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The Florida Internist

Summer, 2000
Vol 2, No 2

From the Governor
Frederick E. Turton, MD, FACP

Going Public

The Florida Chapter ACP-ASIM has begun two educational efforts in order to reach out to the public regarding important public policy issues and to communicate important clinical information to our patients. The Chapter will be working with two committees and their chairs to meet these goals.

James W. Loewenherz, MD, FACP has redesigned the Chapter’s Health and Public Policy Committee (HPPC). Jim and his committee are charged with the task of insuring that our patients hear the voice of the ACP-ASIM. This committee will be responding in the news media to state and national issues and provide the Florida news media with position papers on important health and policy issues. Additionally they will develop a speakers/writers bureau designed to provide the Florida news media with informed physicians who can explain important health and policy issues in a way our patients can understand. As the HPPC proceeds with their plans the Florida Chapter ACP-ASIM will be established as one of the state’s foremost authorities on health and policy issues affecting the people of Florida.

Currently the ACP-ASIM’s priority public policy issues are Access to Care, Patient Safety, Medicare Prescription Drug Benefit and Patient’s Bill of Rights. Full discussion of these and other College positions can be found at http://www.acponline.org/home/policy.htm

Daniel M. Lichtstein, MD, FACP and his new Community Education Committee will be in charge of an effort to provide quality community health education directly to the public and at the same time inform the public just what it is internists and the subspecialists of internal medicine can do for them. Danny will begin a cooperative, statewide community education project with a private hospital chain. He will develop a bureau of internists and subspecialists who will speak directly to the public about important clinical issues in local hospitals scattered all over Florida. In addition to a clinical theme the College’s "Doctors For Adults" materials will be distributed and promotional material focusing the publics attention on local members of the ACP-ASIM will be made available.

With the help of Drs. Loewenherz and Lichtstein you will soon see letters to the editor and op-ed pieces appear in your newspapers. These articles will speak to the problems in the healthcare system in this country and offer substantive solutions. You may even see colleagues interviewed by the press regarding clinical issues and healthcare controversies. Additionally, you will see colleagues speaking at local hospitals about clinical issues while promoting the internist, subspecialists of internal medicine and local Chapter members.

Your Chapter is going public to have real doctors discuss real issues in real-time. Would you like to help? Call (800) 542-8461-1-1 and tell us what you can do. ]

From the President

Kenneth R. Ratzan, MD, FACP

Leadership Day 2000; the National Health Care Agenda of ACP-ASIM

On May 16th and 17th 2000 seven members of our Chapter visited Washington DC to attend the ACP-ASIM’s 8th Leadership Day. Leadership Day brings the thrust of our organization to bear upon the members of congress to lobby for several important health related issues. Under the direction of Bob Doherty, Senior Vice President and Elizabeth Prewitt, Director of Governmental Affairs and Public Policy of the ACP-ASIM, the College runs a superbly well organized program to educate us on the important health care issues on the College’s agenda and to maximize our effectiveness in dealing with our Senators and Representatives. Our group met with the offices of Senators Connie Mack and Bob Graham, Representatives Mark Foley, Bill McCollum, Dan Miller, Dave Weldon, Joe Scarborough, Ileana Ros-Lehtinin, Karen Thurman, Lincoln Diaz-Balart, Alan Boyd, Carrie Meek, and Tillie Fowler.

The College was interested in highlighting four key health related issues this year;

