Governor's Newsletter
Summer 2001

Ramon S. Dunkin, MD, FACP
Governor, Indiana Chapter

Governor's Column

This Spring I've had the privilege of participating in several ACP-ASIM activities: the Board of Governors meeting and Annual Scientific Meeting in Atlanta, and Leadership Day in Washington, DC.

A record number of resolutions (thirty-six) were introduced and voted on and thirty were sent to the Board of Regents for action (see pages 5-6 for more details.) Refer to the ACP-ASIM web page for the actions taken. These resolutions addressed many concerns of academic centers, physician in private practice, and our patients. I appreciate the input from many of you regarding the resolutions.

The ACP-ASIM leadership continues to work with the ABIM to reduce the onerous aspects of the initially proposed process of "Continuous Professional Development," for recertification and has gained several concessions thus far, including delay in implementation.

The Annual Scientific Meeting again impressed me with the quantity and quality of sessions offered. As a sub-specialist I took advantage of many sessions outside my field in an effort to broaden my horizons. I would encourage other sub-specialists to attend the annual meeting.

Dr. Cheryle Southern and I went to the Annual Leadership Day in Washington, May 8 and 9. We received a full day of orientation about the current legislative atmosphere in DC and status of health care legislation of concern to our membership. I was impressed at the progress being made on measures that ACP-ASIM has championed and helped influence such as the Medicare Education and Regulatory Fairness Act (MERFA), which addresses the hassle factors plaguing all health care providers, the Bipartisan Patient Protection Act (patient bill of rights, the REACH bill, which provides health insurance for many of the uninsured through tax credits, and a bill to provide prescription benefits for Medicare recipients.

On May 9, Dr. Southern and I visited with the healthcare aides of six of our Indiana legislators, presenting ACP-ASIM's views on the above bills, and left fact sheets with the aides. Representative Julia Carson graciously left a conference meeting to spend several minutes with us. This was my first experience at Leadership Day, Dr. Southern's third. Both of us felt we had learned a lot but probably hadn't influenced the legislators much. They need much more input from our members and our patients ­ so write letters, send e-mail, call, go to town meetings when the legislators are back in Indiana, and encourage your patients to do the same. As we were reminded in DC, "All politics is local" and "Politics is not a spectator sport."

None of the legislative aides we met with indicated that they have physician advisory committees in Indiana and said they would appreciate having names of physicians that they could contact in their district, regarding health care concerns. If any of you are interested please notify your Congress person, or let me know and I'll relay the information.

Evergreen Award

ACP-ASIM Evergreen Awards are given each year to a few state chapters which complete projects or programs that enhance the organization's membership, advocacy, diversity, or student or Associate activities. At the Atlanta Board of Governors meeting, our Chapter was given an Evergreen Award for our Associates' Annual Meeting. This was accomplished almost entirely by the Associates under the leadership of Dr. Michael Sha, a resident at IU. Michael will be the next chairman of the National Council of Associates, following in the footsteps of two other IU representatives, Eric Milbrandt and Holly Mattix.

New FACP'S

Six Indiana Chapter members who have advanced to Fellowship at the Convocation at the Atlanta meeting. Those were:

Ed Bolander, Carmel
Herbert Cushing, Greenwood
Shlomo Hellerstein, Indianapolis
David Kay, Goshen
Taegee Kiehm, Mishawaka
Howard Lee, Indianapolis

The Convocation is a very memorable ceremony. I encourage all new Fellows to participate in a Convocation.

Student Interest Group

The Indiana University Internal Medicine Student Interest Group (IMSIG) has been busy over the last several months. Our final large group meeting of the year was about "Giving Bad News," presented by Dr. Karen Roos from the IU Department of Neurology. It was well received by those who attended as Dr. Roos discussed openly her own feelings and approach to giving bad news to patients and families. IMSIG also presented two small discussions about the sub-specialties of Infectious Diseases with Dr. Richard Kohler and Geriatrics with Dr. Glenda Westmoreland.

With the close of the current academic year IMSIG elected officers and representatives that will form the 2001-2002 IMSIG-Student Advisory Board (SAB) are:

Chairman: Michael Emery, MS IV
Vice Chairman/Educational Chair: Clark Boccone, MS III
Financial Officer: Laura Baugh, MSIV
Secretary/Web Site Coordinator: JeffScott, MS II
Alumni Liaison: Stephanie Hasan, MSIV
National Primary Care Web Director/CommunityService Director: Amanda Myers, MS IV

Student AdvisoryBoard members include:

Joe Mishkin, MS IV
Michelle Strong, MSIV
Lael Desmond, MS III
Stephanie Jeske, MS III
Tom Lahr, MS III
Vishal Parikh, MS III

Planning will begin soon for our Annual Westside Health Fair, which is scheduled to coincide with National Primary Care Week in October 2001. Finally, IMSIG would like to congratulate all of our seniors as they graduate and begin their residencies.

