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June 2013


Banu E. Symington, MD, FACP, ACP Governor


Message From Your Governor

Greetings Fellow Idaho Physicians

Check out some photos from San Francisco.

Moscone Center

San Francisco Building

Trans America Building

Union Square Building

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Chapter Development Activity

The Idaho ACP has had an exciting spring. On March 19th, we had a buffet dinner with Dr. Steven Weinberger, Executive Director of the ACP which was funded by a grant from the Chapter Development Fund of the ACP. Over 25 (including at least one nurse practitioner and some non-member residents) had the opportunity to meet and personally talk with Dr. Weinberger. The next morning, Dr. Weinberger gave a grand rounds on “High Value Cost-Conscious Care” at the Boise St. Luke’s campus to a standing room only audience. I was delighted to see a handful of St. Al’s physicians in the audience, a testimony to Dr. Weinberger’s ability to build bridges. Questions were texted in from offsite locations watching via VTEL. There was great interest expressed in bringing Dr. Weinberger back to Idaho. See this link for a practical approach to using technology to achieve high value care.

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HPV-spread the word so you don’t spread the virus!

See my guest blog on this topic and feel free to comment directly on the blog.

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ACP Launches Mobile-optimized Literature Resource

The American College of Physicians released ACP JournalWise, a personalized, mobile-optimized updating service for clinical articles from a large number of medical journals, at Internal Medicine 2012. ACP JournalWise is a free benefit for ACP members

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Internal Medicine 2013

Early in April, 35 Idaho physicians attended Internal Medicine 2013 in San Francisco. I heard this is some kind of record. Dr. Emanuel Ezekiel, oncologist, ethicist, and frequent Perspective contributor to the NEJM, gave the opening speech at the meeting. I noticed an uncanny resemblance, both in mannerisms and physical appearance to his brother, former Obama White House Chief of Staff and current Mayor of Chicago, Rahm Emanuel. See the interview with these two brothers and their third famous brother, Ari Emanual, Hollywood agent and inspiration for Ari Gold in the series, Entourage.

These three brothers must have a very proud mom!

Dr. Abraham Verghese gave a moving presentation to the Board of Governors on the connections between literature and medicine, “The Pen and the Stethoscope: Connections Between Literature and Medicine.” By the way, he commented on the fact that while we have made much medical progress in the past century and have recognized many new diseases, our medical language has become relatively impoverished. He particularly misses the medical metaphors such as strawberry tongue of scarlet fever, peau d’orange of breast cancer, and water-hammer pulse of aortic insufficiency. I challenge the Idaho membership, especially Dr. Moe Hagman and the residents of the Boise VA to make a list of recent medical metaphors to share with Dr. Verghese. Please email Kerrie Dschaak with your metaphors.

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Be a Match Campaign

My class of Governors (the 2016 class), led a Be A Match campaign at Internal Medicine 2013 that was very successful. Nearly 50 new donors were registered and almost $3,000 in donations was collected at the meeting. This was done to honor a classmate Governor who is undergoing an allogeneic unrelated bone marrow transplant to treat myelodysplasia caused by extensive prior chemotherapy for lymphoma. You might know of Robin Roberts, Good Morning America co-host, who has gone public both with her breast cancer treatment and her subsequent bone marrow transplant. Her myelodysplasia (formerly known as preleukemia) was also treatment related, but she was lucky enough to have a sibling donor. This is a noble cause which I encourage you all to get involved in. If you are under 45, you can be typed to be a potential bone marrow donor. Alas, we learned that at 45 you are “old” in unrelated bone marrow donor terms, but you can still support the cause by donating money. We need more donors and research money as we see more leukemia and myelodysplasia, due to longer lifespans, cumulative toxin exposures, successful chemotherapy for first cancers and shrinking family sizes. For more information about the Be A Match foundation.

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Congratulations to the New Fellows!

We had two new Fellows walk at convocation in San Francisco.

Dr. Janice Boughton of Coeur d’Alene

Dr. Lisa Burgette of Twin Falls

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Congratulations Masters!

Dr. C. Scott Smith

Dr. Danny Hindson was honored posthumously.

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Welcome New Members

Muhammad Kashif Adnan, MD, Nampa
Eric K. Allen, DO, Chubbuck
Andrea S. Christopher, MD, Boise
Amy N. Cowan, MD, Ketchum
Anthony B. Crest, MD, Coeur D Alene
Thomas Dirocco, MD, Twin Falls
Ann E. Hansen, MD, Boise
James Hawkes, MD, Pocatello
Heather A. Healy, NP, Boise
Jared R. Helms, DO, Twin Falls
Troy L. Johnson, MD, Meridian
Danielle Orchard, MD, Boise
James H. Schrader, DO, Eagle
Martha G. Shelver, NP, Boise
Christopher J. Sjoberg, NP, Boise
Dan S. Zuckerman, MD, Boise

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High Value, Cost-Conscious Care

Whether we like it or not, High Value Care is coming. Why not be as prepared as possible. The High Value, Cost-Conscious Care Curriculum has been jointly developed by the ACP and the AAIM in an effort to address the “critical seventh general competency for physicians.” There is a ten module self-study course that will help get you ready.