  1. Access to care. Two reports released earlier this year by the ACP-ASIM entitled "No Health Insurance? It’s Enough to Make You Sick" and "No Health Insurance? It’s Enough to Make You Sick: Latino Community at Great Risk" documented unequivocally that patients without health insurance compared to insured Americans tend to live sicker lives and die earlier. In keeping with this position we lobbied for access-to-care tax credit legislation introduced by Senator Jeffords of Vermont and Representative Army of Texas. These bills provide refundable tax credits to low income families expressly for the purchase of health insurance. In addition, we lobbied to support the administration’s proposals to expand Medicaid to cover all individuals at or below poverty and to increase funding for outreach programs to increase enrollment for persons eligible for Medicaid and State Children’s Health Insurance Programs (S-CHIP
  2. Patient Safety. At the end of last year the Institute of Medicine issued the report "To Err is Human; Building a Safer Health System". It stated that more people die each year as a result of medical errors than from motor vehicle accidents, breast cancer, or AIDS. Moreover, the US healthcare industry lacks a systematic way of identifying, analyzing, and correcting unsafe practices. The report laid out a comprehensive strategy for addressing these problems and challenged our profession to make significant changes to achieve a safer healthcare system. The College accepts this challenge to improve the quality and safety of patient care. We support setting a national goal of reducing medical errors by 50% within five years. In so doing we asked lawmakers to support the creation of a Center for Patient Safety within the Agency for Healthcare Research and Quality (AHRQ) and support further examination of how best to report and analyze data on patient errors. Most importantly we feel that confidentiality of reported data must be protected so that physicians and other health professionals can be encouraged to report all adverse incidents without fear that their cooperation will increase their exposure to lawsuits for professional liability or other sanctions.
  3. Medicare prescription drug benefit. Everyone in Washington seems to support some sort of program to help Medicare recipients pay for their medications. The problem comes with its implementation. There are almost as many programs on the table as there are interest groups in Washington. In addition, President Clinton seems to want to make the passage of a Medicare prescription drug coverage his legacy. We lobbied for enactment of legislation to provide a prescription drug benefit to Medicare recipients without bankrupting Medicare. The highest priority for support would be to help low income beneficiaries. We are against mandating formularies but if a formulary is instituted decisions of which drugs should be included should be based on effectiveness, safety, and ease of administration- not just costs.
  4. Patients Bill of Rights. In the Fall of 1999 the House of Representatives passed a comprehensive patients’ bill of rights act supported by ACP-ASIM. This was different from the Senate bill which fell far short of what we want for our patients. The house version of the bill applies to all insured Americans, not just those in ERISA plans; requires that physicians rather than health plans make determinations regarding medical necessity and appropriateness; and holds all health plans, including those exempt from state regulation under ERISA, accountable in a court of law for medical decisions that would result in death or injury to a patient. We lobbied for keeping the above provisions in the final bill.

Overall, I was personally impressed with the organization and effectiveness of the College and its direction of Leadership Day. It certainly raised our consciousness of the healthcare issues facing our nation, it gave us an opportunity to express our views to our elected representatives in Congress, and it made me proud to work for an organization led by individuals with great vision, skills, and direction.

Finally, it was with great pride that our Florida Delegation was present at the awards dinner on May 16, 2000 to recognize Fred Turton as national Key Contact of the Year for the ACP-ASIM.

 

The Uniqueness of Me: Diversity in Medical Care

P.V. Caralis, MD, JD, FACP

If the U.S. Census Bureau’s population projections are correct, our nation once again is at a crossroads, undergoing significant demographic changes. Latinos will triple in numbers from 31.4 million in 1999 to 98.2 million in 2050. African-Americans will increase 70 percent, from 35.9 to 59.2 million; Asians and Pacific Islanders will triple from 10.9 to 37.6 million; Native Americans and Alaskans will increase from

Approximately 2.2 to 2.6 million. Also the foreign-born population, most coming from Asia and Latin America will increase from 26 to 53.8 million. The nation’s workforce will be composed of over 50 percent racial and ethnic minorities and immigrants. The reality will be that this wonderful melting pot is made up of a number of different ethnic groups, each with their own unique characteristics and flavor, who are united in spirit and a common destiny in the

U.S. Doctors, nurses and other health care professionals are beginning to recognize and address the complexities of providing care in a multicultural society. A number of studies are being published on how cultural backgrounds affect medical practice, ranging from treating diseases like hypertension and heart disease to informed consent and end-of-life care. For example, advance directives are based on the Eurocentric value of autonomy, what most white American believe in, but that may not be shared by people from different cultures. More than 75 percent of the world’s population live in societies where the group rather than the individual is the primary unit. Asking them to delegate one person to make decisions violates their sense of identity and family. There is little doubt that we need to establish programs to bridge the cultural differences among doctors and patients.

