Governor's Newsletter
Summer 2002

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

Professionalism

The recent paper in the Annals and the Annual Session Meeting in Philadelphia serve to remind us of the principles of professionalism as applicable to the learned professions, specifically the medical profession. Most of us probably feel this is unnecessary: that we are free of any susceptibility to be swayed by outside influences to violate these principles. However, when we consider the efforts of drug companies at thought control, managed care restrictions on health care, governmental regulations, financial pressures, patient demands for inappropriate services and malpractice fears, we may find our priorities swayed from patient primacy and societal good. I believe a condensed form of that Professionalism paper would be a good replacement for the Hippocratic Oath, still recited at many medical school commencement ceremonies. I deem worthy for all of us a re-reading of the Annals paper on professionalism.

Annual Scientific Meeting, 2002

As Governor of the Indiana Chapter I feel obligated to attend the Annual Scientific Meeting, but each time I come away glad that I attended, feeling that I learned much from the variety of well-presented, evidence-based sessions. This year was no exception. There were lively and very productive Board of Governors and Board of Regents meetings. Four days of scientific presentations followed.

We had a well-attended reception sponsored by our Chapter and the I.U. Medical School Alumni Association. The always impressive convocation ceremony welcomed to fellowship 14 Indiana members. Two Indiana University Medical Center Faculty were honored with awards. At the Awards Luncheon our Chapter received another Evergreen Award for our Associate members' newsletter, which keeps Internal Medical house staff and medical students informed.

Indiana Awardees

Congratulations to Dr. George Sarosi and Dr. Kurt Kroenke. Dr. George Sarosi was awarded the Distinguished Teacher of the Year Award and awarded Mastership in the College for his years of excellent teaching and his contributions in the diagnosis and treatment of fungal diseases. Dr. Sarosi is Professor of Medicine at Indiana University and Chief of the Medicine Service at the Roudebush Veteran's Hospital in Indianapolis.

Dr. Kurt Kroenke was awarded Mastership in the College for his contributions to education and research in general internal medicine and for his activities in the ACP-ASIM. He has served as a faculty member at several Annual Scientific Meetings and Chair of the Scientific Program Committee for the 2000-2002 Annual Meetings. Dr. Kroenke is a Professor of Medicine at the I.U. School of Medicine and a Senior Research Scientist at the Regenstrief Institute for Health Care. Dr. Kroenke is the current President of the Society of General Internal Medicine. Please congratulate them when you see them!

Indiana Chapter List Serve

Our Chapter e-mail List Serve is our best means of keeping members up-to-date on Chapter business. Please keep us informed of any change in your e-mail address.

The PIER Project

The much heralded PIER program is now available online. The free program provides easily accessible guidelines on diagnosis and treatment of over 150 common conditions plus an excellent medication information program. I encourage you to check it out.

Chapter Elections

Election of Governor-Elect and several Chapter council members is coming up. Ballots listing candidates nominated by you and your fellow members will be mailed to you in the next few weeks. Please participate in this democratic process.

Board of Regents Take Action on Spring 2002 Resolutions

At the April 13, 2002 Organizational Meeting of the Board of Regents, Dr. David Dale, Chair, Board of Governors, presented for discussion and vote twenty (20) Spring 2002 Resolutions from the Board of Governors, along with recommendations for their referral and implementation. As such, the BOR took the following action on these resolutions:

The Board of Regents voted to adopt and refer Resolution 7-S02, Patient Confidentiality and Common Sense, to the Health and Public Policy Committee for implementation:

RESOLVED, that the Board of Regents continue to monitor all confidentiality regulations by regulatory agencies in order to prevent any misguided efforts from interfering with safe, efficient health care delivery.

The Board of Regents voted to refer the first and second resolved clauses of Resolution 8-S02, Physicians and the Healthcare Products Industry, to the Education Committee to take the lead for study and report back with recommendations, with input from the Ethics and Human Rights Committee. A third resolved was added by the BOR to indicate that this resolution should also be referred to the ACP-ASIM's Delegation to the AMA:

RESOLVED, that the Board of Regents work with and assist the AMA and ACCME as these organizations work to implement and improve their national guidelines and standards, on behalf of the profession; and be it further

RESOLVED, that the Board of Regents convene a CME stakeholders summit to include, but not limited to, representatives of the healthcare products industry, AMA, ACCME and subspecialty organizations, to explore the future of CME funding; and be it further

RESOLVED, that Resolution 8-S02 be referred to the College's AMA Delegation.

