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Governor's Newsletter Fall 2001

C. Scott Smith, MD, FACP
Governor, Idaho Chapter

ACP-ASIM Response to the Terrorist Attacks

The fall newsletter is usually produced after the Board of Governor's meeting. This year, that meeting was scheduled to begin on September 13th and was cancelled due to the terrorist attacks. The American College of Physicians-American Society of Internal Medicine (ACP-ASIM) extends its condolences to the families and friends of those affected by the national tragedies of September 11 and pledge its commitment to helping America through this difficult time. Our 115,000 members grieve for those who lost their lives in New York, Washington, D.C. and Pennsylvania.

As primary care physicians and specialists, internists are prepared to help patients with the health consequences associated with the aftermath of these traumatic events. Even those who did not experience direct personal loss from the events in New York, Washington, D.C. and Pennsylvania will be affected emotionally. We are asking our members to talk with their patients about the recent events during office visits. The American Red Cross (http://www.redcross.org/) has regional chapters nationwide that can help with grief counseling and other services, and has downloadable information available to help patients cope with feelings of loss, fear and anxiety. Other resources include:

  • The American Psychiatric Association is providing a disaster psychiatry page, which gives information useful to physicians in preparing for and responding to disasters and other traumatic events. It also features several publications on disaster psychiatry and information for patients on how to cope with the traged
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  • The American Academy of Pediatrics is offering advice on how to communicate with children and adolescents during times of crisis
  • The Centers for Disease Control and Prevention have released respiratory disease fact sheets for physicians and the general public
  • The Federal Emergency Management Agency (FEMA). Includes comprehensive health resources and information on how to help victims

Although biologic or chemical agents were not employed in the recent attacks, the College recognizes that there is a heightened sense of concern about such agents. ACP-ASIM's Bioterrorism Center (http://www.acponline.org/bioterro/) provides information vital for all practicing internists regarding biological terrorism. Visit (http://www.nbc-med.org/) for information about biological warfare, on-line courses, medical references, publications, and other related sites.

Recent events have touched all Americans, and resonated throughout the world. Internists worldwide have sent messages of support about the tragic events. ACP-ASIM joins with internists around the world in expressing our hope and commitment toward recovery, healing, justice, and peace in these difficult times.

Town Hall Meetings

The Idaho Chapter has received a small grant to subsidize a series of "town hall" meetings in many of the communities around our state. Look for them coming to your community soon! The purpose of these meetings is three-fold:

  • To hear from you. We want to know what you need and how we can help.
  • To create tighter relationships between internists around the state.
  • To introduce interested non-member internists to the organization.

Focus on Safety

ACP-ASIM has launched a three-year initiative to help reduce medical errors and improve patient safety in doctors' offices and other non-hospital settings. The effort will be funded by a grant from the Agency for Healthcare Research and Quality (AHRQ) and will draw on the strengths of ACP-ASIM's role as the largest medical specialty organization in the United States and its governance through 77 local region and state chapters. ACP-ASIM's top three leaders will be co-investigators in the project.

The project aims to raise physician awareness of patient safety issues among ACP-ASIM's 115,000 members. The College will develop a patient safety curriculum that will be offered in chapter and region meetings. Further, an interactive online forum will be developed to assist practicing physicians develop local strategies to improve office-based systems that affect medical care.

"The new patient safety curriculum will address several gaps previously identified as contributing to medical errors," said Bernard M. Rosof, MD, FACP, chair of the ACP-ASIM Board of Regents. "In a systems' approach to reduce medical errors, we'll look at communications between physician and patient, and the role of the patient; team training and application of information technology in the office system, and incidents of pharmaceutical drug errors."

The project is unusual, since most research on patient safety has occurred in hospital and institutional settings. "Our goal is no less than to change individual physician's practice in the office setting," said Rosof.

"We're starting with our members, the nation's internists," said William J. Hall, MD, FACP, ACP-ASIM President. "But we believe that the curriculum and procedures we develop will be applicable to a wide audience of primary care and sub-specialty physicians."

The new initiative is the result of a searching examination by ACP-ASIM leaders and committees to determine the College's optimal role in reducing medical error and improving patient safety.

The new ACP-ASIM project has a strong research component. The project will include pre-tests of physicians' information about patient safety, post-tests after participating in one of the new education modules, and a randomized control group, according to Christel Mottur-Pilson, PhD, director of ACP-ASIM's scientific policy department and the project's principal investigator. For more information, contact Dr. Mottur-Pilson at ACP-ASIM headquarters at 800-523-1546, ext. 2513.

