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Governor's Newsletter, Summer 2000

From the Governor

Serafino Garella, MD, FACP

The Northern Region of the Illinois Chapter of the ACP-ASIM has had the good fortune of experiencing a succession of extraordinarily effective and successful Governors. Looking back just at the last twenty years, we find Rolf Gunnar (1980-84), who went on to become the Chair of the Board of Regents and is now Chair Emeritus; Whitney Addington (1984-88), whose career with the ACP-ASIM was actually just beginning at the end of his term and who just now completed a highly successful stint as the College's President; Jim Webster (1988-92), who in addition to leading the Buehler Center for the Aging is presently spearheading the Illinois Ad Hoc Committee to Defend Health Care; and Andy Hedberg (1992-96), who followed his Governorship with his appointment as a Regent.

And then there was Warren Furey. Here are just a few of Warren's major accomplishments during his term as Governor of the Northern Illinois Region, 1996-2000:

  • Between 1996 and 2000, 112 Fellow were inducted and membership increased by 43%, marking Illinois as one of the most rapidly growing Chapters.
  • Five Masters were inducted: Stuart Levin and Quentin Young in 1997; Stephen Kurtides and James Webster in 1999; and Whitney Addington in 2000.
  • The chapter received three Management Awards, one Excellence Award and two Evergreen Awards.

In addition, under his attentive stewardship, Illinois physicians were graced with several Individual College awards:

  • In 1996, Dr. Rolf Gunnar received the Alfred Stengel Memorial Award for Outstanding Service to the ACP-ASIM;
  • In 1999, Dr. Jan Fawcett received the William C. Menninger Memorial Award for Distinguished Contributions to the Science of Mental Health;
  • In 2000, Dr. Bernard Adelson received the Ralph O. Claypoole Sr. Memorial Award for Devotion of a Career in Internal Medicine to the Care of Patients; and
  • Again in 2000, Dr. Kathy Johnson Neely was bestowed the Richard and Hinda Rosenthal Foundation Award.

On a more personal note, I wish to point out some other notable achievements. Drs. Warren Furey and Nancy Lee Furey, MD, FACP, celebrated their 39th wedding anniversary. Their marriage has been blessed with five children, and now with two grandchildren: James Furey McKay, ala "Sweet Baby James," son of Anne Furey McKay, MD and Jonathan McKay; and Grace Kaylee Furey, ala "Amazing Grace," daughter of Peter and Suzanne Furey, recent graduates of Northwestern University School of Medicine, Warren and Nancy's Alma Mater.

It is also important to congratulate Warren on his capacity to survive four CEOs in as many years as Chairman of Medicine at Mercy Hospital. A final accomplishment is in my mind most extraordinary: together with Nancy, he initiated, led and infused tremendous vitality and passion to the movement to pass the Bernardin Amendment to guarantee universal access to health care for the people of Illinois. It is often said that "behind man's success there is a woman hard at work." In the case of the Furey's partnership, I would rather say that Nancy was right there at the side of Warren's success.

The College is now embarking on several difficult and important campaigns, in addition to continuing its long-term goals of improving overall patient care and the education and professionalism of physicians. Whitney Addington, in his eloquent and stirring speech at the Convocation ceremony, highlighted several major goals for the profession. He emphasized the need for continued enhancement of physicians' education and knowledge, coupled with efforts at improving the environment of practice by appropriately modifying burdensome regulations. He presented a compelling and passionate case for universal access to health care, the lack of which is a definite health risk and a medical and social tragedy. Finally, he enjoined all of us, his colleagues, to take better care of ourselves, for both our physical and spiritual needs.

It is clear that, largely as a result of former President Addington, the drive to secure decent health care for all Americans has returned to the forefront of the College's attention and will remain prominent in its agenda. This goal will be accomplished through political action and better education of the public, which will ultimately build into an irresistible demand.

