Governor's Newsletter, Fall 2000

Eugene P. Libre, MD, FACP

GOVERNOR'S MESSAGE

My official term as Governor of the DC Chapter began on April 13, 2000, during the Annual Session in Philadelphia. I took over the leadership of our Chapter from Werner F. Barth, MD, who has skillfully directed our Chapter for the past four years. During my year as Governor-elect, Werner was an excellent mentor, thereby making the transition process as smooth as possible. Dr. Barth will be a member of the current Governor's Council and his advice and expertise will be greatly appreciated. I am also very pleased that Richard B. Perry, MD, MACP, who preceded Dr. Barth as Governor, has also agreed to remain on the Governor's Council.

HIGHLIGHTS OF THE ANNUAL MEETING

1) Whitney W. Addington, MD, MACP, ACP-ASIM President 1999-2000, transferring the office of the Presidency to our current President, Sandra A. Fryhofer, MD, FACP.

2) During the Annual Convocation, Dr. Addington gave a stirring speech in which he urged internists to bridge the gulf between the joy of practicing medicine and the pressures besetting the business of medicine. He also asked physicians to focus their energies on patient advocacy.

3) At the opening ceremony, the keynote address was given by Sir George Alberti, MD, President of the Royal College of Physicians in London. He spoke of the challenges of practicing medicine in a single-payer system. Great Britain's National Health Service offers good service to the "acutely unwell," but patients wait too long for non-urgent care.

4) Abraham Verghese, MD, FACP, received the Nicholas Davies Memorial Scholar Award. During his lecture, this remarkable physician/writer pointed out the unique opportunities that physicians have in being active participants in patients' struggles with their humanity and their lives. Some of these stories undoubtedly should be told. His latest book, The Tennis Partner, is an example of one such story. I recommend the book to you highly. I found it to be one of the most interesting and unusual books I have ever read.

NEW COMMITTEES

Women in Medicine

Barbara Alving, MD, MACP, will chair the Women in Medicine Committee for the DC Chapter of ACP-ASIM. I urge anyone interested in finding out more about this committee to please contact Dr. Alving at (301) 435-0080.

Retired Physicians Committee

Richard B. Perry, MD, MACP, will chair the newly formed Retired Physicians Committee. Several unique activities are being planned. For more information, please contact Dr. Perry at (202) 728-9630.

Medical Student Committee

Jehan El-Bayoomi (Gigi) MD, FACP, will chair this committee. Kindly direct any comments or questions to her at (202) 994-8472.

ADVANCEMENT TO FELLOWSHIP

This year 15 individuals from our Chapter were advanced to Fellowship. They are: Jay M. Barnett, MD; Edwarda M. Buda, MD; David M. Essayan, MD; Junette C. Gibbons, MD; Mark F. Gourley, MD; Margaret A. Hamburg, MD; Peter G. Hamm, MD; Peter C. Hill, MD; Patricia D. Kellogg, MD; Prudence P. Kline, MD; Ken Kobyashi, MD; Valerie D. Riddle, MD; Nada Roche, MD; Paul A. Silver, MD; and Frederick K. Williams, MD.

Some of the recently elected Fellows from our area, who took part in the Annual Convocation Ceremony are pictured below.

During the same Convocation Ceremony, five new Masters were recognized from our Chapter. They are, Arthur Atkinson, MD, MACP; Alan Nelson, MD, MACP; Paul Plotz, MD, MACP; Richard B. Perry, MD, MACP; and Kenneth Shine, MD, MACP.

CONGRATULATIONS TO ALL!

LEADERSHIP DAY

On May 16 and 17, 2000, members of the ACP-ASIM from many of the 50 states, met at the J.W. Marriott Hotel for strategy sessions to enable us to meet with our local congressional representatives. On May 16, several presentations were made by members of the College leadership, including Sandra Fryhofer, MD, FACP, President, as well as Robert Doherty, Senior Vice President, Washington Office ACP-ASIM. Instructions regarding issues of importance to be discussed with Congressional representatives were reviewed.

On Wednesday, May 17, following a 7:30 a.m. breakfast, our entire group was briefed by Senator James N. Jeffords
(R, VT), Chair of Education Labor and Pension Committee. He is also a member of the Finance Committee, which has jurisdiction over Medicare and Medicaid. Senator Jeffords addressed strategies for reducing the number of uninsured citizens in the USA. He has introduced a tax credit bill (S2320) with bi-partisan support to assist low-income families buy health insurance. A similar bill was introduced in the House (HR-4113) under the leadership of House Majority Leader Dick Armey (R-26-TX).

Shortly thereafter, we were addressed by Representative Lois Capps (D-22-CA), House Commerce Health and Environment Subcommittee member. She addressed the problems with prescription drug coverage, which should be available to all Medicare beneficiaries. The question is "how to do it?" High on the list of issues we should support is the Patients' Bill of Rights, the excesses of HMOs and access to specialized and emergency care, as well as ensuring the accountability of managed care companies.