The Board of Regents voted to adopt and refer Resolution 10-S02, Physician Support of Project Hope, to the Membership Committee for implementation:

RESOLVED, that the Board of Regents initiate dialogue with a representative from Project Hope to gather more detailed information about their plans to provide health care via a hospital ship; and be it further

RESOLVED, if volunteers are requested, that the Board of Regents encourage the involvement of the AMA, appropriate medical societies, national nursing organizations and pharmacists professional associations to join ACP-ASIM in recruiting volunteers from among their memberships to staff the hospital ship.

The Board of Regents voted to adopt and refer Resolution 11-S02, Development of ACP-ASIM Products for PDA, to staff for implementation:

RESOLVED, that the Board of Regents continue to vigorously support the enhancement of educational services, advocacy aids, practice tools and communication devices for the handheld computer.

The Board of Regents voted to adopt and refer Resolution 12-S02, Award Nominations, to the Awards Committee for implementation:

RESOLVED, that the Board of Regents adopt a policy calling for the names of all nominees for College Awards to be sent at the earliest phase of consideration to the Governor representing the Region in which the nominee maintains membership, along with the opportunity to offer comments.

The Board of Regents voted to adopt and refer Resolution 13-S02, Cost-Savings Input from Governors, to the Executive Committee of the Board of Governors for implementation:

RESOLVED, that the Board of Regents continue to move towards streamlining College affairs by regularly querying Governors for their input regarding cost-saving measures.

The Board of Regents voted to adopt and refer Resolution 14-S02, Governors-elect Registration Fees, to staff for implementation:

RESOLVED, that the Board of Regents revise current College policy to include the Annual Session registration fee for the Governors-elect to attend Board of Governors meetings.

The Board of Regents voted to refer Resolution 16-S02, New Name for ACP-ASIM, to the Marketing and Communications Committee for study and report back with recommendations:

RESOLVED, that the Board of Regents adopt "American College of Physicians" as the College's new corporate name as proposed by the Marketing and Communications Committee; and be it further

RESOLVED, that the Board of Regents develop a plan to minimize the costs of this name transition by all appropriate means, such as, utilizing a "doing business as" registration or phasing in other required changes over the next several years.

The Board of Regents voted to adopt and refer Resolution 18-S02, Compensation for Coumadin Management, to the Medical Service Committee for implementation:

RESOLVED, that the Board of Regents request payers, including Medicare, to reimburse physicians for management of outpatient anticoagulation.

The Board of Regents voted to adopt and refer Resolution 19-S02, Telephone Consultation Reimbursement, to the Medical Service Committee for implementation:

RESOLVED, that the Board of Regents present strategies to obtain compensation for non-face-to-face evaluation and management of patient care at the September 2002 meeting of the Board of Governors.

The Board of Regents voted to refer Resolution 20-S02, Mercury Sphygomomanometer, to the Education Committee for study and report back with recommendations:

RESOLVED, that the Board of Regents research the impact that the removal of mercury sphygmomanometers from healthcare institutions and clinics would have on accurate and reliable reading of blood pressure and therefore the practice of Internal Medicine.

The Board of Regents voted to refer Resolution 21-S02, Evaluation of Compliance Programs, to the Medical Service Committee for study and report back with recommendations:

RESOLVED, that the Board of Regents determine the effect of compliance programs on internists, to include average increases in overhead costs caused by the programs and whether the programs have had any positive or negative effect on the quality of patient care provided.

The Board of Regents voted to adopt and refer Resolution 22-S02, Timely Payment of Critical Care Claims by Medicare Carriers, to the Medical Service Committee for implementation:

RESOLVED, that the Board of Regents use its influence to demand that Medicare carriers pay claims on the critical care codes 99291 and 99292 in a timely fashion without demanding more paperwork, unless there is evidence that the bill is incorrect.