In addition, under the leadership of the new President, Sandra Adamson Fryhofer, MD, FACP, the College will continue its campaign to limit and reverse the problem of increasing bacterial resistance to antibiotics, improve health care for women, and enhance patient safety by reducing medical errors.

I am personally energized and enthusiastic about the possibility I am being offered of working with you in the pursuit of the College's goals in Illinois and in the nation. We will need to work together to achieve them. I know Warren and Nancy will remain active participants and supporters in all the Chapter's activities, most prominently in the movement to advance the Bernardin Amendment and in the recognition of our colleagues through College awards and Masterships. Andy Hedberg, Whitney Addington, Jim Webster and Rolf Gunnar will continue to lend their wisdom, experience and conviction. In addition we will be assisted by the members of the Council and of the entire Downstate Region led by Governor David Steward, MD, FACP.

If we are to continue with the string of successes that the Chapter has experienced in the past, however, the Council and I will need the participation of all of you, friends and colleagues of the Illinois Chapter. We are asking for all of you to help us. You can assist us in many ways. You can encourage other colleagues who are not yet members of the College to join; you can submit your application for advancement to Fellowship, or help others to advance to Fellowship; you can let us know who among your colleagues deserves to be granted one of the Chapter or College awards. You can even help shape the College's stance on different issues by participating in the Resolution process. Most importantly, we ask you to increase your active participation in advancing the College's agenda, which is the agenda that will result in better health care for all.

I look forward to working with you on all these matters, and I thank you for the honor you have granted me.

From Our Past President

Whitney Addington, MD, MACP, Northern Illinois Region

I appreciate the opportunity to write about my year as President of the American College of Physicians-American Society of Internal Medicine. It was a wonderful year. I remain convinced that the greatest assets of the College are the members and reputation. Ada and I have made many new friends and getting to become good friends with individuals such as Dave and Betty Gullen and Munsey and Joan Wheby has been a joy. The Addingtons, Gullens and Whebys are copying the tradition begun by retired Governors and will hold our own annual reunion. I cannot express the pleasure I experienced in speaking at least once a week with Walt McDonald and Jim Bergin. The affection and respect we shared for each other was palpable and reminded me of happy days in the past where physicians spoke primarily of patients, students, house officers and research.

Rest assured that your leadership is painfully aware of the hostile environment that surrounds clinical practices. At every Chapter meeting I listened to horror stories. I was moved and motivated by our members and attempted to stimulate the College to address these difficult issues. I am not alone in believing that we will soon enter a post-market place driven managed care era. The College must assist its members in surviving the current nightmare and provide strong leadership in the future in the reorganization of the Health Care system.

Nowhere was professionalism better demonstrated than in the Decision 2000 campaign. I trust everyone shared my enthusiasm for the College's publication: "No Health Insurance? It's Enough To Make You Sick." The College is the leading professional medical society in advocating Universal Health Insurance and I believe played a large part in returning this issue to the national agenda. The two presidential candidates' recent proposals are totally inadequate, but the debate has just begun. The present lack of political will about uninsured Americans will change if the American public demand it. And the American public is increasingly making such demands.

I shall never be able to adequately express my gratitude to those who have promoted me and supported me in my service to the College as Fellow, Governor, Regent and President. You know who you are and I thank you.

Americans, the medical profession, the College and each of us will do well in the future as long as we remain loyal to our values and to professionalism. Remember what the Frenchman, of all people, de Tocqueville wrote: "America is great because America is good. When America is no longer good, it will no longer be great."

ACP-ASIM's Efforts to Reduce the Hassle Factor

Prepared by the Department of Managed Care and Regulatory Affairs, March 2000

The ACP-ASIM's Department of Managed Care and Regulatory Affairs Department has compiled a comprehensive list, which outlines the College's efforts to reduce the hassle factors faced by physicians. From meeting with the staff of the Department of Health and Human Services (HHS) and the Office of Inspector General (OIG) to influencing pending legislation on physician-assisted suicide, the ACP-ASIM is dedicated to fighting the hassle factor battles for its members.