At 9:30 a.m. when the briefings from the members of Congress were finished, we all left for appointments with our individual members of Congress. These appointments had been set up approximately 6 to 8 weeks earlier. Jerry Meyer, MD, FACP, Vice-President of our organization joined me, together with David Hellmann, MD, FACP, Governor of the Maryland ACP-ASIM Chapter and three other physicians from Baltimore, Mary Newman, MD, FACP, Harold Standiford, MD, FACP, a previous Governor of the Maryland Chapter, and Donald Casey, MD, FACP, presently working with the Delmarva Foundation. In all instances this year, because of voting taking place on the floor of both Houses, the individual Representative or Senator was not present. We did meet with legislative aides or staff assistants for Congresswoman Constance Morella, Congressman Benjamin Cardin and Senators Barbara Mikulski and Paul Sarbanes and were able to make our positions known regarding many issues applicable to patients' rights and also economic issues, including the desperate need for medical school funding. This effort, which has been actively ongoing for several years, is extremely important and enables us to get a hands-on assessment of how our Government in Congress functions. I urge those of you who are willing to donate one and a half days of your time next year to contact me to ensure that our local
representative group is even stronger.

ASSOCIATES' MEETING MAY 13, 2000

The Eighth Annual Associates' Meeting was held at USUHS. More than 150 individuals attended. In addition to nine excellent podium presentations, there were 72 posters which were judged. The poster sessions were divided into morning and afternoon groupings. Two individuals were honored as recipients of the Karl Wipplinger Award for excellence in teaching, leadership and other fine qualities of a good doctor ­ Leonard Sandler, MD, from the Washington Hospital Center and Bruce Clemons, MD, from the National Naval Medical Center. Dr. Wipplinger, is a retired internist who practiced medicine for more than 35 years at the George Washington University Medical Center and was extremely active in student and resident education. He was also involved in continuing medical education for active practitioners. Dr. Wipplinger was on hand to make the presentations.

The keynote speaker for the meeting was Dr. Elmer Huerta, who received a national award at the Annual Session for his work in the Latino community. From his office at the Washington Hospital Center, he transmits a daily radio program, which is syndicated in many cities. He also has a weekly Saturday television program at 2 p.m. Between both of these activities it is estimated that he reaches approximately 15 million people a week.

A very exciting and entertaining Jeopardy competition was held, moderated very skillfully by Ray Mitchell, MD, FACP. The winning team was Walter Reed.

The Associates' Meeting continues to become increasingly popular and we hope this will result in a greater number of Associates joining our ranks. If you know of colleagues who would make suitable candidates at the Associate level, kindly ask them to submit an application, which can be obtained by contacting headquarters in Philadelphia, or contacting Robert Wilkinson, MD, FACP, our local Chairman of Membership and Credentials, at phone: (202) 872-1973, or fax: (202) 785-4929.

CHAPTER REGIONAL MEETING

On January 14-15, 2000, our Annual Chapter Meeting took place at USUHS in Bethesda. The meeting was well attended. Dr. Rowen Zetterman, current Chair of the Board of Regents, was the Official College Representative (OCR). The Governor's Dinner, hosted by Werner F. Barth, MD, FACP, took place on Friday evening at The Bethesda Country Club.

This year, because of a schedule change, we will be having a second Annual Meeting in this new millennium year. The dates are set for November 3-4, 2000. You should have already received two notices about this event. One as a calendar (save the date) postcard and the other the final program for the meeting, which was mailed in mid-August. The reason for moving the date was because many of our members preferred that the meeting not be held in January since snow and ice problems had made attendance difficult at several meetings in past years.

The November Regional Chapter Meeting promises to be a great success. We are delighted to have as Official College Representative (OCR), Sandra Fryhofer, MD, FACP, who is the current President of the National ACP-ASIM. In
addition to giving a major presentation on Friday afternoon, she will give the official College Update report to our membership and will also take part in the Town Meeting. On Saturday morning she will moderate a 7:30 a.m. breakfast for Women in Medicine. Dr. Richard B. Perry will moderate a 7:30 a.m. breakfast for Retired Physicians. Dr. Fryhofer will be present for the Governor's Dinner to be held at Congressional Country Club on Friday evening, at which time she will give a brief talk about her experiences as president of our organization.

IN APPRECIATION

I would like to express my sincere thanks to several individuals who have made my job so far, smoother and relatively easy to perform.

Dr. Michael Gold and his committee for putting together a very excellent program. It took many hours of preparation by many individuals. Again, thank you very much for a job well done.

Dr. Catherine P. Lucey should be recognized for her outstanding leadership and organization in setting up the
Associates' program.