The Board of Regents voted to adopt and refer Resolution 23-S02, JCAHO's Requirement to Prepare a Healthcare Environmental Impact Statement, to the ACP-ASIM's JCAHO representatives via College staff for implementation:

RESOLVED, that the Board of Regents, through its representatives on the Board of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), recommend that JCAHO prepare a "Healthcare Environmental Impact Statement" whenever JCAHO proposes new standards or makes new interpretations of existing standards; and be it further

RESOLVED, that the JCAHO Healthcare Environmental Impact Statement shall fully discuss the impact of the standards on institutional operations, planning, infrastructure, capital investment, medico legal risk, human resources and clinical practice, and shall detail the costs of meeting the standard and the problems institutions will experience in securing adequate resources, including availability of health care personnel; and be it further

RESOLVED, that the Board of Regents use its influence on the JCAHO Board to develop initiatives to have the Healthcare Environmental Impact Statements prepared by JCAHO used to influence payors, regulators and state and local governments to provide the necessary fiscal, regulatory and infrastructure support to implement new JCAHO standards appropriately and effectively.

The Board of Regents voted to adopt and refer Resolution 24-S02, Benefits Improvement and Protection Act of 2000, to the Medical Service Committee for implementation:

RESOLVED that the Board of Regents support and advocate the interpretation of the BIPA 2000 provision for Medicare coverage "including drugs and biologicals which are not usually self-administered by the patient" as inclusive of Low Molecular Weight Heparins used in the short term outpatient treatment of venous thrombosis.

The Board of Regents voted to adopt and refer Resolution 26-S02, Pharmaceutical Products Shortage, to the Health and Public Policy Committee for implementation:

RESOLVED, that the Board of Regents address the pharmaceutical products shortage by: (1) using influence and resources to encourage and collaborate with governmental regulatory bodies, news organizations, health care organizations, patients rights groups and the pharmaceutical industry to study this problem and report causes and potential solutions to the public, (2) placing an article on this problem in the Observer, and possibly other publications, (3) monitoring the scope of this problem using available information collected by other organizations, and (4) taking added steps resulting from the above collaborations and information.

The Board of Regents voted to adopt and refer Resolution 27-S02, State and National Nursing Shortages, to the Health and Public Policy Committee for implementation:

RESOLVED, that the Board of Regents make it a priority to support legislation and advocacy programs that will expand opportunities for nursing education, will increase faculties of nursing schools, and will address strategies for retention of nurses in the field; and be it further

RESOLVED, that the Board of Regents support initiatives that promulgate to the public the value of registered nurses in patient care, patient safety, and costs of health care.

The Board of Regents voted to adopt and refer Resolution 29-S02, Restoration of J-1 Visa Waivers for Underserved Communities, to the Health and Public Policy Committee to take the lead for implementation, with input from the Council of Associates:

RESOLVED, that the Board of Regents work to restore and maintain programs by federal agencies and state governments through which an adequate number of international medical graduates may obtain J-1 visa waivers to provide medical services in underserved communities.

The Board of Regents voted to adopt and refer Resolution 32-S02, Enhancing Practical-Practice Specific Information in the Observer, to the Publication Committee for implementation:

RESOLVED, that the Board of Regents support the inclusion of a feature to the Observer modeled after the ASIM's Intercom publication.

The Board of Regents voted to adopt and refer Resolution 34-S02, Support of Full and Thorough Treatment, to the Medical Service Committee for implementation:

RESOLVED, that the Board of Regents support that the current College policy be amended as follows: ACP-ASIM believes that any effective patient protection legislation must require that physicians, rather than health plans, make determinations regarding the medical necessity appropriateness and number of test procedures and treatments.

If you need additional information regarding the Spring 2002 Resolutions, or if you have any questions regarding the BOG Resolutions Process, please contact Alison Dufner, Resolutions Administrator at (800) 523-1546, ext. 2716, or (adufner@acponline.org).

New Fellows

Fourteen new Fellows from Indiana were initiated at the convocation ceremony at the Annual Meeting in Philadelphia. Those are as follows:

John Addo - Fort Wayne
Akram Al-Makki - Lafayette
Ernest O. Asamoah - Nobesville
Jose Bufill - South Bend
Jeffrey Dichter - Muncie
Medhat Girgis - Bedford
Amna Iftikhar - Munster
Faizan Iftikhar - Munster
James Lewis - Richmond
Patrick O'dea - Granger
William Province - Franklin
Socorro Vargas - Indianapolis
Stevan Webster - Evansville
David Wilcox - Indianapolis

Many more new Fellows have yet to attend convocation. Congratulations to all of the above.

Health and Public Policy Committee

Your HPPC, Chaired by Caitilin Kelly, continues to meet periodically by conference call with state legislators as guests. If you have issues you would like addressed, please notify Caitilin Kelly, Carolyn Downing at ISMA, or myself.

