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Governor's Newsletter - Spring 1999

Message From the Governor

Political Action Committee and the ACP-ASIM

Dear Colleagues,

I write this note from my hotel room in New Orleans during a break in the action at the ACP-ASIM Board of Governors meeting. Among the issues freshest in my mind is the discussion about the College establishing a Political Action Committee (PAC).

Last fall, the Board of Governors voted, by a considerable majority, to advise the Board of Regents to authorize the formation of a PAC for the organization. I supported the measure, though I have not felt entirely comfortable with the decision to do so. The Board of Regents, which ultimately decides College policy, voted to enter a thinking and information-gathering phase, including requesting clarification from the Internal Revenue Service, before voting up or down PAC formation. Viscerally, I do not like the impact that I perceive PAC's have had on the American political process. Had the issue ended there, I would have voted no on the PAC issue. However, I feel pretty naïve in the ways of politics. Many bright and savvy colleagues on the BOG, who seemed to me to know more about working with legislators than I, advocated that a PAC be endorsed, that a PAC would provide the College with yet another tool to use in its advocacy efforts. In the end, I accepted their arguments and not the advice coming from my viscera.

Actually, I welcome the Regents' decision to pause before deciding definitively on this issue. It gives me the opportunity to try to solicit input from all of you on the issue. I would like your input whether you care or not about the issue; even knowing you don't care one way or the other will be useful feedback. Please take the time to give me advice and to inform me about your opinions on the issue. Check a box on the survey form on the last page of this newsletter. Add a comment if you want. And I would appreciate feedback from everyone, including our associate members.

This newsletter contains information on resolutions passed at the spring Board of Governors meeting. Also, you can learn the outcomes of recent chapter elections, see who are the new members on our chapter committees, read about the committees' recent activities, find out who among your colleagues were recently advanced to Fellowship in the College, and get updated on Associates' activities.

I hope you find this newsletter worth at least a quick review, and please complete the survey on the last page.

Sincerely,

Richard B. Kohler, MD, FACP

Election Results

Governor

Our new Governor, beginning in April, 2000, will be Ray Dunkin. For those of you who do not know him, Ray is a pulmonologist in private practice in Indianapolis. He is senior member of a group that includes eight pulmonologists, five oncologists, three allergists, and three general internists. The group provides patient care at multiple sites in central Indiana, including in Indianapolis, Danville, Kokomo, Noblesville, Tipton, and Crawfordsville. Ray is Clinical Professor of Medicine at the IU School of Medicine and is a longstanding volunteer faculty member.

Ray attended this year's Board of Governor's meeting and has begun the process of transition to leadership, learning how the College and the Board of Governors works and developing a sense of the issues that he will face as Governor. I congratulate Ray on winning the election and look forward to the perspective he will bring to our Chapter and to the Board of Governors from his many years of practicing privately.

At the same time, I would like to thank Rose Fife for her willingness to run for election and to serve if elected. To have been nominated by her peers in the Chapter is a testament to the high esteem we have for her.

Chapter Council

The winners of elections for Chapter Council seats have already met several times since the results became official on December 13, 1998. The new council members are:

219 area - Northern IndianaFrank Byrne
765 area - Central IndianaCharles Routh
317 area - Indianapolis MetroRobert Lubitz
812 area - Southern IndianaCaitilin Kelly

IU School of Medicine - Mary Ciccarelli

At-large 1 - Ramon Dunkin

At-large 2 - Robert Rudesill

The other current council members are:

At-large 3 - Cheryle Southern

Associate member - Eric Milbrandt

Governor - Yours truly

The Council has taken the following actions at its first three meetings:

• Decided to hold a strategic planning retreat for Council members and committee chairs. This will occur in June.
• Obtained legal review of, and approved, the new chapter bylaws that must now be forwarded to the College Board of Regents for approval.
• Decided to leave the Chapter dues at $25 per year for the upcoming year.
• Approved a budget for the next year.
• Elected Robert Rudesell as the new Council treasurer, a post he has held in the ISIM.
• Voted to retain Carolyn Downing on contract with the Indiana State Medical Association to handle a number of administrative duties.

New Chapter Committees

The Council has endorsed the appointments to several chapter committees. These include:

Awards Committee

Robert Robinson (chair) (Indianapolis), Barbara Backer (LaPorte) and Jean Creek (Bloomington).

