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Governor's Newsletter - Fall 1999

From the Governor

For the past couple of years the Illinois Chapter of the ACP-ASIM has had a single Governor's newsletter, produced with variable contributions from the three Governors, other members and staff. The newsletter came from the Northern region office, where Nancy Furey, MD, did a lot of the basic editorial work, and has been sent to all members in both the Northern and Downstate regions of the Chapter. With this newsletter, I hope that tradition will change and that at least twice a year, the Downstate Region will sponsor its own newsletter, created by Downstate members and sent primarily to them.

The time is right for this new effort. The merger of the ASP and ASIM and the corresponding merger of the state versions of these groups, kicks off a new era in our organization, with hopes that internists, both generalists and subspecialists, can speak with an increasingly unified voice. The numbers and the influence of Downstate internists continue to grow, along with our need to relate effectively among each other across our large geographic area. The particular interests and needs of internists "below I-80" differ in more than just latitude from those of our northern compatriates. In fact, these differences may be widening somewhat due to circumstances beyond our direct control - such as managed care issues; the difficulty delivering higher tech, more elaborate care in rural areas; and the problems facing some of our rural hospitals. And, the source of our new members - our medical students and residents in Peoria, Champaign, and Springfield - have, in the last couple of years, become more interested and active in ACP-ASIM activities as well as in internal medicine as a specialty. A newsletter by Downstaters for Downstaters should play an important role in finding new common ground, learning about the College and our colleagues, and giving the ACP-ASIM a more visible role in the lives of present and future Downstate internists.

Does this mean that we forever silence our Northern Region partners, never to hear from them again? I don't think so. We still have much to gain from belonging to the same Chapter, and sharing a newsletter now and then is a good way to stay in touch. So, for now, about half the time, we'll have a Downstate newsletter and the other half, we'll have a single mutually produced edition.

For future editions of the Newsletter, all members of the Downstate Chapter are invited, or urged (or begged?) to suggest or submit items of interest, news items, poetry, fiction, opinion pieces, or whatever, to make this a truly Downstate product. The "editorial staff" will be contacting some of you with assignments and requests - thanks in advance for your gracious willingness to produce!! With your help, we'll have this on the newsstands right on time.

So, welcome to a revitalized Downstate Newsletter, hot off the presses. And, happy reading!!

David E. Steward, MD, FACP
Governor, Illinois Downstate Region

Illinois State ACP-ASIM Scientific Meeting

Over 200 ACP-ASIM members and others gathered in Oak Brook, Illinois, October 8-9, 1999, for the 1999 Illinois ACP-ASIM State Scientific Session. They were treated to a remarkable meeting that spanned a range of important topics from basic science to clinical practice to the social imperative for improved access to healthcare coverage for all.

The meeting included presentations about basic clinical skills such as advising patients about screening and preventive care (reviewed by Dr. Gary Martin), and listening to the heart (presented, with audio heart sounds, by Dr. George Kondos). The popular "Multiple Small Feedings of the Mind" program included four outstanding speakers (Drs. Diane Altkorn, Jim Graumlich, Robert Kushner and John Phair) with focused, highly useful advice for practicing physicians. Drs. Paul Carryon and Vivian Levy contributed their perspectives about the unique problems of minority populations in Chicago and our college representative, Dr. Charles Francis, discussed the national under-utilization of health care services by minorities.

On Saturday morning, we were enlightened and entertained by a great "Professor in Action" session with Stu Levin, MD, and Jim Webster, MD. The town meeting focused on issues of the uninsured. In a fashion that could not be reproduced anywhere but Illinois, a range of speakers, including Whitney Addington, MD, ACP-ASIM President, and a range of perspectives, were heard to address our country's most important healthcare problem.

Several other important events occurred around this meeting. John Clarke, MD, Holly Humphrey, MD, and John Schneider, MD, won Laureate Awards of the College, and Dr. Gail Mullen of Mt. Vernon, received a national award for her public speaking on behalf of ACP-ASIM.

And, prior to the meeting, the Council of the Illinois Chapter of the ACP-ASIM met and approved the latest, corrected version of the new bylaws for the merged organization. In follow-up, immediately after the meeting on Saturday afternoon, the Illinois Society of Internal Medicine Governing Council also met to disband the Illinois Society of Internal Medicine in favor of the newly merged organization. These actions complete the details of the merger and will lead to the official election and appointment of the new, combined state wide council that is called for in the newly-approved bylaws.