The following is a sampling of the College's efforts as prepared by its Department of Managed Care and Regulatory Affairs Department. For the complete list, log on to ACP-ASIM Online at http://www.acponline.org/hpp/hassles.htm.

1. Easing Evaluation and Management (E/M) Documentation Requirements:

  • Urged the Medicare Payment Advisory Commission (MedPAC) to recommend that E/M documentation requirements be made less burdensome; ACP-ASIM's recommendations were included in their March 2000 report.

2. Simplifying Claims Processing and Credentialling:

  • Reached agreement on a process that will allow ACP-ASIM leaders to meet regularly with policy-making representatives from the BCBSA and the Health Insurance Association of America (HIAA). Both HIAA and BCBS have recently announced initiatives to reduce hassles affecting physicians. ACP-ASIM has been invited and agreed to participate in both efforts.

3. Opposing Imposition of Mandatory Hospitalist Programs:

  • Persuaded United Healthcare to withdraw its mandatory hospitalist plan in Rhode Island; influenced MCOs in Florida and Texas to withdraw their mandatory programs and make them voluntary.

4. Simplifying Billing for Laboratory Tests:

  • Participated in the negotiated rulemaking committee to develop standard Medicare policies for 23 clinical laboratory tests with the goal of reducing the administrative burden physicians' face when ordering lab tests and to eliminating Medicare carrier policy variability. New proposed rule has been published for comment that incorporates the rulemaking committee's recommendations, including most of ACP-ASIM's concerns.

5. Addressing Concerns about Fraud and Abuse:

  • Achieved revisions in OIG's "Who Pays, You Pay" campaign materials that are more physician friendly, and that direct patients to resolving billing issues with their physicians first, rather than calling the OIG Fraud Hotline. The revised materials note that most physicians are honest and want to work with patients to resolve questions about bills.

6. Improving CPT Codes for Care Plan Oversight Services:

  • The CPT Editorial Panel agreed to an ACP-ASIM proposal, submitted jointly with the American Academy of Family Physicians, that would allow physicians to bill for the time they spend communicating with family and other care decision-makers regarding coordination of care for home health and hospice services.

7. Reducing Other Hassles:

  • Made numerous recommendations aimed at promoting fairness in the way Medicare audits physicians and seeks recoupment of money paid to physicians based on those audits. Met with an independent auditor that prepared a report on ways to improve Medicare's review processes. ACP-ASIM's recommendations also aim to eliminate the elements of the current process that coerce physicians into accepting settlements on Medicare's terms.
  • Provided guidance to HCFA so the agency can ensure all of its Medicare carriers are not restricting patients' ability to be evaluated by an internist (or other physician) prior to surgery.

8. Empowering Physicians to Influence Third Party Payers:

  • Lobbying for comprehensive patient bill of rights legislation (Norwood-Dingell bill) that will provide physicians and patients with greater rights to influence and appeal inappropriate denial of payments. The bill would also prohibit gag clauses, assure that physicians-not MCOs-define what is medically necessary, and allowing recourse to the courts when self-insured plans deny needed benefits. Norwood-Dingell bill was passed by the House of Representatives last year. The College is currently influencing House-Senate conferees to report legislation based on Norwood-Dingell, rather than a weaker version passed by the Senate.

9. Helping Internists Cope with Hassles:

  • The College's Department of Managed Care and Regulatory Affairs and ACP-ASIM's Center for a Competitive Advantage have developed numerous educational resources to help internists cope with requirements from Medicare and private payers in the least burdensome manner possible. Resources include a guide on compliance with federal fraud programs and Medicare audits, a laminated list of ICD-9 codes typically used by internists, and a pocket guide to coding for E/M services.
  • The Department of Managed Care and Regulatory Affairs authors a monthly column in the Observer on coding, coverage and payment policies.
  • ACP-ASIM maintains a toll-free hotline to enable internist-members to get personal assistance in resolving problems with Medicare and other payers. The hotline number is 1-800-338-2746, ext. 4533.