Laureate Awards

Each year at our Annual Chapter Meeting, Laureate Awards are given to one or two senior members in honor of their contributions to our profession, their community, and ACP-ASIM, and who exemplify the title "Physician." If you know of deserving candidates, please notify Dr. Cloyd Dye, Chmn. of the Awards Committee, at Henry County Hospital, 1000 North 16th St, Newcastle, IN 47362, or e-mail him at cdye@hcmhcares.org.

Chapter E-Mail Listserv

As announced previously, the Indiana ACP-ASIM Chapter has established an e-mail listserv in order to communicate rapidly with all members. This will allow rapid notification of items of importance. The content and distribution of all messages is rigidly controlled. No commercial material or financial solicitations will be permitted.

We hope to have as complete and current a directory as possible. The listserv is:

Indiana-ACP-L@iupui.edu. To enter the listserv, send an e-mail to: listserv@listserv.iupui.edu and include in the text the following command: subscribe Indiana-ACP-L your name.

State Chapter Dues

When members of ACP-ASIM are billed annually for dues there is a separate item for State dues, which are voluntary. When you are a member of the national organization, you are automatically a member of the State Chapter and receive all the benefits and privileges; therefore, we encourage all to pay the State dues.

Advancement from Membership to Fellowship

"How do I advance from Membership to Fellowship?" is a question frequently asked by you, the ACP-ASIM members. Below, is a summary of the requirements and pathways that a candidate must fulfill and/or meet in order to become a Fellow of the College.

The Candidate Must:

  • Be certified by the American Board of Internal Medicine, the Royal College of Physicians and Surgeons of Canada, or the American Osteopathic Board of Internal Medicine. Members residing in Québec Province have the option of being certified by the College des Médecins du Québec.
  • Have been a Member in good standing for 2 years in the ACP, ASIM, or ACP-ASIM, and in practice or in an academic position for at least 2 years since completion of training.
  • Have an active medical license in good standing (if in clinical practice).
  • Have confined his or her professional activity to internal medicine or a subspecialty of internal medicine.
  • Be proposed and seconded by two current Masters or Fellows with reference to character, ethics, and medical activities. The proposer and seconder must each write detailed letters of support for the candidate, outlining professional contributions and accomplishments.
  • Be endorsed by the appropriate ACP-ASIM Governor.
  • Have shown continuing scholarship and professional accomplishments.
  • Document continuing professional activities, including teaching, both institutional and community-based; hospital committee work; community service, especially the voluntary provision of medical care; and participation in continuing medical education activities as both teacher and student.

The current guidelines acknowledge a range of professional activities that indicate continuing scholarship and professional achievement. Recognizing different kinds of professional growth and continuing scholarship permits four different pathways for advancing to Fellowship. A candidate may apply under a combination of pathways.

Pathways

The College has established four Pathways that serve as guidelines to qualify for Fellowship. For each of the following pathways, the candidates must meet the basic requirements listed above.

Pathway 1: Members must have demonstrated skill in written medical communication.

Pathway 2: Members must have significant and continuing certification activities and/or teaching (both institutional and community-based), and/or community activities that indicate professional achievement and scholarship; they must have undergone recertification, or they must have participated in the Medical Knowledge Self-Assessment Program (MKSAP) with a passing score. In addition, subspecialty certification or certificates of special competence in adolescent medicine, critical care medicine, clinical cardiac electrophysiology, geriatrics, or sports medicine can qualify a candidate for this pathway, but are not adequate by themselves.

Pathway 3: Members must have been active members in ACP or ASIM for at least 10 years, with substantial participation in programs and activities, as well as demonstration of other professional accomplishments.

Note: Outstanding candidates who have been active Members for fewer than 10 years may qualify by combining Pathways 1and/or 2 with Pathway 3.

Pathway 4: Members must have distinguished professional activity in teaching, patient care or professional service over many years.

Candidates must document each pathway; however, a candidate may be accepted without fulfilling one pathway if his/her work in other pathways is deemed outstanding by the Credentials Committee. For a complete copy of the "Requirements for Advancement from Membership to Fellowship" and/or an advancement to Fellowship proposal, contact Dr. Dunkin (see page six for contact information), or call ACP-ASIM Customer Service at (800) 523-1546, ext. 2600. The "Requirements for Advancement from Membership to Fellowship" can also be found on ACP-ASIM Online at www.acponline.org/college/membership/required.htm.

Action Taken on Board of Governors Resolutions

The Board of Regents took action on a number of resolutions developed by the Board of Governors at its spring 2001 meeting at Annual Session.