In all, the meeting was exceptionally well received, and is evidence of the remarkable depth and breadth of quality and talent within our state organization.

Warren Furey was responsible for organizing this meeting and deserves our heartiest congratulations for a spectacular result. We look forward to next year's meeting at the Springfield Hilton Hotel, October 13-14, 2000.

Report from the ACP-ASIM Board of Governor's Fall Meeting

"Altitude changes Attitude" - from the Asheville, North Carolina Chamber of Commerce tourism brochure.

The ACP-ASIM's 1999 Fall Board of Governor's meeting was held at the Grove Park Inn Resort in Asheville, North Carolina, September 30 through October 2, 1999, and was attended by 95 Governors, 22 Governors-elect, assorted other speakers, staff and a few Regents. The BOG meets twice a year, in the fall and again just before the Annual Session in the spring. These meetings serve several purposes - resolutions are debated and voted upon; important issues and initiatives of the College are discussed, with Governors receiving a lot of information and some "marching orders"; and Governors get to see each other, compare notes, commiserate and hear some new ideas. This meeting was the best of the four I've attended - more interesting and substantial, and better organized that the others - perhaps because the "merger" is much farther along now and doesn't dominate the meeting. Here's a summary:

Day One

The BOG meeting opened with a "Leadership Update" from Executive Vice-President, Walt McDonald, MD, who described the ACP-ASIM's need to improve relations with subspecialists and their organizations. He also reviewed the issue of "patient safety" that may become a College theme in the future. (If you don't understand what "patient safety" means, join the club - it seems to be a catch-all term covering adverse iatrogenic/nosocomial events, physician competence and credentials, and protection of patients from abuse.) Whitney Addington, MD, ACP-ASIM President, followed with a challenge to keep universal access to health care as a leading public policy issue for the College and for our Chapters.

The BOG then heard a scary, but very good presentation by Merle Sande, MD, and Ralph Gonzolez, MD, about the growing dilemma of antimicrobial overuse and resistance. This is the College's "theme" for this year, and a number of efforts are underway to address it, including providing speakers for Chapter meetings and plans to focus on this topic at the Annual Session in April.

Testimony about resolutions, workshops and other small group meetings completed Day One.

Day Two

There were three highlights of Day Two. First was a superb session entitled "On Being a Doctor," with excerpts from the Annals of Internal Medicine series of the same name, and a moving presentation by our own Warren Furey, MD, aptly described by the moderator as "one of the great good men" in the College. Second was a pair of presentations by representatives of the Council of Student Members and the Council of Associates (residents). These Councils are fully operational, representing over 30,000 of the ACP-ASIM's 110,000 members, and their leaders play an active role in meetings of the Governors and Regents. And third was the always effective and interesting "Washington Report" by Alan Nelson, MD and Bob Doherty of the ACP-ASIM's Washington Office. They described current hot legislative topics - some of which are already old hat, like patient's rights and Medicare reform. They also noted their office's crucial interactions with the Inspector General's office to re-cast the "Fraud and Abuse" campaign by the OIG into a (hopefully) mutually beneficial effort to improve how physicians can easily and accurately document their work.

Day Three

The two main events of Day Three were the debate/vote on resolutions (reviewed elsewhere in this issue), and a discussion of collective bargaining for physicians. The collective bargaining issue provoked vigorous debate and commentary, with recognition on the one hand that some employed physicians may have little voice in their relationship with their employers without some sort of collective bargaining effort; countered on the other hand by concern that we must avoid using collective bargaining solely to promote physician self-reward, to the potential detriment of our patients. The ACP-ASIM has devised a policy about this which can be found on the organization's web page.

If you would like additional information about any of these issues, please let me know.

Resolutions at the 1999 Fall Board of Governors' Meeting

3-F99 - RESOLVED, that the ACP-ASIM solicit reports from the various states on the effectiveness of their efforts to address tort reform. The College should periodically prepare a report making this information available to chapters and regions.

Comment - this resolution evolved from an original proposal to advocate for putting plaintiffs' attorneys at financial risk for unsuccessful lawsuits.

4-F99 - RESOLVED, that ACP-ASIM continue to develop an expedited application process and a shortened time frame for accreditation of local CME programs.