Illinois Council

Ex-Officio Members

President
David E. Steward, MD, FACP
(217) 782-2596; (217) 524-8156 (fax)
dsteward@siumed.edu

Vice President
Serafino Garella, MD, FACP
(847) 723-7194; (847) 696-3391 (fax)
serafino.garella-MD@advocatehealth.com

Secretary
Sara L. Rusch, MD, FACP
(309) 655-7481; (309) 655-3818 (fax)
rusch@uic.edu

Treasurer
John F. Schneider, MD, PhD, FACP
(773) 702-4630; (773) 702-2468 (fax)
jschneid@uhs.bsd.uchicago.edu

Governor-Elect
Stephen R. Goetter, MD, FACP
(217) 876-5670; (217) 877-0596 (fax)
sgoetter@mem.po.com

Council Members

Craig Backs, MD, FACP
(217) 529-1149
(217) 529-4203 (fax)
cbacks@pol.net

Raymond Curry, MD, FACP
(312) 503-9443
(312) 503-7654 (fax)
rcurry@nwu.edu

Gail L. Clifford-Mullen, MD
(618) 244-2754
(618) 244-2604 (fax)
drg28@midwest.net

Patrick Fahey, MD, FACP
(708) 216-3300
(708) 216-0363 (fax)
pfahey@luc.edu

James Foody, MD, FACP
(312) 704-5570
(773) 702-3538
jfoody@medicine.bsd.uchicago.edu

Ashutosh Gupta, MD, FACP
(773) 947-2289
(630) 325-4674 (fax)

Lawrence P. Jennings, MD, FACP
(618) 262-5113
(618) 263-3195 (fax)

Patricia L. Russell, MD
(773) 585-5700
(312) 324-8408 (fax)

Michael Silver, MD, FACP
(312) 942-6744
(312) 563-2157
msilver2@rush.edu

Sunil K. Sinha, MD, MBA
(618) 997-5311
(618) 549-0714
sinhamd@aol.com

Vesna Skul, MD, FACP
(312) 551-1301
(312) 551-4774 (fax)
vs1955@aol.com

Wayne Williamson, MD, FACP
(312) 649-6565
(312) 649-9842 (fax)

Home Stars 2000 - Northern Illinois ACP-ASIM

Athanasios I. Bonoris, MD
Joan D. Boomsma, MD
Barbara J. Brotine, MD
Laurie G. Broutman, MD
May T. Chow, MBBS
Craig S. Conover, MD
David Gerard De Marco, MD
Nancy C. Dolan, MD
Audrey L. French, MD
Robert E. Hirschtick, MD
Nkemakolam A. Iroegbu, MBBS
Octavio M. Lopez, MD
A.K. Mathew, MBBS
James B. McAuley, MD
David B. Neely, MD
Kathy J. Neely, MD
T. Paul B. O'Donovan, MB, BCh
Dennis S. O'Leary, MD
Bhadresh A. Patel, MBBS
Louis A. Piccoli, MD
Dale S. Raines, MD
Robert A. Raines, MD
Rosalind Ramsey-Goldman, MD
Anastasios Raptis, MD
Vera H. Rigolin, MD
William B. Seiden, MD
Leonard B. Siedband, MD
Dean N. Silas, MD
Seshan Subramanian, MBBS
Richard C. Treanor, MD

New Appointments

Janet Riddle, MD
James Sipkins, MD

Advancement to Fellowship

Deadline for Fellowship Applications in Philadelphia - December 1, 2000

Participants in the Annual Session - Philadelphia 2000

Moderators

Whitney Addington, MD, MACP
Inequalities in World Health: Causes & Challenges

Nancy C. Dolan, MD, FACP
Update in Women's Health

William J. Elliott, MD
Update in Clinical Pharmacology and Therapeutics

Norman Farnsworth, PhD
Herbal Medicine: What Works and What Doesn't

Wendy S. Levinson, MD, FACP
Update in General Internal Medicine

Panelists/Workshops

Gail Clifford Mullen, MD
C. Anderson Hedberg, MD, FACP
Marketing Yourself as a "Doctor for Adults"