Diversity, however, can take many forms and not just visible characteristics like religion and culture. There is danger in creating stereotypes and assuming that every member of a group carries particular traits and beliefs about medical care. A kaleidoscope of experiences may impact on an individual’s uniqueness. They include historical oppression, war and its aftermath, cultural and spiritual traditions, physical disabilities, gender, sexual preference, discrimination and poverty. One can’t presume that Cubans and Puerto Ricans have the same belief systems because they share the umbrella term of "Latinos". Even within groups, the Cubans who fled in the 1960’s don’t share the same experiences as the rafters of today nor do Southeast Asians feel the same when some include those who literally came out of the "killing fields." Intertwined with these factors are personal experiences with health and illness. Life-long interactions with the health care system also contribute to how people come to perceive and value health care. Although African-Americans have suffered discrimination and may come to mistrust health care systems, studies show that mistrust is not sociological but "situational", exacerbated by health care providers who fail to adequately communicate diagnoses and options and by failing to understand patient’s wishes.

Physicians should not presuppose views, beliefs, or care preference of patients or families, based on a cursory knowledge of the ethnic, religious or social groups to which they belong. To provide health care for diverse populations, physicians must first identify and understand their own values and recognize their own preferences as personal and not necessarily in the "best interests" of the patient. The second, and most important step is to listen. If you are willing to listen, it doesn’t matter what your cultural background is or what your patient’s background is. You don’t need to be a medical anthropologist or world historian. You can elicit from the patient what in their cultural background is important to them. Finally, since an important factor in healing is educating our patients, consumer information should be available and conveyed using a variety of means to reach people whose language and learning styles are different. Information transmission includes the availability and appropriate use of translator services in health settings.

There are challenges for all of us ahead. Where we go from here as a nation is up to all of us. The "culture of medicine" has strong traditions but what we can no longer do is to preserve the status quo of historical models of interaction and decision-making. We need to understand and come to terms with what others believe and give "voice" to the diversity in our patients’ voices.

New Law Will Expedite HMO Payments

By Christopher L. Nuland, Esq., General Counsel

With the full backing of organized medicine, the Florida legislature this year passed important legislation designed to punish those who abuse the HMO billing process. For the vast majority of physicians whose honest claims often are left unpaid for long periods, the legislation offers the promise of prompt payment. The legislation, however, also provides the legal authority for regulators to punish those whose billings methods are less than scrupulous. Among the highlights of the bill are the following:

  • Unless specifically prohibited by a provider’s contract with an HMO, the provider may bill the patient if an HMO denies responsibility for a claim for any reason. Previous law often prevented such billing, and the new law still prohibits billing the patient for a portion of the bill (other than the co-payment) if the HMO pays the claim at its usual rate for referrals may not be withdrawn retroactively.
  • Systematic downcoding will be defined as an Unfair Claims Settlement Practice for which an HMO can lose its license.
  • AHCA will establidsh a program for settling claims disputes by January 1, 2001.

Physicians should note, however,t hat "systematic upcoding" has now been defined as insurance fraud for which providers may be prosecuted.

Any member with a question on the new law, which is scheduled to become effective on October 1, 2000, may contact the General Counsel’s office at 904-355-1555.

Maintain Control of Your Office

By: Corey L. Howard, MD, FACP

Let’s face it as physicians we were not trained as businessmen. Nevertheless, for many of us, medical practice is a business and a big one at that. One major mistake that is often made is giving up control of your office. When you do this you notice that revenues begin to creep down and mass confusion strikes. All of a sudden, your squeaky clean, efficient machine breaks down. The next thing that happens is you fire the office manager and hire a consultant to fix the mistakes in billing, coding and your books. Several thousand dollars later you start looking for another office manager because you realize that there are no way you can do all of the work and be a full time physician.

Does any of this sound familiar? Well it should. It happens to physicians every day all across the United States. What can we do to protect our businesses and ourselves? The first step is to make sure you understand your business before having others manage it. You do not need to have an MBA from Harvard to understand the business side of your practice. However, you will need to learn some basic accounting skills to understand the books. You will also have to bone up on your personal skills to help motivate others to work to their maximum potential.

