Governor's Newsletter, Spring 2002

Joseph W. Stubbs, MD, FACP
Governor, Georgia Chapter

From the Governor's Corner

As we head toward the 2002 Annual Session, the College has been very active on many fronts. September 11th was a sobering reminder of the inadequacy of our nation's responsive capabilities to biochemical terrorism. Concern regarding medical errors and patient safety continue to loom large. With the downturn in the economy and the increase in unemployment, the numbers of uninsured are starting to rise, and in some states, the rise has been dramatic. Based on a flawed reimbursement methodology, Medicare has now enacted an unprecedented 5.4% cut in reimbursement for physicians. These are but a few of the issues that the College is actually working to rectify or solve.

President Bush has made a major initial budgetary commitment in the fight against biochemical terrorism. The College has expressed strong support for the President's initiative, but has warned that a much greater commitment of funds will be required to create the really necessary infrastructure to cope with future potential acts of biochemical terrorism. Further, the College has expressed concern that funds to fight biochemical terrorism not be taken away from other important biomedical research.

Since the Institute of Medicine report on patient safety in 1999, the College has been at the forefront in implementing educational measures designed to reduce medical errors and improve patient safety. The College has received a three-year grant from the Agency for Health Care Research and Quality (AHCRQ) to develop and implement a patient safety chapter educational program designed for the physician's office. So far, three modules have been developed and fifteen chapters will receive patient safety training in 2002, and another seven in 2003.

The College has already sponsored research documenting the serious health consequences of being uninsured. An uninsured female with breast cancer has 47% greater risk of dying than an insured female with breast cancer. Uninsured individuals with chronic conditions such as heart disease, hypertension, diabetes, and arthritis are far less likely to see their physician regularly, obtain prescribed medicine, or carry out accepted periodic screenings. The College is currently lobbying the White House and the Bush Administration to aggressively address needed reforms in making health care, with a guaranteed basic minimum of services, available to more Americans. The College is also in the final stages of preparing a seven-year plan for providing health care access to all Americans.

Equally important to insuring care for Americans is insuring physician availability. This year, physicians have had to adjust to a 5.4% cut in the Medicare reimbursement rate. Further, based upon methodology that currently exists for determining that rate, physicians could be facing similar reductions over the next several years to come. This could pose an unacceptable financial burden to physicians caring for Medicare recipients unless the methodology is changed. The ACP-ASIM has provided testimony to the House of Representatives Committee on Energy and Commerce urging Congress to act immediately to halt the 5.4% reduction. The College also expressed strong support for the Medicare Payment Advisory Committee recommendation of replacing the current update formula with a new framework that would base reimbursement for physician services on the estimated change and the cost of delivering services for the coming year, less an adjustment for productivity growth.

The College continues to strongly advocate for both the patient and the physician. Such a balance insures that the College remains on track in its mission to enhance the quality and effectiveness of health care by fostering excellence and professionalism in the practice of medicine.

A Look at Georgia's New Governor-Elect, Dr. Rhee Fincher

Congratulations to Dr. Rhee Fincher who has been voted Governor-Elect for the Georgia Chapter ACP-ASIM. Rhee will officially take this position at the close of the ACP-ASIM's business meeting April 13, 2002, and become Governor of the Georgia Chapter at the end of the Annual Session meeting in 2003.

Since 1994, Dr. Fincher has been Professor of Medicine at MCG, and is also currently Vice-Dean for Academic Affairs as well. She was elected Fellow of the American College of Physicians-American Society of Internal Medicine in 1986 and has been an active member in the College, both at the national and state level, since that time. As a former small-town Georgia practitioner and current full-time academic internist, Dr. Fincher sees her mission as Governor to be that of a bridge builder and enhancing collaboration between subspecialty organizations, the AMA, legislators, third party payers, educational organizations, and the ABIM I urge each of you to use this transition as an opportunity to reflect on what you would like to do and is able to do in the way of involvement with our Chapter and let Dr. Fincher know.

Changes at the Top

As many of you know, Dr. Walt McDonald announced his retirement effective June 30, 2002. A Board of Regents search committee performed a very wide reaching and extensive search, and unanimously reached the conclusion that the best replacement was Dr. John Tooker, MD, MBA, FACP, who is the current ACP-ASIM Deputy Executive President and Chief Operating Officer of the College. Dr. Tooker has served as Deputy Executive Vice President and Chief Operating Officer of the College since 1995, and has been an active leader and member of the ACP-ASIM for years. He has previously served as the ACP-ASIM Governor for Maine, Chair of the Board of Governors, and as a member of the Board of Regents.