The following resolutions were adopted:

1-S01, Promote membership in ACP-ASIM with APDIM, APM and CDIM

2-S01, Inclusion of mission and goals statement in meeting agendas

6-S01, Chiropractor scope of practice

9-S01, Publication of winning abstracts as Annals supplement

13-S01, CME credit for reading the Annals of Internal Medicine

18-S01, Impact of HCFA's fiscal intermediaries on Medicare

20-S01, Staffing of heath care institutions

24-S01, Quality of health care delivery

26-S01, Screening colonoscopies

27-S01, Influenza vaccination

30-S01, ADA requirements for ACP-ASIM Chapter meetings

31-S01, Attracting and maintaining Associates/Young Physicians members

32-S01, Rapid member communications

33-S01, Lifetime access to private forums on ACP- ASIM Online

The following resolutions were referred for study to the appropriate committees:

4-S01, Physician compensation for limiting patient care is unethical

5-S01, The proliferation of certification requirements should be opposed

7-S01, Interactions between pharmaceutical companies and physicians

8-S01, Reduced membership dues for Latin American Associates

10-S01, Managed care premium to fund medical education

12-S01, Revision of HCFA's "Claims, Filing, Jurisdiction and Development Procedures"

19-S01, Out of plan referrals

22-S01, Orders for procedures

23-S01, Drugs with narrow therapeutic index

25-S01, Academic health centers

29-S01, Funding of Associates Annual Session participation

34-S01, ACP-ASIM relationship with ABIM

35-S01, Reimbursement for Oncology services

36-S01, Limitation of "User Fees"

The following two resolutions were considered a reaffirmation of current College policy:

14-S01, National Practitioner Data Bank

21-S01, Banish restricted drug lists

The full text of all resolutions is available from the College's Membership Division in Philadelphia. For more information, please contact Alison Dufner at 800-523-1546, ext. 2716, or adufner@acponline.org.

Indiana Chapter 2001-2002 Council Member Roster Resources for Renewal

We have all heard stories of "burned-out" internists who left their practices, or of young residents who chose a field other than internal medicine because they heard of the long hours, bureaucratic hassles, and declining incomes associated with our field. College Governors have listened to their members' concerns about physician burn-out and the need for renewal, and spent the last several months developing a list of resources that could be used by anyone dealing with these issues. The Board of Governors reviewed a variety of speakers, websites, organizations, books, articles, and College publications, choosing resources they would personally recommend to their colleagues. This material has been collated and posted on ACP-ASIM Online, in the Careers section at http://www.acponline.org/careers/. If someone you know is looking for a better balance or a path to renewal, there may be something on this list you can recommend.

There is a response form linked to the list. If you refer to one of the pieces, and would, in turn, recommend it to someone else, let headquarters know. If you are aware of a wonderful resource that's not listed, you can suggest it be added. All feedback will be reviewed by a working group of ACP-ASIM Governors, who will be revising the list on an ongoing basis. Visit the Careers section, check out the renewal project, and let us know what you think!

Young Physicians Subcommittee

The Young Physicians Subcommittee (YPS) wants to hear from young physician members of the College about the
practice environment today. Your frank comments will, through the Subcommittee, have a direct impact on you and your colleagues. Visit www.acponline.org/private/committees/yps/ and let us know what's on your mind.

We'd like to know how you feel about recertification, establishing a practice, coping with stress, and time constraints. Would you like a copy of the YPS Practice Management Survival Booklet? An E/M coding card? A curbside consultation about and evaluating and improving a practice via the College's Practice Management Center? If you answered "yes" to any of these questions, the web site can also be used to request this information. ALL e-mails will be answered.

If you have any questions, please contact Jean Elliott, YPS Staff Liaison at (800) 523-1546, ext. 2692

Malpractice Insurance

As many of you know by now a long-standing formerly physician-friendly malpractice insurance company in Indiana is canceling several internists policies and asking for a 40% increase in premium for many others. It is important to know that there are other reputable companies offering malpractice coverage in Indiana. One of these is The Doctors Company (TDC) which is physician owned, endorsed by ACP-ASIM, and offers discounts for ACP-ASIM members, group practices, and favorable occurrences records. Their premiums compare very favorably to rates formerly charged in the State.

Health and Public Policy Committee

HPPC, chaired by Dr. Caitilin Kelly, meets by conference call every other month. The committee members need your input to formulate policies to present to ISMA, ACP-ASIM, the State Legislators, and our Medicare Carrier. State legislators have attended these meetings on occasion. Rep. Peggy Welch has been invited to the next meeting on Tuesday evening, June 14 at 6:30 PM. All members of the chapter are invited to attend. Details of how to join the conference call meeting will be e-mailed via our Listserv (see article above.)

Dr. Linda Abets continues the frustrating task of attending the Medicare Carrier Advisory Committee meetings.

