Governor's Newsletter, May 1998
I want to thank those of you who took the time to let me know that you had agreed with the comments imparted in my letter to our legislators about the E and M documentation 'guidelines.' I especially want to thank those who took the next step and also sent their own letters. Issue advocacy is never easy. It takes time, can be frustrating, and requires an ability to continue with an issue despite some adversity. I promise to keep using this forum to support our patients and your interests in the public arena, which brings us to:
It's a Done Deal. As of July 1, 1998 We Are the ACP/ASIM
This is big news. It deserves a headline of sorts. To my knowledge the only consolidation of institutions representing medicine. The efforts of our leadership to achieve this work product should be applauded. Now this work must be duplicated at the local level.
The Chapter and the Component Society will be merged over the coming months. A steering committee will work on by-laws and structure and create task forces to study issues as needed. This process will begin in earnest after we receive a model by-laws and potential corporate structures from Philadelphia.
We are not starting at ground zero. Leadership of the Chapter/Component Society have been having informal meetings to this point, and I can see little that will separate us. We have received conceptual guidelines from the national offices. The probability of major controversy is small. However, for those members of the ACP with little understanding of the ASIM (and vice versa) you need to know that we will not be the same organizations as we were. The merger will give us the opportunity to change while building on the strengths of each group. In broad outlines this is what the traditional members of the ACP should expect.
Things that Will Remain the Same
- Our commitment to the needs or our patients
- Universal access to health insurance.
- Identifying the needs of special (urban/rural, poor, disabled) populations.
- Defining the best evidence base for patient management.
- Our commitment to the educational needs of internists
- The annual Chapter meeting will continue.
- Innovation in computer/office based learning.
- Preparatory materials for continuing medical education relating to recertification.
- The best transmission of new, understandable information that impacts your care of patients through the Annals, Journal Club, and Evidence-Based Medicine publications.
- Our commitment to the next generation of Internists
- Support of the Department of Medicine's efforts to interest medical students in a career in Internal Medicine or its subspecialties through the Internal Medicine Club, summer preceptorships, and inexpensive student membership in our Chapter.
- Support of Community Based Teaching.
- Support of our Associates with an annual separate meeting.
- Our commitment to our membership
- Redoubled efforts at getting all qualified members advanced to fellowship in the College.
- Communication of College products of value (e.g. the availability of discount financial planning).
- Our commitment to a basic organizational structure
- There will continue to be a representational form of governance with a single Governor elected every four years from each Chapter who will then reflect that Chapter's views within a Board of Governors. The Board of Governors than recommends policy to a Board of Regents.
Things that Will Change
- Our commitment to our patients
- Develop an enhanced ability to advocate for our patients' and our profession's needs at the national and local levels.
- Develop an enhanced visibility as advocates for good health and health services within Colorado.
- Our commitment to education
- Develop practice resources that make office management, contracting, and development easier and more understandable.
- Develop resources that enable Internists and Internist Sub-specialists to provide the most appropriate care (highest quality, cost-sensitive, satisfied patients) to their patients, and to document this quality to those who will be paying for those services in the coming century.
- Our commitment to the next generation of Internists.
- Develop Chapter organizational models that allow medical students and Associates to have greater input into the ACP/ASIM's policy development, and our own Chapter's processes.
- Our commitment to our members.
- Develop mechanisms to allow members from outside of the front range to have greater involvement in the Chapter's business through the use of telecommunication advances, web site, and 'virtual' committee meetings. Have an meeting at the CMS fall meeting.
- Our commitment to a truly representational structure
- Develop a Chapter resolution process that allows our members to translate their concerns to the Governor and the national office in the form of resolutions.
- Develop a mechanism to allow expeditious review of resolutions from other Chapters prior to national meetings.
- Develop a Chapter organizational structure that allows Committees to have more input into the development, expansion, and resource utilization of the Chapter.
I believe the new state structure will be more capable of meeting our diverse members' needs that the old separate units. It will be a forceful advocate for the needs of our patients and our profession. It will be a powerful voice within the CMS and our statewide health community. This expansion of vision and mission, while maintaining our past values, will have a resource cost.