Let’s talk about your books. Currently, there are many programs for accounting. A basic one would be QuickBooks Pro by intuit. This is a windows based program packed with a lot of power for many types of businesses. It allows you to navigate through all of your financial data with ease. The two main areas concerning your books are the balance sheet and profit and loss statement also called an income statement.

The balance sheet basically shows you what you have in assets and what you have in liabilities. These two categories ‘balance’ and therefore the name balance sheet. The profit and loss statement looks at what is coming in and what is going out. This should be reviewed at least monthly. It tells you where your money is going and how much you are making. This is easy so far. Isn’t it?

Personnel management is a good job for the office manager. However, it is necessary for you to make your employees feel important. Get to know your staff. You can have a positive impact just by sharing your interest and concerns. While there are many "little" events that occur in the office daily, you do not need to take an active role with each of them. You should however, have the final say and your office staff must know that. They need to have a sense that you are ultimately the one in charge.

Once you know all of the functions in your office including the basics of financial management, you can then consider delegating the tasks to the appropriate person. Understanding these functions also allows you to focus on what is important: our patients. ]

 

Resolutions Sent to the Fall Board of Governors Meeting

The Florida Chapter Governors Advisory Council approved two resolutions to be sent to the Board of Governors Conference September 14-16 in Seattle.

The first resolution addresses the timely publication of your newsletter. At the present time, there is a six to seven week delay in the time the newsletter is submitted to Philadelphia for publication and its delivery to your mailbox. The resolution calls for the College to produce the newsletter within two weeks or provide funding to the chapters for local publication.

The second resolution calls for the College to encourage the deletion of drugs from Negative Drug Formularies for which there exist medically equivalent generic substitutes.

 

Supporting Your Chapter Through Chapter Dues

Chapter dues are the backbone of local activities and vital to the success of our chapter. While we are provided some financial support from the national office, the chapter dues collected provide the majority of financial support for local activities. Educational meetings, mentoring programs for medical students, local Associates’ research competitions, advocacy with state legislators, and participation by chapter leaders in Leadership Day on Capitol Hill are just some of the activities supported by your chapter dues. Many of these activities are orchestrated by unpaid volunteer leaders in our chapter. However, increased activities at the local level has created the need for staff support to help manage the day to day operation of the chapter. Your chapter dues help support the cost of local staff and provide funding for new and existing chapter initiatives. When you receive your dues notice, please remember to include the chapter dues in your payment. You will be contributing to the success of many grass roots activities happening right here at home.]

2000 Florida Legislative Session

By N. H. Tucker, III, MD, FACP, Legislative Chairman

The 2000 Florida legislative session has come to a close and we at the Chapter are pleased with our latest achievements.

In close cooperation with the Florida Medical Association, we were successful in passing two bills which will be very important to Florida’s internists. The first of these includes language to prohibit HMOs from requiring the mandatory use of hospitalists for hospitalized HMO patients. This provision was our top legislative priority. It is not anti-hospitalist, because we do support the voluntary participation of hospitalists, but no longer can this be a mandatory situation. Also in the same bill, there is a requirement that only a licensed physician may render an adverse determination. No longer will we have to contend with nurses and other non-physicians making these decisions.

The second major bill may be the most important legislative success we have had concerning the managed care industry in Florida. It creates an external appeals mechanism for claims disputes, including downcoding, between physician and HMOs. Heretofore, the HMO would decide these issues internally and as a result was in the omnipotent role of player, referee, and judge. No more. Other provisions include: extending the prompt pay rules to include non-contracted physicians; prohibiting automatic withholds or takebacks without due process; and prohibiting HMOs from retroactively denying payment after they have authorized coverage for an eligible subscriber. Lastly, this law defines a "clean claim" using the current Medicare definition for a HCFA 1500 form. It also provides for a standardized claim form and uniform coding standards consistent with Medicare. In the past, there have been numerous accounts of claims being inappropriately denied because a physician did not file the claim by the HMO’s definition of a clean claim. These definitions varied from HMO to HMO.