ACP-ASIM Working For You!

People often ask me why they should bother to join ACP-ASIM. The reasons are numerous. Things such as education (of both patients and physicians), professional advocacy, and support tools for office management often top my list of arguments. It seems to me that our most valuable products occur when we meld our expertise in all three areas-education, advocacy, and office support-to address important issues such as adult immunizations and end of life care. Keep up the good work national!

Adult Immunizations

In the first week of October, more than 43,000 general internist members of ACP-ASIM will receive free patient education kits to help them prepare for National Adult Immunization Awareness Week, October 14-20, 2001. This kit was developed by the ACP-ASIM Adult Immunization initiative in response to member's requests for materials that prompt patient self-identification and queries about adult immunization. The tools have a central theme of "Show & Tell." They encourage patients to ask their doctors to show them the facts about immunization, and to tell their doctors if they have received immunizations at another location, so their records can be updated. The tools include:

  • The "Show & Tell" patient awareness poster - A 17" x 24" four-color poster for exam and waiting rooms that covers indications for a number of recommended adult immunizations-not just influenza and pneumococcal vaccines. Flyer-sized versions are also provided for doctors who have limited wall space
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  • I've Been Immunized" forms - A checklist that helps patients remember what immunizations they may have received at health fairs, pharmacies, travel clinics or emergency rooms and allows the doctor to update the patient's files. This form also reminds the patient of immunizations they might need
  • Vaccine Administration Records - For physicians and staff to document immunizations the patient has received, and review what immunizations may still be needed

All of these materials are available for download from the Adult Immunization section of the ACP-ASIM Web site at (http://www.acponline.org/aii/), where members can also find background information on the Advisory Committee on Immunization Practices (ACIP) recommended adult immunizations. Members who did not receive the kit in the mailing to general internists can request one for free by calling Matt Smith at 215-351-2602 or e-mailing (msmith@acponline.org).

End of Life Care

In September, the Center for Ethics and Professionalism inaugurated its Patient Education and Caring: End-of-Life (PEACE) Series by releasing three patient education brochures designed to guide patients through various stages of palliative and end-of-life care. The brochures offer clearly-worded advice for patients and caregivers and are suitable for distribution in doctor's offices. The available brochures are:

  • "When You Have Pain at the End of Life"
  • "Living with a Serious Illness: Talking to your Doctor When the Future is Uncertain"
  • "Making Medical Decisions for a Loved One at the End of Life"

Also available is "Improving Your End of Life Care Practice," a tip sheet for doctors, with suggestions on how to identify patients who would benefit from the brochures and tips on how to "break the ice" in face-to-face discussions about sensitive end-of-life issues.

The patient brochures are available at no charge in packages of 50 each from the Center (call 800-523-1546, ext. 2839 or e-mail (ssmith@acponline.org); they can also be accessed and downloaded in PDF format on ACPOnline at (http://www.acponline.org/ethics/patient_education.htm).

For further information on the End-of-Life Care project, contact Lois Snyder, JD, at 800-523-1546, ext. 2835 or email (lsnyder@acponline.org) or see the Center for Ethics and Professionalism Web page on ACPOnline at (http://www.acponline.org/ethics/eolc.htm).

Chapter Meeting

This year, the Idaho Chapter Meeting will again be merged with the VA Medical Center's Annual Retreat. It will be held at the Elkhorn Resort in Sun Valley on January 17-20, 2002. To sign up, call Nancy Williams at (208) 422-1325 or email at (Nancy.Williams@med.va.gov).

It is the 25th anniversary of the VA's training program. To commemorate this, all the speakers will be graduates! Topics include, "Medicine in Brazil", "Veterans' Reflections on the Past Century", "The Language of Medicine", "Adventures in Pathogen Discovery (Including West Nile Virus)", "Health Care Resource Distribution in Rural Areas", and "Channelopathies: From Obscure Disorder to Everyday Diseases". There will also be updates on ACLS, prostate cancer, multiple sclerosis, sleep apnea, Parkinson's disease, and valvular heart disease plus much more. Small group workshops are back by popular demand, featuring renal, GI and cardiac cases.

Contact Information

Banu E. Symington, MD, FACP
Governor, Idaho Chapter
Twin Falls, Idaho

Kelly Hess
Executive Director, ACP Idaho Chapter