In addition, effective at the conclusion of the Annual business session on Saturday, April 13, 2002, the following new officers and regents will assume office:

  • President Elect: Munsey S. Wheby, MD, FACP
  • Treasurer: Cyril M. Hetsko, MD, FACP
  • Incumbent Regents - elected for 2nd terms (to expire in 2005): Stephen C. Beuttel, MD, FACP; C. Anderson Hedberg, MD, FACP; Barbara L. Schuster, MD, MACP; Donna E. Sweet, MD, FACP
  • New Regents - elected (terms to expire in 2005): Stephen G. Pauker, MD, MACP; William B. Applegate, MD, FACP; W. Perry James Stackhouse, MD, FACP

Leadership Day at the Gold Dome

The Georgia Primary Care Coalition held its Second Annual Leadership Day at the State Capitol Monday, January 28, 2002. The Coalition consists of the three leading primary care organizations in the state, the Georgia Academy of Family Practice, the Georgia Chapter American Academy of Pediatrics, and the Georgia Chapter ACP-ASIM. I was pleased to see so many medical students taking this opportunity to attend and see how important it is for physicians to take an active role in health care legislation. The day provided our members with great opportunities to listen to legislators and government leaders on health care issues as well as provided opportunities to lobby our legislators regarding issues such as scope of practice, Medicaid reimbursement, and regulatory relief issues. Lt. Gov. Mark Taylor capped off the meeting by being our featured luncheon speaker. Our thanks for the success of this meeting goes to the Executive Directors of these three organizations: John Berglund with the Georgia Academy of Family Practice, Rick Ward with the Georgia Chapter American Academy of Pediatrics, and Nancy Brady with our own Georgia Chapter.

ACP-ASIM National Leadership Day

The ACP-ASIM will be sponsoring its own Tenth Annual National Leadership Day on Capitol Hill May 21-22, 2002. Leadership Day 2002 presents a challenge of bringing urgency to our agenda while the Congress and the Administration have been absorbed in homeland security and the war in Afghanistan. Bio-terrorism is the only ACP-ASIM issue that directly relates to these national priorities. The current budget restrictions will require advocates to make a very strong case for their priority that carry price tags. Issues that will be addressed include patient's bill of rights, Medicare prescription drug benefit plan, tax credits to reduce the number of uninsured, fixing the 5.4% reduction in the Medicare fee schedule, and regulatory relief.

Governor's Advisory Council Meeting

The Georgia Chapter Governor's Advisory Council met on January 27, 2002 at Atlanta Medical Center. One of the major issues addressed was a new membership campaign. Dr. Henry Patton, Chair of the Membership Committee, outlined the Peer-to-Peer program, which is designed to engage all members as recruiters on a one-to-one basis to encourage colleagues to join or advance to Fellowship. It is a program to enhance personal contacts to increase membership. Dr. Patton handed out to all members of the Governor's Advisory Council packets indicating names of ABIM certified non-member customers in the Georgia Chapter, organized by city. Each recruiter will be given as many membership packets as needed to use in their recruiting efforts. For the program to be a success, our Chapter needs more than just the Council members to act as recruiters. Any member interested in trying to recruit more members should contact Dr. Henry Patton in Covington, GA at (770) 787-6900, and he will be happy to send you all the information and materials necessary.

Otto Goyco, Chair of the Diversity Committee, presented our Chapter's profiles broken down by ethnicity. Among the minorities, African Americans are the largest group (80%) and the next largest group is Hispanics (3%). Women are under-represented in both groups. The Council agreed that our Chapter needs to try to reach out and make contact with other ethnic physician organizations, such as the Georgia American Physicians of Indian Origin and the Korean Medical Association of Georgia. Through such contacts, there is hope that we can increase the diversity of our Chapter's membership.

At the request of the Chief Residents, the Council accepted a proposal to include at our Annual Chapter Meeting a Resident's Competition in Medical Jeopardy. Three hours will be required for the competition with the preliminary round being from 10-12 on Friday, and the final round being at 4 o'clock on Saturday. Dr. Harold Szerlip, from MCG, will be working with Atlanta Medical Center Chief Resident, Dr. Mohammed Wehbi, to organize this.

Dr. Stubbs reported on the Diabetes Care Improvement Project. He indicated that the Georgia Chapter continues to partner with the Georgia Medical Care Foundation and the Southwest Georgia Area Health Education Center to develop a peer education training program designed to provide skills and tools for physicians throughout Southwest Georgia to better manage diabetic patients. He indicated that the organizations are currently in the process of seeking funding for the program that should amount to around $150,000. The Council approved allocating $10,000 from the Georgia Chapter towards this project as a show of our commitment.