We were successful in increasing Medicaid funding for the first time in a decade. There will be an increase in both physician reimbursement and graduate medical education funding.

Finally, we were able to defeat numerous bills which would have expanded the scope of practice for various allied health professionals. Those bills include: 1) ARNPs (nurse practitioners) and PAs prescribing controlled substances; 2) optometrists obtaining hospital privileges and performing laser surgery; 3) psychologists prescribing medications; and 4) pharmacists expanding their scope of practice.

I want to thank those physicians who took time out of their busy practices to make legislative visits to Tallahassee to fight for all Florida internists and our patients. Those physicians are Hermes Koop, Ruben Caride, Fred Carter, Frank Farmer, Alan Harmon, Stuart Himmelstein, Corey Howard, Cornel Lupu, Margaret Rank and Fred Turton. A special thanks to all of you for a job well done.

We concluded a very successful legislative session but much remains to be done. Please check the 2001 legislative agenda on our website. If any of our membership wish to assist us in our legislative endeavors or have any suggestions as to legislation we should be sponsoring or opposing that we are not, please contact Bob Harvey or me at the ACPASIM (1-800-542-8461-1-2.)

2001 Florida Chapter ACP-ASIM Legislative Agenda

Support

HMO Improvement

  • Oppose "All Products" Clauses
  • Oppose "Hold Harmless" Clauses
  • Support holding HMO’s liable for medical decisions that they make
  • Support requiring HMO medical directors being regulated under the medical practice act and therefore being licensed in Florida
  • Support drug formulary deletions occurring no more frequently than annually.

Tort Reform

  • Expert Witness-must be actively practicing in same specialty as defendant physician
  • Allow defense attorney to talk informally with subsequent treating physician.
  • Monetary penalties for attorneys filing frivolous lawsuits.

Patient Choice

  • "Collective Bargaining Unit" legislation.
  • Increased funding for CHEC for internal medicine residencies
  • Increased access to Medicaid by its eligible population.

Oppose

  • Expansion of allied health professionals’ scope of practice such as:

Prescribing authority for pharmacists, ARNP’s, and psychologists.

Diagnostic testing authority for pharmacists.

Hospital privileges for optometrists.

  • Public disclosure of complaints prior to a finding of probable cause.

 

2001 Florida Chapter ACP-ASIM Legislative Agenda

Support

HMO Improvement

  • Oppose "All Products" Clauses
  • Oppose "Hold Harmless" Clauses
  • Support holding HMO’s liable for medical decisions that they make
  • Support requiring HMO medical directors being regulated under the medical practice act and therefore being licensed in Florida
  • Support drug formulary deletions occurring no more frequently than annually.

Tort Reform

  • Expert Witness-must be actively practicing in same specialty as defendant physician
  • Allow defense attorney to talk informally with subsequent treating physician.
  • Monetary penalties for attorneys filing frivolous lawsuits.

Patient Choice

  • "Collective Bargaining Unit" legislation.
  • Increased funding for CHEC for internal medicine residencies
  • Increased access to Medicaid by its eligible population.

Oppose

  • Expansion of allied health professionals’ scope of practice such as:

Prescribing authority for pharmacists, ARNP’s, and psychologists.

Diagnostic testing authority for pharmacists.

Hospital privileges for optometrists.

  • Public disclosure of complaints prior to a finding of probable cause.

 

Congratulations!

These senior medical students and senior medical residents were selected by their programs as best exemplifying the principles of the ACP-ASIM. Each received a certificate of achievement and a cash award from the Chapter.