Diane Altkorn, MD, FACP
Adam Cifu, MD
Keith Roach, MD
Scott Stern, MD, FACP
Update in General Internal Medicine

Dale N. Gerding, MD, FACP
Reducing Inappropriate Use of Antibiotics: What Has worked and What Hasn't

Anita Gewurz, MD
Allegic Reactions to Drugs and Diagnostic Agents

Ellen Mason, MD
Introduction to Medical Complications of Pregnancy (Basic) Medical Problems During Pregnancy

Robert A. McNutt, MD
MEDLINE and Beyond: Introduction
MEDLINE and Beyond: Honing Skills

Izbela J. Roman, MD, PhD
Opportunities for Physicians in the Pharmaceutical Industry: What Do Pharmaceutical Physicians Do?

Meet the Professor

Colin W. Howden, MD, FACP
Helicobacter Pylori: When and How to Treat

John J. La Puma, MD, FACP
Common Problems in Complementary and Alternative Medicine: Food and Nutritional Supplements

Ellen Mason, MD
Infectious Diseases of Particular Concern in Pregnant and Postpartum Patients Rational Use of Contraception

Distinguished Lectures

Robert J. Kapicka, MD
Presentations: Improving Content
Presentations: Making Visuals

MKSAP for Students

Patrick C. Alguire, MD, FACP, Director, Education and Career Development

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 retail price for MKSAP for Students is $32.50, making the publication very competitive against other, lower quality 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.

Community-Based Teaching Participation - Illinois Northern Award Winners

We are pleased to announce the following recipients of the College's Community-Based Teaching Participation Award. This award acknowledges at least two years of office-based teaching of medical students, residents or fellows in internal medicine practices.

David A. Ansell
John Avramidis
Peter J. Bell
Gregory J. Berry
Roland A. Borrasi
Paula R. Butler
Lester Cohn
Antonio J. Delgado
Sandra E. Dempsey
Hanumant Deshmukh
Frederick Ellyin
Axel G. Feller
Ashok Fulambarker
Eric P. Gall
Janice L. Gilden
Walid F. Khayr
Girija Kumar
John A. Kyncl
Miloslava Kyncl
Sheila V. Maliekel
Kenneth R. Margules
Sunita Mohapatra
Emmanuel Nwaokocha
Jennifer B. Ota
Pallavi M. Shah
Mark Tucci

The Richard and Hinda Rosenthal Foundation Award - New Master of the College

Kathy Johnson Neely, MD
Whitney Addington, MD

The Ralph O. Claypoole Sr. Memorial Award

Bernard H. Adelson, MD

ACP-ASIM Teaching in the Ambulatory Setting

Patrick C. Alguire, MD, FACP, Director, Education and Career Development

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. Dr. Ferenchick is currently an associate professor of Medicine at Michigan State University, the internal medicine clerkship director, and a faculty member in the Michigan State University Primary Care Faculty Development Fellowship Program.

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, ext. 2600 and ask for product number 190400100 ($24.95. Shipping and handling extra.)