The committee met Thursday, May 23, 2002. State Senator Pat Miller was unable to attend as scheduled. The members present all agreed that we need to foster more grass roots input to our legislators to keep them informed about health care issues. Any ideas to facilitate this would be welcomed.

Internal Medicine Student Interest Group

Stephanie Jeske, a senior, is the new IMSIG representative on our Chapter Council. The IMSIG continues to meet regularly with presentations on various aspects of internal medicine. They receive their own newsletter from National and now also received the Indiana Associates newsletter. They have plans for additional health fairs and community projects.

Associates Activities

Wildon Farwell is the new Associate Council Chair-Elect. Roger Egan a current Co-Chair attended Leadership Day in Washington DC with Dr. Cheryl Southern to help our Indiana legislators better understand our concerns about the health care environment.

Membership Committee

Dr. Ram Prasad is our new Membership Committee Chair. Contact Dr. Ram Prasad at (ramspras@yahoo.com) for applications for membership or advancement to Fellowship. I encourage all internists to join and support ACP-ASIM, which remains our best advocate to enhance the practice of internal medicine. I also encourage current members to advance to Fellowship with all of its benefits.

What Can You Do For Legislative Action?

Many of our members, I'm sure, would like to give their members of congress and President Bush a "piece of their mind" about health issues but are not sure how to do it. This can be accomplished easily by going to the Legislative Action Center where you can find the College's position on various issues. If you click on "Elected Officials" and select the issue you want to address, a generic letter to your senators, congressperson and President Bush will appear. Personalize the letter and then send it by e-mail or snail mail. All of this can be done without entering in an ID or password. I encourage you, better yet challenge you, to use this tool to let your opinions be known in Washington.

Get Involved

We need your input in order to represent your concerns about the College and the health care environment at the state and national level. In an effort facilitate that, get to know your area Council Representative and inform him/her of your concerns. We will be providing area membership lists to each Council Representative so that he/she can get to know you.

Chapter Fall Scientific Meeting

Robert Lubitz, Chairman of the Program Committee is hard at work with his members planning for an excellent program for this November. Keep your eyes open for future announcements about the time and schedule. The meeting will be Friday and Saturday, November 14th -15th, 2002 at the Weston. Please save this time in your schedule if at all possible. Attendees at last November's program all rated the program's speakers very highly and we certainly expect the same this year.

Chapter Contacts & Committees

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 West 10th Street
Indianapolis, IN 46202
Phone: 317-630-6262
Fax: 317-630-7522
E-mail: rkohler@iupui.edu

Secretary/Treasurer, Councilor-At-Large-
Michael Buran, MD
1701 North Senate Blvd.
Indianapolis, IN 46202
Phone: 317-962-5178
Fax: 317-962-3065
E-mail: mburan@clarian.com

Councilor-765-
Matthew Neal, MD
2525 University Ave., #300
Muncie, IN 47303
Phone: 765-781-2000
Fax: 765-281-2040
E-mail: jmneal@compuserve.com

Councilor-812-
Caililin 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 Fl.
Indianapolis, IN 46260
Phone: 317-338-2172
Fax: 317-338-6259
E-mail: rmlubitz@stvincent.org

Councilor-219-
Robert Buynak, MD
3630 Willowcreek Road
Portage, IN 46368
Phone: 219-759-4884
Fax: 219-759-8817
E-mail: buynak2@gte.net

Councilor-260-
Jeanne Rowe, MD
1818 Carew St., Suite 110
Ft. Wayne, IN 46805
Phone: 219-483-2211
Fax: 219-484-1686
E-mail: Qball38@aol.com

Councilor-IU-
Timothy Pettigrew, MD
550 N. University Blvd., UH2155
Indianapolis, IN 46202
Phone: 317-274-8660
Fax: 317-274-7263
E-mail: tpettigr@iupui.edu

Associates Council Co-Chairs-
Roger Eagan, MD; Jeff Kreher, MD

Associates Council Chair Elect-
Wildon Farwell, MD

Scientific Program Committee-
Robert Lubitz, MD, Chairman

Health & Public Policy Committee-
Caitilin Kelly, MD, Chairman

Awards Committee-
Lindley Wagner, MD, Chairman

Membership Committee-
Ram Prasad, MD, Chairman

Nominating Committee-
Richard Dexter, MD

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

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