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Governor's Newsletter Winter 2001-02

From the Governor

Serafino Garella, MD, FACP
Governor, Northern Illinois Region

A great deal has occurred in our nation since the last newsletter. As a country we have endured a devastating attack. We are waging a war against terrorism. We are in an "official" recession and we are fighting bioterrorism on the homefront. Air travel has become a more laborious endeavor and opening the mail has become dangerous.

Because of the events of September 11th, 2001, the Board of Governors' meeting scheduled for September 13-15 was cancelled. Six of the resolutions that were to be considered at this meeting were discussed and voted upon via the internet (see box). The remaining resolutions will be discussed at the Board of Governors meeting in Philadelphia in April. The Spring BOG meeting has been extended by one day to make up for the missed meeting.

Our Illinois Associates were busy in August with a Fellowship Day. The day was a huge success with four fellowship program directors (Drs. Nikunj Shah, Paul Greenberger, Kenneth Micetich and Nicole Stankus) and over 80 residents from throughout the state. Not only were the residents able to glean important information about applying for fellowship, but they were exposed to the work of the Illinois ACP-ASIM Associates.

Also in August we welcomed into the Northern Illinois Region five new Fellows (Drs. Gopal Madhav, James Rydel, Alfredo Tiu, Martha Twaddle and Cheryl Woodson), eight new Members (Drs. Javier Bogarin-Geymayr, Pamela Cruz-Carandang, Patrick Cunningham, Gulzar Fidai, Shalina Gupta-Burt, John Leventis and Loren Soria) and 27 new Associates (Drs. Radhika Acharya, Amr Al-bacil, Stella Anozie, Anat Aszodi, Anshul Bamrolia, Cherry Chandi, Shailendra Chavda, Indira Chirravuri, Neal Gold, Kristine Hirschfield, Asima Hussaini, Petar Igic, Stephanie Jones, Nazeer Khan, J. Keith Lemmon, Dawn Lombardo, Della Mathew, Alakananda Nagaraj, Yolanda Poradowski, Bassel Ramadan, Nilam Shah, Omar Shamieh, Sophia Siddiqui, Natasha Siddiqui, Afiz Taiwo, Xiaohui Tan, and Dung Nick Tran.

The Illinois Chapter held its Annual Scientific Meeting November 9-10, 2001. In a departure from the usual format it was held in conjunction with the 28th Annual Illinois Associates Meeting. We had a great turnout and the evaluation forms indicated the meeting was informative, timely, interesting and fun! J. Larry Jameson, MD, PhD, William T. Beck, PhD, Olufunmilayo I. Olopade, MD, and Priscilla Short, MD presented information and participated in a panel discussion on the medical implications of the New Genetics. Kenneth O'Riordan, MD gave an update on hepatitis C, Mark Ricciardi, MD presented an update on coronary angioplasty and brachytherapy and Cristiana Rastellini, MD spoke on transplant approaches for the treatment of diabetes. Dale Gerding, MD, FACP and Brian Schmitt, MD, MPH, FACP gave a very instructive and useful lecture on recognizing and responding to bioterrorism. Bernard Rosof, MD, FACP, Chair of the Board of Regents of the ACP-ASIM was our College Representative and brought us up-to-date on College activities. In addition, he chaired a very lively Town Meeting on the certification and re-certification process. Richard Trachtman, Director, Congressional Affairs, ACP-ASIM gave us information about what the ACP in Washington is doing post-September 11th.

