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April 2013


From the Governor

As I enter my second year as Governor of the ACP Indiana Chapter (going from a “freshman” to a “sophomore”) I thought I would share some of the things that we do, as it involves many national activities as well as local ones. Twice a year I attend the Board of Governors’ (BOG) Meeting, once in the fall and once right before the Annual Meeting in the spring (coming up next week). I’m in the “class of 2016” which is when I will end my term. The ACP provides superb leadership training for its Governors and each “class” is grouped together, allowing me to get to know a smaller group of Governors pretty well. Some states (e.g., New York, California, etc.) have more than one Governor because of their large size.

The BOG meetings focus around resolutions submitted by the membership. The BOG discusses, debates and finally votes on these resolutions and decides which ones to move up to the Board of Regents (the College’s policy-making body) for final deliberation. This is one way that the Governors can represent you, the practicing internists, across America. One might refer to the Board of Regents (BOR) as the “central nervous system” and the BOG as the “peripheral nervous system” of the College!

We also have many educational sessions on recruitment, meeting strategies, and how to run the chapter, which is, in essence, its own non-profit business (ACP Indiana Chapter and ACP Indiana Chapter Services are registered with the state as corporations). We do things any business does (pay bills, file tax returns, etc.—although as a non-profit we do not pay taxes).

As we “move up the ladder” we also have the opportunity to be on national committees which help set College policy. This year I was fortunate to have been selected for the Governance Committee.

Each May the Chapter sends a delegation to ACP’s Leadership Day in Washington (May 21-22 this year). This is a superb two-day program intended to educate members about current healthcare legislative issues and gives us an opportunity to go out and meet our legislators in an effort to have our voice heard.

My experience so far as Governor has been an invigorating one—the vast number of enthusiastic, intelligent, and committed people I have encountered (both at the state and national level) has far exceeded my expectations. I thank you for this opportunity.

As always I would like to hear back from ACP members about we can be doing to bring new initiatives to the chapter. I can be contacted at jneal6@iuhealth.org or (765) 747-4350.

J. Matthew Neal, MD, MBA, FACP
Governor, Indiana Chapter

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Internal Medicine 2013 Meeting

April 11-13, 2013, San Francisco, CA

I hope to see many of you in San Francisco at the national meeting. ACP National is always a great time to catch up with colleagues, peruse the displays, partake in fine dining/entertainment, and attend many educational sessions. Wish good luck to our Doctor’s Dilemma team and our poster presenters! I will provide a detailed recap in the May newsletter.

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Indiana Chapter Reception at Internal Medicine 2013

Friday April 12, 2013, San Francisco, CA

If you are planning on attending Internal Medicine 2013, we are having an Indiana Chapter reception on Friday, April 12, from 5:30-7:00 at the Palomar Hotel’s Fifth Floor Lounge (12 Fourth Street, two blocks from the Convention Center). It would be great to see you there—if you are coming please RSVP to Donna Seawards at donnaseawards@gmail.com.

Another highlight of the national meeting is Convocation, where the new Fellows are officially “hooded” signifying induction as a Fellow of ACP. While attending Convocation is not required for Fellowship, I would encourage all the new Fellows to try and attend at a future meeting if you cannot make San Francisco. Marching through the ballroom with the other Fellows is an exhilarating experience!

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Be The Match® National Marrow Donor Program at National Meeting

One of my fellow Governors was recently the recipient of a matched unrelated donor stem cell transplant. It has brought home in a very personal way the fact that life can be capricious and that none of us is immune from a serious health challenge. This year my class of Governors (2016), with support of the ACP staff, is sponsoring a special opportunity that I hope that you will support and take advantage of.

We have invited Be The Match®, the donor registry for the National Marrow Donor Program, to hold a drive at Internal Medicine 2013 to expand the number of donors in the national registry to offer treatment to more patients, like our fellow colleague. These patients suffer from leukemia, lymphoma and other blood cancers. Be The Match® needs donors of all ethnicities so patients of different ancestry have the same chance of survival. About 70% of patients in need of a transplant do not have a matching donor in their family. They depend on the registry to find an unrelated donor. Also, due to medical technology, 75% of donations are peripheral blood stem cell donations, only 25% are marrow donations. To join the registry, you must be between the ages of 18-44.