Outstanding Medical Student Awardees:
Clay Sizemoor, University of Florida
Maria Cannarozzi, University of South Florida
Patricia Thompson, University of Miami

Outstanding Resident Awardees:
Phillip Scheinberg, MD, Mount Sinai Medical Center
Joe Lezama, MD, University of South Florida
Augustine Lee, MD, Mayo Clinic Jacksonville
Yvonne Diaz, MD, University of Miami
James Crum, MD, Orlando Regional Medical Center
Ian Morales, MD, UF Health Science Center-Jacksonville
Michelle Rossi, MD, University of Florida
Nirupama Vemuri, MBBS, Cleveland Clinic Florida

 

Florida Chapter to honor New Laureates

Awards Presentation

Saturday, September 23, 2000

Fred A. Carter, MD

Dr. Carter received his medical degree from Indiana University, served in the US Army Medical Corps and practiced in LaPorte, Indiana before moving to Martin County in 1975. He has served numerous professional organizations with distinction including as President of the Martin County Medical Society where he continues on its board, as an active 25 year delegate to the FMA, as Vice-Chairman of the FMA Council on Legislation, and as President of the Florida Society of Internal Medicine. Dr. Carter was instrumental in the formation of an indigent care clinic in Martin County and continues to provide care in his retirement.

He received the FSIM’s 1996 Charles Donegan award and special recognition that same year from the American Society of Internal Medicine for his advocacy efforts.

Dr. Carter and his wife, Mariann, reside in Palm City, Florida.

P. V. Caralis, MD, JD, FACP

A native Miamian, Dr. Caralis was one of ten females in her medical school class and served four years on the student council. She graduated with honors and completed her training at Jackson Memorial Hospital before joining the faculty of the University of Miami. She holds an appointment as Professor of Medicine, University of Miami, and Chief of the Section of General Medicine, Miami V A Medical Center. Dr. Caralis also earned a law degree and coordinates the Medical Ethics, Law and Social Policy course in addition to her other teaching responsibilities.

She served as Treasurer of the Florida Chapter, ACP 1984-1988 and as regional representative. She was elected to fellowship in 1985 and currently is chair of the Chapter’s Ethics Committee. She also serves on the editorial board of The Florida Internist.

Federico A.Justiniani, MD, FACP

Dr. Justiniani pursued his medical degree and postgraduate studies from the University of Havana in 1960. He left private practice in 1964, came to Miami and began a rotating internship. In 1969 Dr. Justiniani completed another residency and accepted an appointment as Program Director at Mount Sinai Medical Center which he held until 1974. He serves as Director of Medical Education at that institution and holds an appointment as Professor of Medicine, University of Miami.

Dr. Justiniani is a revered teacher of internal medicine, has lectured extensively nationally and internationally, and organized the Pan American Medical Seminar at Mount Sinai which continues in its 25th year. He organized a mini-residency rotation for Latin American physicians and has served the Cuban Society of Internal Medicine in Miami in a leadership role. He has been Fellow of the College since 1974 and represented the ACP at the Third Venezuelan Congress of Internal Medicine.

 

"Aging into the Twenty-first Century" theme of the 32nd Florida Chapter ACP-ASIM

Scientific Session

Gloria Weinberg, MD, FACP, and the faculty of Mount Sinai Medical Center have arranged a superb program for the 32nd Florida Chapter ACP-ASIM Scientific Session at the PGA National Resort and Spa. Chronic diseases which afflict the elderly will be discussed as well as the diagnosis and management of acute illnesses in the elderly. There are workshops in a number of disciplines including end-of life issues and palliative carewhich can be substituted in lieu of HIV/AIDS courses for license renewal through an amendment to Chapter 765 of the Florida statutes governing advance directives. A session will be devoted to improving one’s documentation skills and reimbursement as well as a seminar on fraud and abuse issues. A malparactice presentation utilizing real cases, real doctors and real lawyers is also planned.

Dr. Joseph E. Johnson, III, FACP, Senior Vice President of Membership will join us as well as Mark Gorden Senior Associate for Clinical and Regulatory Affairs at the Washington D. C. office. Risa Lavizzo-Mourey, MD, FACP, ACP-ASIM Regent and Director of the Institute on Aging at the Univversity of Pennsylvania Health System has agreed to attend as our College representative. Robert G. Brooks, MD, FACP Secretary of the State of Florida Department of Health and Lieutenant Governor Frank Brogan are featured speakers.

The 15 CME credit scientific session is free to all members who have paid 1999-2000 chapter dues.