I am not a politician. I won't try and kid you and say that we can create this future at no cost to you. I will be asking for more of your time to help with these new initiatives. Opening up our committee structure through the use of telecommunications will cost $3-400/meeting; adding a more formal resolutions session to our annual meeting will likely add an extra day to it; having an impact on CMS and state policy development has a cost. Those 150 of you who were paying dues to both organizations will be saving money. The national organization dues will remain the same.
We cannot keep the current $15 per member per year 'elective' Chapter dues structure. Current national average in the ACP is $25-30 per year. Most are raising it higher. I am not sure what is the 'right' amount, but at our annual business meeting there was a clear message transmitted to me that there needed to be an increase and that within the constraints of the bylaws state dues should be mandatory.
Therefore: as of this fall's dues statement the chapter dues will be increased to $25, and there will be no mention of their being voluntary on your statement.
Other News From Around the Chapter
The ACP Annual Session in San Diego
The Convocation - I was privileged to lead 7 of our colleagues into the main hall of the San Diego Convention Center where they inducted into the College as Fellows. They were Alan P. Aboaf, MD, FACP; Lawrence S. Allen, MD, FACP; Eugene D. Jacobson, MD, FACP; Steven P. Lawrence, MD, FACP; Paul P. Preston, MD, FACP; Paul E. Shingledecker, MD, FACP; and Christopher J. Unrein, DO, FACP.
It really is a grand affair. I encourage any members that have recently been advanced to fellowship, and who haven't taken the opportunity to come an induction ceremony to consider attending the Annual Meeting in New Orleans in April 1999.
The Associates Poster Sessions - Associates from Colorado were well represented at the Clinical Vignette Poster Finalist Sessions. NINE Associates were selected to present (almost 20% of the total selected). One of the nine won a grand prize award of $750 but all of the posters were of uniformly high quality, and each Associate got a free trip to the meeting. Each was a credit to their mentors, the College, and this Chapter. Remember these names when looking for your next partner or fellow:
Jennifer Heinicke, MD (University of Colorado) - Winner
Michele Basche, MD (University of Colorado)
Teresa A. Cherry, MD (University of Colorado)
David J. Farber, MD (University of Colorado)
Sarah Faubel, MD (University of Colorado)
Melinda Hockensmith, MD (University of Colorado)
Katherine E. Hoekstra, MD (St. Joseph's Hospital)
Steven A. O'Brien, MD (University of Colorado)
Laura Wolsko, MD (University of Colorado)
The Board of Governors Meeting (Prior to the Annual Session)
Although somewhat anti-climatic the official sealed ballot vote to confirm the merger of the ACP and ASIM had at least historical intensity. An appropriate lightness was added the next day when Bill Reynolds told the Board of Governors that there was a problem with the vote count and it had to be repeated again (April Fools !).
Most of the Resolutions discussed and passed were non-controversial in content and tone (against land mines, for volunteerism in Internal Medicine, study the effect of Hospitalists, recognize that the role and function of the Board of Governors should be reevaluated in light of organizational changes). I appreciate the ten members of the Chapter who were willing to rapidly review and provide comments on the Resolutions that I could incorporate into my comments on the floor of the resolutions meeting.
The Internal Medicine Club
I had the pleasure of speaking briefly to the 40 or so first and second year students who attended the Internal Medicine Club at the School of Medicine on April 15th. The overall topic was 'Career Options in Internal Medicine,' and my contribution was to describe future trends in Internal Medicine and the ACP/ASIM. Other speakers included Mark Earnest, MD (Asst. Prof. Of Medicine), Becky Hanratty (MS IV, Matched in Internal Medicine at the University of Colorado), and David Tuuk, MD (Asst. Prof. Of Medicine). All contributed an excellent overview for the students.
Wanted: All Internists and Internist Sub-Specialists Who Still Enjoy Their Profession and Are Interested in Shaping a Young Persons Future
For any of you who are interested in becoming more involved in medical student teaching as part of the ACP's and the Department of Medicine's Community Based Teaching Project, please contact Lorraine Adams, MSW who heads the Department's office of medical student education. This could mean preceptorships, participation in the primary care course, mentorship, or just addressing the students at an Internal Medicine Club meeting in the coming year.