Health and Public Policy Committee

Caitlin Kelly (chair) (Bloomington), Linda Abels (Indianapolis), Neal Irick (Indianapolis), Lois Lambrecht (Bloomington), Michael Mirro (Fort Wayne), Clay Molstad (Indianapolis), Kevin Neese (Evansville), James Poulos (Lafayette), James Richardson (Indianapolis), Cheryle Southern (Indianapolis) and Gregory Sutliff (Bloomington).

Education Committee

Bradley Sutter (chair) (Indianapolis), E. Ray Knight (Jeffersonville), Robert Lubitz (Indianapolis), Eric Milbrandt (Indianapolis), David Kay (Goshen), Richard Dexter (Indianapolis) and Cheryle Southern (Indianapolis).

Other Committees

The Credentials Committee must be formed. The Council is also considering the establishment of a Communications Committee responsible for the facilitation of communications between the Council and Chapter members. At the present time, Associate Joe Koss (Muncie) manages the Chapter web site.

Chapter Associates Council

Eric Milbrandt (chair; PGY 3, St. Vincent), Michael Sha (chair-elect; PGY 2, IU), Malathi Srinivasan (PGY 4, at-large), Chris Karras (PGY 3, Ball), Joe Koss (PGY 2, Ball), Debbie Harp (PGY 1, Ball), Cliffton Bong, (PGY 3, IU), Ayesha Khan (PGY 1, IU), Melanie Bozard, (PGY 3, Methodist), David Zimmerman (PGY 2, St. Vincent) and Angela Biltimier (PGY 1, St. Vincent).

Summary of Committee Activities

Awards Committee

Submitted by Robert Robinson, Chair, Chapter Awards Committee

The Awards Committee has proposed to the Council two names of nominees for the Chapter 1999 Laureate Awards and of a member for advancement to Master in the College. The Council has accepted the Awards Committee report.

Health and Public Policy Committee

Submitted by Caitilin Kelly, Chair, Chapter Health and Public Policy Committee

The HPPC met on 3/18/99 by teleconference. About half the committee's members were able to attend this, the first, meeting. The Committee will try to meet at least six times per year.

The group set the following goals:

• Increase our involvement with the Medicaid Advisory Committee and the Indiana Medicare Carrier Advisory Committee. We already have an HPPC member attending both of these committees. We will try to solicit Chapter members' concerns, set priorities, and bring prioritized concerns to these committees. We will try to inform members of the relevant activities of these two important advisory committees and our HPPC's interactions with them.
• Discuss submitting a resolution to the Indiana State Medical Association requesting voting privileges for specialty sections within the ISMA House of Delegates.
• Serve as a source of expertise to the public and our state legislature.
• Maintain awareness of, and support, ACP-ASIM health and public policy goals, which hope fully will be facilitated by the new national ACP-ASIM electronic Chapters Health and Public Policy network.

Education Committee

Submitted by Brad Sutter, Chair, Chapter Education Committee

The Chapter Education Committee has been working hard to put together an excellent meeting for this fall. Our Committee report will consist of the tentative agenda for the Indiana Chapter Meeting.

This year's Chapter Meeting will be held at the downtown Hyatt in Indianapolis on Friday, November 19 and Saturday, November 20. The Associates will hold their meeting on Thursday afternoon, November 18 and that agenda appears on page 9. The tentative agenda follows:

The meeting registration fee will be $65. Registration forms will be sent out in about 6 weeks. Individuals wishing to register now may do so by calling Shelley Tyler at (317) 274-3628.

New Fellows Inducted Into the Chapter in New Orleans

Congratulations to the following 15 Chapter members who are now officially Fellows in the College by virtue of a) meeting the criteria for fellowship in the College, b) submitting the necessary documentation, and c) attending the induction ceremony at the Convocation of the College's Annual Session.

Summary of Resolutions Passed at the April 1999, Board of Governors Meeting

The Board of Governors acted on 20 resolutions at the spring Board of Governors meeting. Those that passed are summarized below.