To learn more about becoming a donor or to make a contribution visit this site. If you are attending, I hope you can find time during your busy week in San Francisco to stop by Booth #1040 in the exhibit hall at the Moscone Center to join the national registry of donors and help save a life.

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Update from Women in Medicine Council

The Women in Medicine Indiana Council is co-chaired by Heidi Lakanen, MD, FACP, and Marla Current, MD. During the Indiana Chapter meeting in November 2012, the WIM council hosted a mentoring breakfast whose topic discussions included time management skills, survival tips for work-life balance, and unique challenges that women physicians continue to face. These gatherings are valuable and rare opportunities for women physicians to connect with fellow women physicians who have similarly busy lives. We look forward to having more opportunities in the future for networking and sharing of ideas, challenges, and thoughts. Potentially this could include an online discussion/forum group or blogging type format. The co-chairs are open to any suggestions from members in this regard. You may email Marla at mschrock@iu.edu or Heidi at HLakanen@IUHealth.org.

If you are planning to attend Internal Medicine 2013 in San Francisco, please consider attending the networking luncheon hosted by the Women in Medicine National Council on Friday, April 12 from 1-2pm in San Francisco Marriot Marquis, GG Section B.

Also consider attending the event hosted by IU Center of Excellence in Women’s Health/ISMA/AMWA/IUSM office of Faculty Affairs called Negotiating the Divide: The Unexplained Trend of Men Earning More than Women: We Can Change This. Food and Drink will be provided at this event and women physicians from all levels of training are invited to attend and participate. The event will be Thursday April 18 at Fairbanks Hall, Room 1110 on the IUPUI Campus, 5:30-8:30pm. RSVP to iucoe@iupui.edu.

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ACP Indiana Chapter Webinar: "Quality and Safety: The GME Challenge”

J. Matthew Neal, MD, MBA, CPE, FACP, FACE
April 25, 2013
6:30 pm - 7:30 pm
Register: https://www3.gotomeeting.com/register/452187246

Objectives:
1. Understand the basics of the accreditation process and reliance on new metrics.
2. Understand basic quality and safety metrics important for the GME program of the future.
3. Understand the importance of integrating quality and safety and consequences of not adhering to current practice guidelines.

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Hold the date for the 2013 Indiana Chapter Meeting!

November 15-16, 2013
The Marten House Hotel & Lilly Conference Center
Indianapolis, IN

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Items of Interest

Studies Show Shorter Shifts Not Helping Medical Residents Improve Patient Safety

USA Today (3/25, Lloyd) reports on two studies appearing in the Journal of the American Medical Association, which found that "a workplace regulation designed to limit hours worked by doctors in training to improve patient safety and enhance medical residents' well-being has backfired and needs to be re-evaluated." According to the researchers, "the shorter shift has not improved young doctors' depression rates or how long they sleep. Most concerning: Medical errors harming patients increased 15% to 20% among residents compared with residents who worked longer shifts." Sanjay Desai, lead author of one study and director of the internal medicine residency program at the Johns Hopkins Hospital in Baltimore, said that "the changes have 'unintended consequences' and have been under scrutiny because there wasn't good data to support them."

The Los Angeles Times (3/26, Morin) reports, "The problem, according to researchers, was that interns were required to do the same amount of work but in fewer hours. Shorter shifts also require more patient 'handoffs' from one doctor to another." Dr. Srijan Sen, a University of Michigan Medical School psychiatrist and lead author of the other study, commented, "It was clear that interns do not function optimally after working 24 hours in a row. So there was real hope that reducing the maximum shift length would help both interns and patients. However, our results suggest that the negative unintended consequences of the reforms may outweigh any positives."