Dr. Leonard Sandler, Chairman of the Associates, also performed yeoman's work in putting the program together
and helping to organize the meeting.

Dr. Robert S. Wilkinson Jr., for his continued excellent efforts in the areas of Membership and Credentialing.

Dr. Martin Dillard for his very dedicated work on the Awards Committee, which he has undertaken for a number of years. He is very much appreciated.

I also wish to thank Dr. Jerry F. Meyer, our Vice-President, for his valuable contributions over the years and, particularly, for attending Leadership Day with me.

Dr. Alan G. Pocinki, who also helped with the Leadership Day activities, but more importantly, helped spearhead a meeting with MAMSI regarding the difficulties all of us in the Washington Metropolitan area face with the insurance industry. He continues his tireless efforts with numerous agencies to improve our economic concerns.

A special thanks to Dr. Ray Mitchell for his endless hard work with the Associates and his skill as the moderator for the Jeopardy competition.

Last, but certainly not least, special thanks to both Werner Barth and Richard Perry, who have been my mentorand who hopefully will continue to serve as Council Advisors during the next 3 1/2 years of my tenure.

LAUREATE AWARDS

During the November meeting, two individuals from our Chapter will be honored with the highest recognition our local Chapter can confer the Laureate Award. Formal presentation of this award will occur during the Governor's Dinner, Friday evening, November 3 at Congressional Country Club. This year's recipients are:

Werner F. Barth, MD, FACP, former Governor and also former Chairman of the Department of Rheumatology at the Hospital Center. He is a most deserving recipient of this award for all that he has done for our Chapter and medicine overall, both on the local and national level.

Charles Duvall, MD, FACP, who has been, for many years, extremely active in the ASIM and served as its National President. Chuck has been a medical practitioner in the Washington area for many years. His skill as a physician and his ability to deal with complex legislative policy issues as they affect the economic wellbeing for physicians over the years, has been greatly appreciated by all of us.

NOTE FROM THE VICE-PRESIDENT

Jerry F. Meyer, MD, FACP

In my first note to you I outlined some of the problems I see in the practice of medicine and how our organization should be active in helping to correct some of them. The adventure has begun.

As you may know, ACP was not a practice oriented political organization until the early 90's when it
supported a universal healthcare budget. This certainly not a conservative idea for a private industry like medicine. The idea fortunately died with Hilary Clinton's plan.

For the past eight years ACP has had a leadership day. Since the merger in 1998 it has been a coordinated ACP-ASIM effort. Leadership Day consists of presentations of legislative matters currently before the Congress followed by a half day of lobbying. Our Governor, Eugene Libre and I attended this activity May 16 and 17.

The four items we were told to cover were:

1) Encourage allocations of $200 million to support a bureaucracy to reduce medical errors.

2) Support a bill giving tax credit for poor people for medical insurance.

3) Support giving Medicare recipients drug coverage.

4) Support a patient's rights bill.

I had concerns about this agenda. It is altruistic, but does not deal with the problems of the internist, most specifically poor payment for services.

The medical errors theme came from the Institute of Medicine book about medical errors which cited in a few paragraphs 2 studies done in 1984 and in 1992. The IOM's spin on this was refuted by one study's lead author in the New England Journal of Medicine. We are all aware of medical errors but if one exaggerates their extent it is like crying fire in a crowded theatre when there is no fire. The overreaction can be very harmful. We need the $200 million for patient care.

Supporting a tax credit may be fine, but it may result in more people with poor health plans.

Supporting a Medicare drug benefit is fine, but how will it be funded? Congress claims a Medicare surplus. It should be given back to the providers. This will not occur if they use it for payment of drugs.

A Patient's Rights Bill is a two edged sword. It may limit patient's ability to contract with insurance carriers. The only true patient right is when patients would be able to buy insurance of their own choice tax free rather than what their employers give them.

In addition, we should have been talking about the Campbell antitrust bill to both congressmen and senators and should have been asking for restoration of funds removed in the balanced budget act of 1997 when Congress overestimated the growth of medical expenditures.

I have written letters about these concerns to the Chairman of the Board of Regents, Rowen Zetterman, MD, FACP, and to the President, Sandra Fryhofer, MD, FACP. Dr. Zetterman graciously wrote back agreeing with many concerns and said he would bring them to the Board of Regents. I, in addition, expressed my feelings about the intrusiveness of ABIM's recertification program. We will also meet with Dr. Fryhofer at our annual local meeting in November to get her input.

This is a potentially powerful organization of more than 110,000 physicians that can be helpful to the practicing internist if we all give our input. We will plan to put some of these concerns in the form of resolutions at the next Board of Governors Meeting.

Please let me hear your thoughts about how ACP-ASIM can be helpful to the practicing internist.

Jerry F. Meyer, MD, FACP

Fax: (202) 832-9475