  1. Introduction to Healthcare Value
  2. Healthcare Waste, Costs, and Over-Order of Tests
  3. Health Insurance
  4. Healthcare Costs and Payment Models
  5. Biostatistical Concepts You Need to Know
  6. Screening and Prevention
  7. Balancing Benefits with Harms and Costs
  8. High Value Medication Prescribing
  9. Barriers to High-Value, Cost-Conscious Care
  10. Local Quality Improvement Project

This is available FREE to all ACP members. Get prepared for the change… and be prepared to explain to patients that we are moving towards rational medical care, NOT rationing of medical care.

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Leadership Day 2013

I had the privilege of attending 2013 Leadership Day on Capitol Hill. Joining me was J.P. Manning, a WWAMI medical student who has just completed his first year in Pullman, WA. He is the handsome bearded fellow in the picture with Senator Mike Crapo. Our trips were enabled and facilitated by the generosity of Governors from other states with deeper pockets. We met with Senators Mike Crapo and James Risch as well as aides from the office of Congressman Raul Labrador.

With Senator Mike Crapo

With Senator James Risch

The ACP is lobbying for repeal of the SGR, for exemption of certain essential services such as NIH, CDC, HRSA and four others from across the board cuts, for expansion of graduate medical education (these slots fund residency training and have been stagnant at 1996 levels despite the aging and expansion of the population at need). It is projected that there will be a 90,000 physician shortage by 2020, more than half in the primary care fields. The ACP is also lobbying to make private insurers contribute to the cost of GME. Finally, the ACP would like legislators to sponsor a pilot project of no-fault health courts as an alternative to costly, time-consuming, and often regionally discrepant malpractice outcomes. I am pleased to say that both Senators were in agreement with these positions.

For an uplifting commentary on the privilege of being internists/hospitalists in the current era, see ACP President Molly Cooke’s article, "Professional excellence, service make ACP essential".

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Recruit-A-Colleague

We all know the pain of getting bills. Last week I had the thrill of receiving a check for $100 for the chapter through the Recruit-a-Colleague campaign. Yes, you heard it here, national will donate $100 to our state chapter for each colleague that is recruited by an existing state member to become an ACP member. I don’t know how much longer this promotion will be going on… so let’s get cracking. Especially those of you who had a wish list of activities at the annual business meeting.

The national Recruit-a-Colleague program rewards successful recruiters with dues credits for each new full Member or Physician Affiliate member recruited (up to the amount of annual dues) and a chance to win a trip to the annual Internal Medicine meeting. The program runs each year from April 1 through March 15.

The chapter program still rewards the individual recruiter as stated above, but it also:

  • Provides a $100 reward to the recruiter's chapter for each new member recruited
  • Provides one free registration to Internal Medicine 2015 for the chapter per every 10 new members recruited
  • Provides an additional $25 reward to chapters for each of the first two years that a new member who is recruited through this program renews his/her membership.

To participate, simply forward to your colleagues a membership application. To qualify for the program, your name must be listed on the recruiter line of the application, and the form must include the code RACC.

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ACP Physician Affiliate and non-Physician Affiliate Memberships Now Available

While you are recruiting members, remember to recruit non-internist physician colleagues and non-physician colleagues under two new ACP programs:

ACP’s Physician Affiliate membership category is for physicians trained in specialties other than internal medicine. In the past, the College received requests for membership from physicians who did not meet the requirements of full Membership. These physicians often worked alongside ACP members in their practices, and were exposed to the valuable benefits and resources that the College offered. In the spirit of supporting a patient-centered care delivery system based on a team-based environment, the College has expanded its eligibility for membership, while still maintaining its mission and focus on internal medicine. With that in mind, Physician Affiliate membership was approved. It is important to note that Physician Affiliates are excluded from voting, holding office and attaining Fellowship. They may sit on any committee or council that has open seats for non-members.

Non-Physician Affiliate membership is available to licensed non-physician health care professionals working on a patient-care team led by an MD, DO, or a physician holding an internationally equivalent degree and who maintain their professional credentials to practice. Eligible professionals include: physician assistants, nurse practitioners and other advanced practice nurses, registered nurses, pharmacists and doctors of pharmacy, and clinical psychologists.

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Chapter Dues

Finally, talking about dollars and cents and the generosity of other states, the Idaho chapter state ACP dues have been $20 for the past twenty years. We also have the lowest state dues. All the activities that can make our chapter a self-sustaining and hopefully growing one – whether hosting a dinner for Dr. Weinberger, having small chapter meetings, buying software to enable video conferencing, sending physicians to Leadership Day or Medical Jeopardy at the annual meeting, hosting small group meetings on Women in Medicine or practice management for Young Physicians, takes money. Without pharma support or bake sales, the chapter can only generate this money through recruitment of colleagues and raising dues. I am proud of what we have achieved so far this year:

  • Advanced several members to Fellowship and two to Mastership
  • Had our first newsletter in years
  • Two Idahoans attended Leadership Day with Senators
  • Successful chapter development grant application and activity
  • Received the Chapter Excellence Award, first time in 11 years

Let’s keep up the momentum. To do this, we will need more funds. At the last business meeting in January 2013, we did authorize an increase in the state dues to $40. Please support our chapter with your membership and your involvement. And, remember to recruit a colleague or two!

Until next time,

The Guv
Banu Symington, MD, FACP and proud ACP member

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