All Americans Must Have Health Insurance - A Joint Statement

The physicians of America believe that adequate health coverage and access to health care services are vitally important to their patients and to the nation. Despite economic prosperity and substantial job creation during the last decade, there remains a considerable and increasing portion of the American population that does not have health insurance coverage. As a result, those individuals defer obtaining preventive and medical services, jeopardizing the health and well being of themselves and their families. Currently, the US relies primarily on a private, employment-based system to provide health insurance. In the mid-1980s, the percentage of Americans with employment-based coverage began to fall and the country began to experience increases in the number of Americans who are uninsured. From 1987 to 1997, the number of Americans who were uninsured rose steadily from 31.8 million to 43.1 million. During this period, the percentage of people with employer-sponsored coverage dropped from 69% to 64%. The erosion of employment-based insurance coverage and the general decline in the number of people carrying private health insurance has generated a great deal of concern across the nation and in particular to physicians and other health care clinicians everywhere. We acknowledge that lack of adequate health insurance is not the only barrier to accessing health care services - there are numerous other barriers. These barriers include geography, poverty, language, inadequate housing, environment, cultural considerations, and the organization of services. There currently exists an important "window of opportunity" to influence public policy with the upcoming 2000 election. We challenge the 106th Congress and declare 2000 presidential candidates to make the critical issues of health insurance coverage and access top priority. All of the under-signed societies believe all American should have health coverage and consider it imperative to push the issue onto the national agenda, increase public awareness, and set off a public debate of the issues involved. While each of our societies may support, different approaches, we all seek to achieve the same objective: providing all Americans with health care coverage.

Affirmative deals that will guide any future agenda include these three important concepts:

  1. All Americans must have health care coverage.
  2. Health care coverage will contain a benefits package that provides quality care.
  3. Medical necessity determinations made under the benefit package should reflect generally accepted standards of medical practice, supported by outcomes-based evidence, where available. We recognize that these standards will continue to evolve.

There are four core values that should be incorporated into any future policy related to increasing health care coverage:

  1. We place the interest and well being of our patient as paramount.
  2. We support universal coverage that is designed to improve the individual and collective health of society.
  3. We must have an infrastructure that maintains the highest quality of service, education, research and administration of care.
  4. We believe patients, individually and in partnership with their physicians, have a responsibility for their own well-being and health.

We recognize there may be more than one way to finance providing all Americans with coverage. A variety of financing options, including employer funding, individual funding, government funding, or combinations of these options, has been offered as possible "reforms." Expanding the individual's ability to choose among several health insurance options is crucial. We support pluralism of health care delivery systems and financing mechanisms in achieving coverage for and access to health care services. There is a need to reform the current system to provide health coverage for all. We urge all medical societies to join us in advocating for change and working towards moving the issues of coverage and access to the forefront. We agree to the following: (1) to commit our organizations to this issue as a high priority; (2) to keep each other informed of our advocacy efforts, and to coordinate our activities where possible; and (3) to continue this pursuit until our goal of health coverage for all is achieved.

American Academy of Family Physicians
American Academy of Pediatrics
American College of Emergency Physicians
American College of Obstetricians and Gynecologists
American College of Physicians-American Society of Internal Medicine
American College of Surgeons
American Medical Association
American Academy of Cosmetic Surgery
American Academy of Facial Plastic Reconstructive Surgery
American Academy of Neurology
American Academy of Ophthalmology
American Academy of Otolaryngology-Head -Neck Surgery
American Academy of Pain Medicine
American Academy of Physical Medicine and Rehabilitation
American Association of Thoracic Surgery
American Association of Clinical Endocrinology
American Association of Neurological Surgeons
American Association of Orthopedic Surgeons
American College of Allergy, Asthma and Immunology
American College of Cardiology
American College of Medical Quality
American College of Nuclear Physicians
American College of Osteopathic Surgeons
American College of Preventive Medicine
American College of Radiology
American Geriatrics Society
American Osteopathic Association
American Pediatric Surgical Association
American Psychiatric Association
American Society of Reproductive Medicine
American Society for Surgery of the Hand
American Society for Therapeutic Radiology and Oncology
American Society of Abdominal Surgeons
American Society of Addictive Medicine
American Society of Cataract and Refractive Surgery
American Society of Clinical Pathologists
American Society of General Surgeons
American Society of Hematology
American Society of Maxillofacial Surgeons
American Society of Plastic Surgeons
American Urological Association
Association of American Medical Colleges
Congress of Neurological Surgeons
North American Spine Society
Renal Physicians Association
Society for Critical Care Medicine
Society of General Internal Medicine
Society of Nuclear Medicine
Society of Thoracic Surgeons

For Young Physicians

The Young Physicians Subcommittee (YPS) of the ACP-ASIM has developed two new products for young physicians - the Young Physician Practice Management Survival Packet, which provides information about the resources that the College has to offer the young physician in the early stage of his/her career, and the Evaluation and Management Coding Card, which is designed to help the young physician select appropriate levels of service for history, exam and medical decisions-making.