Dr. Cheryle Southern attends the Medicaid Committee meetings and keeps the HPPC and the Council updated.

Please relay any concerns about your practice environment to members of the HPPC, or Dr. Kelly.

The carrier advisory committee continues to meet quarterly. The next meeting is planned for June 2001. New draft policies to be discussed include:

1.) Bilaminate skin substitute (Apligraf)

2.) Blood glucose monitoring

3.) Hepatic function panel

4.) Hyperbaric oxygen therapy

Proposed revisions to existing policies will be reviewed for diagnostic mammography.

Please feel free to provide me copy of your comments or recommendations. It is important to include a clinical rationale for your position with appropriate references from standard textbooks and/or peer reviewed journals. If possible, include alternative indications or guidelines.

Refer to the Administar Federal website for pertinent guidelines - http://www.astar-federal.com.

Governor
Ramon Dunkin, MD
3266 N. Meridian Street
Indianapolis, IN 46208
Phone: 317-924-8315
Fax: 317-924-8324
E-mail: rdunkin@memclin.com

Past Governor
Richard Kohler, MD
1101 W. 10th Street
Indianapolis, IN 46202
Phone: 317-630-6262
Fax: 317-630-7522
E-mail: rkohler@iupui.edu

Secretary/Treasurer
(Elected by Council)
Councilor-At-Large
Michael Buran, MD
1701 N. Senate Blvd.
Indianapolis, IN 46202
Phone: 317-929-5178
Fax: 317-929-3065
E-mail: mburan@clarian.com

Councilor - 219
Dana Kellis, MD
Parkview Hospital
2200 Randallia Drive
Ft. Wayne, IN 46805
Phone: 219-484-6636
Fax: 219-480-5978
E-mail: dkell@parkview.com

Councilor - 765
J. Matthew Neal, MD
2525 University Ave., #300
Muncie, IN 47303
Phone: 765- 781-2000
Fax: 765-281-2040

Councilor - 812
Caitilin Kelly, MD
1004 West First Street
Bloomington, IN 47403
Phone: 812-333-2800
Fax: 812-333-0725
E-mail: cakelly@indiana.edu

Councilor - 317 Metro
Robert Lubitz, MD
St. Vincent Hospital
2001 W: 86th St., 3rd floor
Indianapolis, IN 46260
Phone: 317-338-2172
Fax: 317-338-6359
E-mail: rmlubitz@stvincent.org

Councilor - IU
Mary Ciccarelli, MD
Wishard Hospital, Dept. Medicine
1001 W 10th Street., OPW M200
Indianapolis, IN 46202
Phone: 317 -630-6906
Fax: 317 -630-2667
E-mail: mciccare@iupui.edu

Councilor-At-Large
Nicki Turner, MD
2525 University Avenue, #300
Muncie, IN 47303
Phone: 765-281-2000
Fax: 765-281-2040

Councilor-At-Large
Timothy Pettigrew, MD
3820 Tansel Rd.
Indianapolis, IN 46334

Associates Council Chair (1 yr)
Michael Sha, MD
4410 E. 116th Street
Carmel, IN 46033
E-mail: mcsha@iupui.edu

Scientific Program Committee

Mary Ciccarelli, MD, Chairman
Cheryle Southern, MD
Richard Kohler,MD
Robert Lubitz, MD
Michael Sha, MD
Edward Ross, MD
Ramon Dunkin, MD

Health & Public Policy Committee

Caitilin Kelly, MD, Chairman
Linda Abels, MD
Neil lrick, MD
Kevin Neese, MD
Jim Poulos, MD
Lois Lambrecht, MD
Greg Heumann, MD
Clay Molstad, MD
Cheryle Southern, MD
Michael Mirro, MD
Ramon Dunkin, MD, ex-officio

Membership Committee

Clay Molstad, MD, Chairman

Awards Committee

Cloyd Dye, MD, Chairman

Nominating Committee

Richard Dexter, MD

(Three or more members) Needed every two year.

Representatives to the:

Medicare Advisory Committee Meetings- Linda Abels, MD
Medicaid Meetings - Cheryle Southern, MD
ISMA Section at the Annual Meeting - Caitilin Kelly, MD and Cheryle Southern, MD
ISMA Legislative Commission Meetings - Cheryle Southern, MD

Mark Your Calendars...

Indiana Chapter Fall Meeting
Our Annual Meeting will be Friday and Saturday, October 19- 20, at the Westin Hotel by the Convention Center in downtown Indianapolis. We'll have a good mix of scientific and socio-economic presentations.

What's New

Contact Information

Indiana Chapter Governor:
Michael C. Sha, MD, FACP

Shelly Symmes
Chapter Administrator
Ph: 317-261-2060
Email: ssymmes@ismanet.org