The ACP-ASIM should:

1. Develop a mechanism to communicate to the ABIM certain concerns about the current recertification process.
2. Study further the advisability of adopting a policy condemning the endorsement or sale for profit of non-prescription goods from physicians' offices.
3. Develop guidelines for informing the College electorate about candidates nominated.
4. Develop a mechanism to document content area of CME credits earned through the College to address specific content area requirements established by some credentialing entities.
5. Urge delay in implementation of HCFA's evaluation and management documentation guidelines and give HCFA an opportunity to reconsider its approach and regain the confidence of American physicians.
6. Oppose performance-based contract requirements that create inappropriate incentives for identification of payment errors and require HCFA in its contracts with Professional Review organizations to use the consultative and educational use of Continuous Quality Improvement Projects as the means of payment error prevention.
7. Develop by-laws that permit state chapters to consolidate into single entities capable of unified activities and advocacy.
8. Advocate for policies that insure access to and reimbursement for integrated medical and psychiatric care.
9. Encourage all medical schools to integrate geriatric education into the overall educational experience.
10. Seek legislation to require health care organizations to provide adequate advance notice of formulary changes.
11. Advocate to the appropriate entities that methadone be considered no differently than any other DEA Schedule II agents.
12. Strongly encourage the study of the long-term impact of genetic engineering on the food supply and human health.
13. Encourage the Royal College of Physicians and Surgeons of Canada to approve the MKSAP as an acceptable form of self-learning study credit for internists to maintain RCPSC certification.
14. Work with the AMA and HCFA to require all Medicare carriers to include the fee schedule for office laboratory tests in the "Enrollment Package and Physician Fee Schedule" for Medicare Part B each year.
15. Oppose the mandatory use of hospitalists.

These resolutions will now go to the Board of Regents for further action that may consist of acceptance, rejection, or referral to committee and/or staff for further study and recommendations.

Indiana Internal Medicine Resident to Chair the National Council of Associates

Eric Milbrandt will chair the national ACP-ASIM Council of Associates (COA). Eric is a 1996 graduate of the IU School of Medicine and a third year internal medicine resident at St. Vincent Hospital. This July he will begin a fellowship in pulmonary and critical care at Vanderbilt University in Nashville, Tennessee.

As the COA Chair-Elect, Eric will work with other Council members to represent over 24,000 resident and fellow members of the College, expressing COA opinions and resolutions as a voting member of the Board of Governors. After becoming COA Chair at Annual Session 2000, he will continue to promote Associate issues as a voting member of the Board of Regents.

Indiana Associates Activities

Submitted by Eric Milbrandt, Chair, Chapter Associates Council

The Indiana Associates Council has been very busy! Planning for the Fall Associates meeting is well underway (see below) and will again be held in conjunction with the annual Chapter meeting at the downtown Hyatt. This year's meeting will include a job fair, several hands-on workshops, and a Jeopardy-style medical trivia competition between residency programs. Other Council activities include a free clinic volunteer's resource guide, a medical student mentoring project and a Habitat for Humanity house-building day.

Nominations for the Associates Council will be received at the beginning of the academic year, July and August 1999. Newly matriculated interns are eligible to be elected for a three-year term. Please contact your program representatives for details on the election process.

Indiana Associates Meeting Agenda

Mark Your Calendar

1999 Indiana Chapter Meeting
Hyatt Regency Hotel, Indianapolis
Friday, November 19 and Saturday, November 20, 1999
Friday Evening Reception and Special Activity To Be Announced
6:00 - 9:00

Stephen Anderson, MD, FACP (South Bend)
David Cheng, MD, FACP (Indianapolis)
Judith Culpepper, MD, FACP (Indianapolis)
Fred Frick, MD, FACP (Indianapolis)
James Heckaman, MD, FACP (Fort Wayne)
Sunil Juthani, MD, FACP (Fishers)
Steven Kaiser, MD, FACP (Muncie)
Habib Komari, MD, FACP (Indianapolis)
Barry Krieble, MD, FACP (Indianapolis)
John May, MD, FACP (Indianapolis)
Lee McKinley, MD, FACP (Bloomington)
Frank Messina, MD, FACP (Indianapolis)
James Neal, MD, FACP (Muncie)
Cheryle Southern, MD, FACP (Indianapolis)
Vance VanDrake, Jr., MD, FACP (Fort Wayne)

I know with certainty that many other members of the Chapter meet the qualifications for advancement to Fellowship in the College. If you would like my views on the suitability of your own proposed advancement, please contact me.

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