Comment - New York Governors, the proposers of this resolution, previously had access to CME accreditation through the New York Society of Internal Medicine, but this was lost in the ACP-ASIM merger. The above resolution addressed their concerns to a degree, but perhaps will not solve their problem of getting "one day" turnaround for CME approval of their programs.

6-F99 - RESOLVED, that ACP-ASIM advocate that a direct physician-patient relationship remain inviolate and that the use of the Internet for prescribing should facilitate, not circumvent, that relationship; and be it further RESOLVED, that ACP-ASIM advocate that Internet prescribing occur only in the context of an established physician-patient relationship.

Comment - a late submission, this resolution was directed specifically at shady drug sales [i.e., phen-fen, or Viagra] over the Internet. The two-part resolution resulted from some concerns that the first statement was not strong enough or specific enough.

The resolution regarding recertification was referred to the Education Committee for further study. As you recall, the original resolution had two parts, the first reinforcing our support for a recertification process, and the second stating that failure to recertify should not result in loss of credentials or privileges at any institution. In general, the Governors were not comfortable that these two resolutions were, as they were written, compatible with each other. The issue seemed, finally, to focus on the validity of the recertification process - many Governors seemed to think that the current process had very little relationship to whether a physician was really competent or able to practice good internal medicine.

Resolutions not adopted included a "campaign reform" resolution that did not reflect a clear consensus of the Governors, and was felt to be over-extending the agenda of the College; and a "national and chapter dues" resolution that was withdrawn by the proposers with the consent of the Board of Governors because the issue is already under active study by at least two College Committees.

Upcoming ACP-ASIM Events

April 13-16, 2000 - Philadelphia, Pennsylvania, ACP-ASIM Annual Session

May 18, 2000 - Springfield, Illinois, Illinois Downstate ACP-ASIM Student/Associate/New Member Meeting

Summer, 2000 - Marion, Illinois, Primary Care CME (co-sponsored by (Date TBA) Marion VA, SIU and ACP-ASIM)

October 20-21, 2000 - Springfield, Illinois, Illinois ACP-ASIM State Scientific Meeting

Public Policy Committee

By: Craig Backs, MD, FACP

Dr. Steward, Governor for the Downstate Illinois Chapter of ACP-ASIM, has asked me to chair a Public Policy Committee for the Downstate Chapter. This Committee will review and formulate recommendations to the Governor and to the soon to be formed governing Council of the Illinois Chapter of ACP-ASIM.

I would like to have a spectrum of internists on the Committee to represent the diverse types of interests in internal medicine including generalists, specialists, academic and community physicians. I have spoken with a couple of members who have an interest, but I would hope to attract the interest of 8-10 members to have a productive Committee.

I am particularly interested in addressing, in practical and meaningful proposals, the development of a system for universal access to quality health care for all our patients. There is no reason that the seeds for such an ambitious project can't come out of Downstate Illinois.

I will also be interested in addressing the reimbursement and overhead cost issues that uniquely affect the internist. Issues relating to financing of medical education at the pre and post-graduate level will also be a focus of this Committee.

I would hope to have an initial meeting soon after the first of the year, probably in Springfield, at a time such as a Saturday morning/early afternoon.

If you are interested in active participation in this Committee, please send your name and CV to Dr. Steward, so that we can inform you of the time and location of the first meeting.

Connect With Members Through ACP-ASIM's New Online Directory

Do you need to correspond with a member of the College, but find that you don't have his/her current mailing address? Use Member Connection, the College's new online membership Directory, which is accessible to members-only via ACP-ASIM Online.

Updated daily, the information in Member Connection is taken directly from the College's main membership database and can be used to search for colleagues by name, state, city, zip or postal code, country, region or specialty.

Members who wish to be excluded from Member Connection must notify the College in writing. Members can obtain a Directory Exclusion Form on ACP-ASIM Online, or by calling Customer Service at (800) 523-1546, ext. 2600, or (215) 351-2600 (9 a.m. to 5 p.m. EST.)

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, the increase in activities at the local level has created the need for additional 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.

David E. Steward, MD, FACP
Governor, Illinois Downstate Region
Southern Illinois University School of Medicine
P.O. Box 19230
Springfield, IL 62794-1311
Phone: (217) 782-2596
Fax: (217) 524-8156
E-mail: dsteward@siumed.edu