If you would like copies of the survival packet and/or coding card, please contact Jean Elliott, Staff Liaison, Young Physicians Subcommittee, at (800) 523-1546, ext 2692.

Associates' Corner

Illinois Associate ACP-ASIM Clinical Vignette Guidelines

The learning of clinical medicine has always been enhanced by the experience of a physician with a notable patient. The case report format is still an important part of current literature. Dissected to its essential, the vignette emerges as the ACP-ASIM way of leading a colleague into a new concept of emphasizing or extending some well-known one. Several aspects of the Clinical Vignette format are distinctive.

  1. The aim of each report is to transmit a single concept or pearl.
  2. Brevity is the essence of the method; an uncluttered depiction may enter the mind of the tired listener, but negative detail, in the form of traditional or routine data, does not belong here.
  3. How to do it:

    a. Competitive Selection: All housestaff who are Associate Members of the ACP-ASIM and who have potential cases should submit one-page abstracts. The required format for abstracts is available on our website. Each institution should choose one vignette, with a second one in reserve. Vignettes must be actual cases seen by the presenter.

    b. Scope: Material is chosen that is timely and instructive for the planned audience. Presentations from other than medical services have been well received.

    c. Timing: An absolute essential for success of this format is rapid movement. Audience attention spans are short, and each sentence of each presentation must contribute. Irrelevant data are deadly. Since house officer writing tends to be excessively drawn out and cliché, editing is necessary. Few of us are so gifted as to give ad lib presentations; residents should be urged to write out their entire offering and not work from slides. There is a strict time limit of five minutes for each vignette.

    d. Slides should be used for illustration only; show a patient, a lesion, operative findings, histology, a flow diagram, etc., but not the H&P. In short, slides are to show, not to narrate.

    e. Other media such as video can be used when appropriate, e.g., gait disturbance, hemiballismus, a tic, a fit, etc.

    f. Rehearsal is essential for a program of high quality. It is the only way to obtain and keep control of the all-important timing, to delete bad slides, to prune unnecessary data, etc. All presenters will be seated in the front row, in order of presentation. This reduces "dead air" - the vacant interval between presentations - and keeps audience attention at a high level.

  4. Suggestion. A well-prepared vignette also anticipates and deals with questions that might occur to a competent listener; and the importance or significance of the anecdote should emerge unaided. Don't allow questions or comments - keep it moving! There will not be time for formal questions or comments following the presentations.
  5. Judging and awards will be based on:

    a. Teaching value

    b. Clarity of presentation

    c. Academic content

    d. Originality

  6. Abstracts: The abstract should be typed and not exceed 200 words. Include your name, your associate member number (from the label on your Annuals), your institution, mailing address, a contact phone number and the title of your presentation. The abstracts from the competition
    will be published on the website. The deadline for submission of the abstract is Wednesday, September 6, 2000. Please fax the abstract with the required information to (312) 435-0487.

Our vignette competition is one of the highlights of each year. Win or not, vignettes are memorable, a great way to learn and have fun! Join us!

Associates' Day

Please note that Associates' Day has been changed to Wednesday, October 4, 2000, Searle Conference Center at Rush Medical School.

Contact Us

Administrative Assistant: Nikki Keil
ACP-ASIM
332 S. Michigan, #525
Chicago, IL 60604
Phone: (312) 435-0484
Fax: (312) 435-0487
E-mail: nkeil@dellnet.com