be very different than either could have been separately in the past.

Each of our organizations has much to be proud of in its advocacy of your interests. Thus, the Annals of Internal Medicine and ACP Journal Club have become indispensable for any thinking internist or internist sub-specialist who wants to stay current with his/her field. The ACP's internationally recognized educational products have made it a leader in recertification tools, evidence-based medicine, and computer-based learning technology. The ASIM has earned a well-deserved reputation for its effective representation of internists' practice interests in the public arena, and for its managed care products. Both organizations can take pride in their unswerving public support of the need to provide all of our citizens equitable access to appropriate health care, and in their continuing advocacy for our profession and our professionalism. The intent of the national organizations will be to keep the best of both the ACP and the ASIM in the newly merged organization.

In Colorado, we also have committed ourselves to create a more potent, more effective, and more representative State organization having this same synergy of ideas and values. We believe that Colorado internists will have an increasingly important local and national advocacy role in all issues that effect you and your patients. We believe that we will be able to participate more fully in making your professional life more creative, understandable, and manageable. We believe that we will make an important difference in how much you enjoy the practice of internal medicine or its sub-specialties. We believe that we can be an important agent for change.

Ultimately, only you can decide whether you want to be part of this new future, or to stand on the side. Only you can decide if you want your ideas and views to have an impact on our decisions, or whether you want others to create our agenda. Our collective future requires that you join, commit to, and participate in the ACP-ASIM. We hope that the values of membership will be self-evident to you, but each of us will be happy to answer your questions as the need arises.

With warmest holiday greetings and the wish for a joyous new year,

Joel S. Levine, M.D., FACP
Governor, Colorado Chapter ACP

Christopher Unrein, D.O., FACP
President-Elect, CSIM