The Illinois Associates presented eleven vignettes and eight posters. It was a very tough job for our three judges (Stephen Goetter, MD, FACP, Governor, Downstate Illinois Region, Bernard Rosof, MD, FACP, College Representative and Diane Wayne, MD, FACP, Program Director, Northwestern) to select the winners from these impressive presentations. In the poster competition, Sudhir Kumar, MD from Illinois Masonic Medical Center won with "The Great Imitator: Secondary Syphilis Presenting as Hepatitis in a HIV Patient with Disseminated Mycobacterium Avium-Intracellulare Complex Infection". Patrick Quinn, DO from Lutheran General Hospital won the vignette competition with his presentation on "A Bowl Full of Jelly Gone Bad". Dr. Kumar and Dr. Quinn will represent the Illinois Chapter at the 2002 Annual Session in Philadelphia. Petar Igic, MD from the University of Chicago won second place in the vignette competition with "It's Elemental My Dear Watson" and Jennifer C. Mackinnon, MD from the University of Illinois-Urbana-Champaign placed third with "Neurosyphilis and Successful Treatment with Ampicillin". Nine Internal Medicine Residency Programs participated in the Medical Jeopardy competitions. The three finalist teams were from Chicago Medical School (Mt Sinai Hospital), St. Joseph Hospital (Chicago) and Northwestern University. The winning team, Northwestern, made up of Punit Chadha, MD, Tina Chadha, MD and Lowell Schmeltz, MD will represent the Illinois Chapter in the Doctors' Dilemma Competition at the 2002 Annual Session.

The Awards Dinner was held on Friday night at The Arts Club of Chicago. I had the pleasure and privilege of presenting the Norris L. Brookens Award to the outstanding resident, Alex Auseon, DO from Evanston Hospital and the Chapter Laureate Awards to David Ansell, MD, FACP and Steven Potts, DO, FACP. Dr. Ansell has been instrumental in getting the "All for Health" coalition off the ground. The coalition has succeeded in being one of only two states to increase dollars allocated to tobacco prevention in 2001. Dr. Potts has been the guiding force behind our Illinois Associates for over ten years and the successful coordinator of all of our recent Associate Days. In addition, Dr. Rosof presented both the Downstate Region and the Northern Region with the 2000 Chapter Excellence Awards for meeting the standards determined by the Chapters Subcommittee for excellence in chapter management.

All in all, I would say the 2001 Chapter Meeting was a success. We had about 450 registered participants in the program. The opportunity for Members, Fellows and Masters to interact with Associates and Medical Students seemed to add excitement to the meeting. The Awards Reception (where the vignette, poster and Jeopardy winners were presented) was a huge success with lively camaraderie obvious throughout. Plans are underway for next year's meeting. If you have any suggestions for a topic to be covered or a locale that can accommodate 500-600 people and does not cost a fortune, please call or e-mail the office at 312/435-0484 or nikkikeil@msn.com.

Our Awards Committee was also very active and very successful. At the Annual Session in 2002 in Philadelphia, Drs. Warren W. Furey and Lewis Landsberg (from the Northern Region) and James Dove (from the Downstate Region) will be elected to Mastership in the College. In addition, the free clinic CommunityHealth, 2611 West Chicago Avenue, will receive the Richard and Hinda Rosenthal Foundation Award.

At the Illinois Council Meeting held just prior to the Chapter Scientific and Associates Meeting, John Schneider, MD, FACP, volunteered to serve as the Chapter Leader for Patient Safety. This is a new position being established by the Philadelphia office. Dr. Schneider will serve as the liaison on patient safety issues between the Chapter and Philadelphia. In additions, Dr. Goetter and I as the two Illinois Governors will serve as the Chapter Leaders for Outreach-Media Relations.

In the coming months we will be holding elections for the Illinois Council. The terms of the Secretary, Sara Rusch, MD, FACP and Treasurer, John Schneider, MD, FACP will expire in Spring, 2002. In addition, the terms of Craig Backs, MD, FACP and Janet Jokela, MD, FACP (from the Downstate Region) and Patrick Fahey, MD, FACP, Ashutosh Gupta, MD, FACP, Patricia Russell, MD and Michael Silver, MD, FACP (from the Northern Region) will expire. One Downstate representative and two Northern representatives will be appointed and one Downstate representative and two Northern representatives will be elected. If you are interested in running for any of these positions, please call or e-mail the office at 312/435-0484 or nikkikeil@msn.com.

Let me take this opportunity to wish everyone a Happy New Year and Peace throughout the world.