There's Still Time ... Georgia Chapter Annual Meeting

The Georgia Chapter annual meeting will be held May 3-5 at the Wyndham Peachtree Conference Center in Peachtree City. The program under the theme "The Spectrum of Internal Medicine" has an outstanding faculty. The program offers 15.5 hours of CME. The Associates' Competition will also be held concurrently. The competition will feature approximately 40 oral or poster presentations from the seven residency programs around the state. Great shopping, dining, golf and other leisure activities are all readily available near the conference center, and of course, downtown Atlanta is just 30 minutes away. It's not too late to sign up. Call now for hotel reservations at (770) 487-2000, and for meeting registrations, call Nancy Brady at (770) 252-1858.

Practice Management Center Report

The College's Practice Management Center has been very active under the directorship of Carl Cunningham. One major PMC initiative was the completion of two HIPAA tools that members could use to help them comply with the privacy and transaction requirements of HIPAA. The Practice Management Center is planning to put these two tools, along with all the other publications, on a CD that will be available to members. It should be ready and available on the College Web site as well as be distributed at the Annual Session in April. The Practice Management Center can be found online and it can be reached via our own Georgia Chapter Web site.

In response to College recommendations, the Centers for Medicare and Medicaid Services "Medicare and You 2002" beneficiary handbooks distributed to physicians will include a ten page insert with physician specific information. Physicians should start receiving the "Medicare and You 2002" physician edition handbook in late January 2002. The entire handbook or the physician insert are all available online.

ABIM Recertification

The College has been actively negotiating with the ABIM regarding their proposed new recertification process. The latest proposal from the ABIM falls short of meeting all the parameters delineated by the Board of Regents after input from the Board of Governors last spring. On the other hand, it does make some progress in making the process more flexible for those required to recertify in the near future. A summary of the latest ABIM position on recertification is as follows:

  • The role of the medical societies is to provide education.
  • The role of the ABIM is to evaluate competencies of its diplomates in accordance with the general principles of the American Board of Medical Specialties (ABMS). The ABIM has developed standards to evaluate diplomates' competencies in these domains.
  • The ABIM and ACP-ASIM are committed to lifelong learning and recertification.
  • Requirement of the completion of the modified SEP components of the ABIM will be delayed until after December 31, 2009. Until then diplomates may complete any five SEP modules on their own schedule.
  • The peer and patient feedback module will remain optional until it can be shown to be valid, reproducible, and applicable to internists in clinical practice.
  • Medical Society self-assessment questions (such as MKSAP) may be accepted for up to two modules. The questions must meet the standards of ABIM and be scored by ABIM.
  • The ABIM will work in collaboration with the medical societies and other entities, such as NCQA and JCAHO in the implementation of the Performance Improvement Modules (PIM's). The goal of this collaboration is to reduce and eliminate redundancy, so that data collected about a diplomate's practice outcomes for any quality initiative can be used for the PIM's if they meets the ABIM's standards.
  • The ABIM will work diligently to provide a computer-based examination as soon as possible.

This proposal will be presented for formal discussion at the upcoming spring Board of Governors meeting immediately preceding the Annual Session and will be considered along with other recertification resolutions.

MEDLINEplus Project - A New ACP-ASIM Foundation Project

All internists have been aware and increasingly alarmed by the amount of misinformation patients are receiving from the Internet. To address the problem, the ACP-ASIM Foundation has announced a new joint project with the National Library of Medicine, the Health Information Referral Project. The project will provide physicians and their patients with information that will allow referrals to be made easily and confidently to an authoritative, advertising-free and user-friendly Web site - MEDLINEplus. The project will help ACP-ASIM members facilitate referrals, particularly for those with chronic conditions and for the elderly. The Georgia Chapter has been selected as one of two pilot sites where the project is expected to begin in the spring 2002.

Awards and Kudos

At the Annual Convocation Ceremony held during the Annual Session on Thursday, April 11, Dr. Robert Copeland will receive one of the highest awards the College can bestow, the Alfred Stengal award, which is an award for a lifetime of service to the College. Dr. Copeland has been a prior Governor of our Georgia Chapter and recipient of the Chapter Laureate Award and the Chapter Governor's Award. He has also served as prior Chair of the Board of Regents and is current Chair of the ACP-ASIM Foundation.

Leigh Stewart, a second year medical student at Mercer University, was elected to serve as a member of the ACP-ASIM National Council of Student Members.

The Georgia Chapter was recently named as one of the recipients of the Chapter Excellence Award, which is awarded to those chapters annually who demonstrate exceptional levels of achievement in chapter management. The award has been given for the past three years, and the Georgia Chapter has been a recipient for each of those three years.

What's New

Contact Information

Vincent Nicolais, MD, FACP,
Governor, Georgia Chapter

Karen Townsend
Executive Director
Ph: 770-693-9973
Georgia Chapter

Michelle Dietz
Administrative Assistant
Ph: 770-920-6995