We have reserved a block of rooms at the PGA at our special group rate of $135. These are available on a first-come, first served basis so make your reservation as early as possible by calling the hotel directly at 561-627-2000 and indicating that you will be attending the ACP-ASIM Florida Chapter meeting. The room block expires August 21, 2000.

If you need more information on the meeting, please contact Alice Sutton at 863-983-3600. To access online meeting information or print a registration form, go to http://www.acponline.org/cme/regmtg/regional.htm

Topics for the 32nd Florida Chapter Scientific Session

PGA National Resort & Spa, Palm Beach Gardens, Florida

  • Aging in Perspective & Issues of Abuse and Neglect
  • Management of Common GI Problems in the Elderly
  • Osteoporosis
  • Hypertension
  • Documentation & Reimbursement Issues
  • Rheumatologic Conditions in the Elderly
  • Exercise and Cardiac Rehabilitation
  • Asthma & COPD
  • Failure to Thrive-What Does It Mean & What Can You Do?
  • Nutrition Workshop
  • Decubitus Management Workshop
  • Palliative Care & Pain Management
  • The Elderly Driver
  • Common Infections
  • Early Detection & Treatment of Alzheimer’s Disease
  • Common Hematologic Conditions
  • End of Life Issues
  • Assessment of Depression & Dementia Workshop
  • In Defense of Dr X
  • How to Handle Common
  • Office Renal Problems
  • Diagnosis and Management of Incontinence
  • Congestive Heart Failure
  • ICU Care in the Elderly
  • Things That Go Bump in the Night

 

MKSAP for Students

The Education and Career Development Department is pleased to announce the release of MKSAP for Students. In creating this product, the College has partnered with the Clerkship Directors in Internal Medicine to create a useful educational tool for 3rd and 4th year medical students. We have chosen to model it after the highly successful Medical Knowledge Self-Assessment Program (MKSAP) for internal medicine physicians. MKSAP for Students consists of a printed collection of nearly 400 patient-centered, self-assessment questions and their answers. The questions begin with a clinical vignette, and the vignettes are organized into 28 different categories that correspond to the Core Medicine Clerkship Curriculum Guide"Training Problems." The approximate retail price for MKSAP for Students is $30.00 making the publication very competitive against other books of this type. It can be purchased at medical school bookstores or by ordering through the ACP-ASIM Customer Service at 800 523-1546, ext. 2600.

Preparation for Recertification Courses

With the first group of time-limited American Board of Internal Medicine (ABIM) certificates set to expire in December 2000, the College is ready to help internists prepare for the recertification examination. Three-day preparation courses will be offered throughout the country (San Diego, Milwaukee, Philadelphia, and Orlando) during the fall and winter months. Additionally, a two-day course is held each year prior to Annual Session. All programs are highly interactive and use brief didactic presentations and case-based multiple-choice questions taken from ACP-ASIM's extensive

MKSAP databank. Using the audience response system, participants practice working through

difficult test questions similar in format to those in the ABIM examination. Experienced course directors have been selected for their outstanding teaching and organizational abilities. For more information, contact Customer Service at 800-523-1546, ext. 2600.

ACP-ASIM Teaching in the Ambulatory Setting

By: Patrick C. Alguire, MD, FACP

The College's Community-Based Teaching Program has just released ACP-ASIM Teaching in the Ambulatory Setting. This 20 minutes videotape is intended to help office-based physicians responsible for precepting medical students and residents improve their teaching skills. The videotape presents nine different teaching scenes, each illustrating a different teaching strategy or problem. Illustrated in the videotape are examples of setting goals and expectations, modeling problem-solving, use of the precepting "microskills," priming and focusing, and providing feedback, as well as examples of common teaching errors. The videotape is accompanied by an 8-page companion text that briefly describes the teaching skill or error being demonstrated.

The videotape was produced by Gary S. Ferenchick, MD, a general internist, who has authored many articles on teaching and teaching improvement, and has designed and directed faculty development workshops for ambulatory-based teachers. This videotape program can be used by individual physicians or as part of a faculty development program. To order, call Customer Service at 800 523-1546 and ask for productnumber 190400100 ($24.95. Shipping and handling extra).