Election of Illinois Council Members

As mentioned above, there are two available positions for election in the Northern Region and one available position for election in the Downstate Region. If you are interested in running for the Illinois Council, please submit your name, address, phone, and e-mail address to the office at 312/435-0484 or nikkikeil@msn.com or ACP-ASIM, 332 S. Michigan Avenue, Suite 525, Chicago, IL 60604. The term of an Illinois Council Member runs for two years. According to the Bylaws of the Chapter a Member of the Illinois Council is involved in "the management, control, and operation of the affairs and properties of the Chapter". Regular meetings of the Council are held at least twice a year (usually at the Annual Session and at the Chapter Meeting). In addition there may be special meetings or conference call meetings of the Council as needed. There is no compensation for service on the Illinois Council, however bona fide expenses arising out of services rendered are reimbursed.

Governor's Message- Downstate Region

Stephen Goetter, MD, FACP
Downstate Illinois Region

Congratulations to Dr. Garella and Nikki Keil on an outstanding Annual Meeting in November. Dr. Garella's column has summarized quite well the events of that weekend. Let me tell you what is in store for the downstate region.

On May 3rd our Third Annual Associates Meeting will be held in Champaign-Urbana at the Hawthorne Suites Hotel. Although the program is incomplete, there will be clinical vignettes and posters presented by students and residents. In addition, the Annual Challenge Bowl among the three downstate residency programs will again be held. More information will be forthcoming.

The Annual Scientific Meeting for 2002 will be held downstate this fall. We tentatively are looking at October 4th and 5th as the date and Champaign-Urbana as the location, with the Carle Clinic and the University of Illinois Medical School hosting us. It will be a challenge to match the quality and content of this year's meeting but we will try. If you have ideas for meeting content, please contact me at my email address.

As mentioned by Dr. Garella, we will have two openings on our Downstate Council up for election this spring. Janet Jokela, MD, FACP from Urbana, has expressed interest in running for election. Also open are candidates for the position currently held by Craig Backs, MD, FACP from Springfield. Again, contact the Downstate ACP-ASIM or the Northern ACP-ASIM and indicate your interest.

My first eight months on the job have been quite interesting. There are so many matters which require my attention or action; it sometimes is mind-boggling. I hope to do better over the next few months as I become accustomed to the position.

To reach me use either my email address sgoetter@pol.net or the office email, snipsG50@aol.com. If you prefer phone contact, 217/876-5622, is my office number. Have any enjoyable winter season.

Pathways to FACP

Do you feel that becoming a Fellow in the College is out of your reach? I did. When I finished my residency, only the academic, research and published members could reach Fellowship. Times change and so have the requirements for Fellowship. I would like to advance as many interested and deserving internists as we can. Below is a simplified outline on fellowship eligibility. If you meet the criteria and have the interest, please contact us and we will help get things started.

Non-Members

  • Regional reputation
  • Division Chief title
  • > 12 peer reviewed papers
  • > Associate Professor

Members - for Pathways I-III must be:

  • ABIM certified
  • Licensed practitioner
  • > 2 years ACP-ASIM Member

Pathway I (Academic)

  • Associate Professor or candidate

Pathway II (Multi-Specialist)

  • > 2 Board certifications
  • Teaching

Pathway III (ACP Booster)

  • > 10 years in ACP-ASIM
  • Active at meetings, MKSAP

Pathway IV (Senior Star)

  • Excellent internist > 10 years

Summary of Key Points on Certification/Recertication Process Proposed by the ABIM

As all ACP-ASIM Members and Fellows are aware, the ACP-ASIM has been interacting closely with the ABIM to try to modify the recertification process to make it more appropriate and consistent with the aims of the College. As a result, the following statements summarize the present position of the ACP-ASIM.