Obama Signals Willingness To Reform Medicare In Budget Deal

In a front-page article, the New York Times (3/29, A1, Calmes, Pear, Subscription Publication) reports on possible progress made between the White House and Congressional Republicans on a deficit-reduction deal. According to the article, "While the two remain far apart on the central issue of new tax revenue, recent statements from both sides show possible common ground on curbing costs of Medicare, suggesting some lingering chance, however small, for a budget bargain." President Obama reportedly "assured House and Senate Republicans during recent separate visits that he could support specific cost-saving changes to Medicare and deliver Democratic votes." Specifically, "participants say, the president told House Republicans that he was open to combining Medicare's coverage for hospitals and doctor services," a move "that would create a single deductible that could increase out-of-pocket costs for many future beneficiaries, but also could pay for a cap on their total expenses and reduce the need to buy Medigap supplementary insurance."

The Wall Street Journal (3/29, A4, Paletta, Subscription Publication) reports that the White House is weighing putting forth a deficit-reduction proposal including major entitlement reforms, a move that some Democrats disagree with because of substantial cuts to Medicare, Medicaid, and Social Security. Reportedly, the main method under consideration is changing the way the Consumer Price Index measures inflation, which would limit both payouts to beneficiaries and growth in tax brackets.

Study: Almost One In Four Doctors Can't Treat Patients Who Use Wheelchairs

Bloomberg News (3/19, Ostrow) reports that research, published today in the Annals of Internal Medicine, has found "Almost one-fourth of doctors are unable to accommodate and treat patients who use wheelchairs more than 20 years after the passing of the Americans with Disabilities Act." The largest cause was the inability "to safely transfer the patient to an exam table," followed by lack of building access. Lead author Dr. Tara Lagu said, "The point of the study is to help doctors realize what the problems are and to help them become more aware of the Americans with Disabilities Act and to identify what the difficulties patients who use wheelchairs are having in accessing health care."

Reuters (3/19, Pittman) reports that to conduct the survey, researchers led by Dr. Lagu attempted to make appointments for a hypothetical patient who was wheelchair-bound due to stroke complications and was obese. The researchers found that 22 percent of the practices called could not accommodate the patient, while another 40 percent would have to transfer the patient to the exam table manually.

The Boston Globe (3/19, Kotz) reports in a 1,000-word story, "More than one in six Boston doctors offices refused to schedule appointments for callers posing as disabled patients in wheelchairs." According to the researchers, who called specialty practices in four cities, "Gynecologists had the highest rate of inaccessible practices in the four cities, with 44 percent informing patients that they need to seek a specialist elsewhere because their offices lacked exam tables that can be raised and lowered, or a lift for transfer out of a wheelchair." The Globe adds, "Practices in Boston denied access to disabled patients about 17 percent of the time, compared with 30 percent in Houston, 27 percent in Dallas, and 14 percent in Portland, Ore."

Bloomberg News (3/29, Runningen) also reports that the President "has proposed, in budget talks with Congress, to cut Medicare spending by $140 billion over a decade by squeezing more savings from drug companies, hospitals and other providers."

Hospitals Expected To Lose $5.8 Billion Under Sequestration

Modern Healthcare (3/29, Kutscher, Subscription Publication) reports, "Hospitals are expected to lose $5.8 billion under sequestration - an amount that could lead to job losses and service cuts, state hospital associations warn." However, "credit rating agencies say the cuts will be manageable for a sector that has demonstrated a keen ability to manage its costs and find new revenue streams. The cuts will most likely impact hospitals with lower credit ratings, which are more reliant on Medicare payments and have fewer reserves to withstand any hit to their operating margins."

Health Plan Affordability Questioned Ahead of ACA Coverage Expansion

As insurers prepare to submit 2014 premium rates to state regulators next month, some stakeholders are questioning whether the Patient Protection and Affordable Care Act will be affordable after all. (MODERN HEALTHCARE)

AHRQ Releases Revised Toolkit Aimed at Curbing Readmissions

The Agency for Healthcare Research and Quality released a revised toolkit hospitals can use to lower their rates of preventable readmissions. (MODERN HEALTHCARE)

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Contact Information

Indiana Chapter Governor:
J. Matthew Neal, MD, MBA, CPE, FACP, FACE
Email: jneal6@iuhealth.org
(765) 747-4350; Fax (765) 751-1451

Donna Seawards
Executive Director
Email: donnaseawards@gmail.com
Ph: 224-356-6101

Chapter Address:
4319 West Clara Lane, PMB #288
Muncie, Indiana 47304