  1. The role of the medical societies is to provide education.
  2. The role of the ABIM is to evaluate competencies of its diplomats 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.
  3. The ABIM and ACP-ASIM are committed to lifelong learning and recertification.
  4. Requirement of the completion of the modified SEP components of the ABIM will be delayed until after December 31, 2009. Until then diplomats may complete any 5 SEP modules on their own schedule.
  5. 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.
  6. 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.
  7. 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 (PIMs). 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 PIMs if they meet the ABIM's standards.
  8. The ABIM will work diligently to provide a computer-based examination as soon as possible.

To remind you, the core concerns of the College about the process originally proposed by the ABIM are as follows:

  1. The process of recertification should be clinically relevant, not excessively burdensome, and not redundant of things that are already being done in physicians' practice environments (e.g. patient and peer evaluation, practice performance measures and improvement plans.) College members have expressed very strong feelings about this!
  2. There should be a clear delineation of the responsibility for high stakes evaluation (ABIM) and education, including self-assessment (ACP-ASIM and other professional societies.)
  3. There should be a clear articulation of the fact that maintenance of competence requires more than just evaluation periodically. It should also encompass relevant continuing education, taking into account learning preferences of the individual physician.

Bioterrorism Resource Center

The September 11 terrorist attacks precipitated a wave of concern about the possibility of bioterrorism. In an effort to educate physicians and provide up-to-date information on biological terrorism, ACP-ASIM has the developed Bioterrorism Resource Center on the College website (http://www.acponline.org/bioterro/index.html).

The information featured in the Bioterrorism Resource Center is broken down into the following sections:

  • Therapeutic Recommendations for Exposure to or Disease Caused by Biological Weapons - Up-to-date recommendations from the CDC and other organizations regarding treatment, exposure, research, etc.
  • Essential Medical Knowledge - General medical knowledge on biological and chemical weapons
  • News - Current events and news releases regarding bioterrorism
  • Additional Resources - Helpful resources to assist in the gathering of information on bioterrorism; websites, journals, recordings, speakers
  • College Activities - ACP-ASIM initiatives and efforts to aid physicians in the battle against biological and chemical threats.

Board of Regents' Actions on Resolutions from the Fall 2001 Board of Governors' (Internet) Meeting

1. Declining Public Health Infrastructure (1-F01) was adopted and referred to the Health and Public Policy Committee as the lead committee for implementation, with input from the Education Committee. The resolution states that the College should "take a leadership role in advocating for a drive to comprehensively improve our country's public health system and its integration with the rest of the our medical systems." It was also referred to the newly created Task Force on Biological and Chemical Weapons of Terrorism.

2. Evaluation and Regulation of Supplements (2-F01) was adopted and referred to the Health and Public Policy Committee for implementation. The resolution calls for the College to work with Congress and other medical societies to permit the FDA and other organizations to evaluate and regulate supplements as they do prescription medications.

3. Reduce Associates Dues (3-F01), which seeks to reduce Associate dues "as much as is reasonable", was adopted and referred to the Membership Committee for implementation. The resolution recommends to reduce Associate dues "as much as possible".

4. The Board of Regents voted to consider inclusion of medical students on Governors' Advisory Councils (5-F01) a reaffirmation of current College Policy and referred it to the Chapters Subcommittee for follow-up with Governors.

5. Reduction of Mailings to Governors (6-F01) was adopted and referred to staff for implementation. The resolution calls not only for a decrease in the use of paper mailings but for an increase in the use of the GIC for all communications to Governors.

6. Continuation of National ACP-ASIM Support for Governors' Newsletter (8-F01) was adopted and referred to staff for implementation. The resolutions directs the funding of production and distribution costs of up to three Governor's Newsletters per year per Chapter, until such time as electronic communication to a sufficient percentage of members is possible.

Dates to Remember

April 11-14, 2002 Annual Session Philadelphia, Pennsylvania
Friday, April 12, 2002 6:30-9:30 PM Illinois Chapter Cocktail Party
Liberty Ballroom, Salon C Philadelphia Marriott Hotel

May 3, 2002 Third Annual Associates Meeting-Champaign/Urbana

May 21-22, 2002 Leadership Day, Washington, DC

October 4-5, 2002 Annual Chapter Scientific Meeting, Champaign-Urbana