Governor's Newsletter
Winter 2001

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

Governor's Column

Less than a year into the job of Governor, I have come to a new appreciation of the many roles played in the Healthcare System by the College, and many services provided our members as well as the great potential for advocacy for all our constituencies locally, nationally and internationally.

The September Board of Governors' Meeting was enlightening with presentations on biotechnology in the 21st century , physician burnout and renewal, the internet and healthcare, and the ABIM recertification plan. The recertification process discussion generated more heat than light with more to come.

Many of you probably have seen or heard of information from Dr. Tom Marciniak titled "The Medicare Office Visit Payment Disaster 2001," suggesting a decrease in payment for our office visits. Bob Doherty, in a detailed critique on the ACP-ASIM web page clearly dispels this specter and indicates that there will be an increased payment for office visits and the new fee schedule, though slightly less than initially expected.

We welcome our new Council members Matthew Neal (Area 765), Dana Kellis (Area 219) and At-Large members Mike Buran, Nicki Turner and Tim Pettigrew. And, we appreciate the loyal service of our departing Council members Bob Rudesill (Treasurer), Frank Byrne and former ISIM President, Cheryle Southern.

We need to continue to interest non-member internists in the many benefits of membership in the College and encourage members to advance to Fellowship when eligible. The process is much less onerous now.

Our associate and student members are increasingly active, to everyone's benefit. The associates' outstanding leadership represent Indiana well.

Many of our members are being asked to participate in a research study regarding primary care physicians' approach to colorectal cancer screening. If you receive such a mailing, I encourage you to participate.

Please direct any concerns you have about the environment of medicine to me at rdunkin@memclin.com, your Chapter councilor (see page 3), or Carolyn Downing at cdowning@ismanet.org.

I look forward to seeing you at the National Meeting in Atlanta in March, or at our State Meeting next fall.

Ray Dunkin, Governor

Indiana Chapter Fall Meeting

Our Chapter Annual Meeting was held in Indianapolis October 13-14, 2000. The program planned by Mary Cicarelli's Education Committee was well attended and provided excellent state-of-the-art information on a variety of topics.

Eric Prystowsky addressed current approaches to control of atrial fibrillation and life-threatening ventricular arrhythmias and Gene Chiao spoke on irritable bowel syndrome. Our College representative, Regent Paul Speckart, talked about sub-clinical hypothyroidism and thyrotoxicosis, while Margaret Blythe brought us up to date on eating disorders. Bob Pascuzzi reviewed and demonstrated how to evaluate the patient with weakness and Pat Healy provided an excellent format for office geriatric assessment.

The Laureate Awards always are an important part of the Annual Chapter Meeting. We want to assure you that all of our senior members are given consideration. If you believe that someone in your area is a deserving candidate, please let our Awards Committee Chairman, Cloyd Dye know. Cloyd's address is Henry County Memorial Hospital, 1000 North 16th Street, New Castle, IN 47362, or e-mail him at cdye@hcmhcares.org.

Chapter E-mail Listserv

As advocacy on behalf of our patients and our profession becomes part of the practice of Medicine, the need to communicate rapidly with our members becomes more important. The Indiana ACP-ASIM Chapter has created an e-mail listserv to mobilize our membership on legislative and regulatory issues and to improve communication within the Chapter.

An e-mail listserv is simply an e-mail distribution program. By sending an e-mail to one address, everyone listed within a particular listserv receives the e-mail. The new Chapter listserv is: Indiana-ACP-L@iupui.edu. Dr. Dunkin will moderate the listserv in order to avoid unnecessary e-mail traffic. To subscribe to 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.

Dr. Dunkin and the other members of the Governor's Advisory Council have embraced this new means of communication. We hope that this new medium will allow us to better serve you, our members, and provide vital information that will be of benefit to both you and your patients.

More Chapter News

  • The HPPC members, scattered across the country, meet by teleconference approximately every two months.

  • The resolution encouraging the state to pay the malpractice insurance of retired physicians who volunteer their time in free clinics was introduced by Dr. Dunkin, and passed at this years ISMA House of delegates.

  • Next year we will introduce the resolution that would give subspecialty voting privileges. Additionally, we plan to introduce a resolution to centralize the credentialling process.

  • Dr. Linda Abels continues to be our representative on the Medicare Advisory Committee. She has worked hard to encourage Medicare to Appropriately reimburse for commonly ordered laboratory tests.

  • Dr. Arnold Krubsack, Medical Director of Medicare in Indiana, has been collecting names of physicians willing to review charts where payment for services has been denied to help determine medical necessity and to improve the claims review process. Currently non-physicians do these reviews.

  • Dr. Cheryl Southern attends the Medicaid Committee meetings and keeps us informed of their proceedings.

  • This year we will encourage the ACP-ASIM to be more publicly and financially supportive of groups involved with dealing with domestic violence.

  • We will continue meeting with state senators and representatives and we support the formation of an ACP-ASIM Key Contact Program that would provide a list of people willing to contact legislators about key health care related laws.

  • We welcome new members as well as any idea/suggestions you might have for us to improve our ability to serve you.

  • Finally, this year we would like to become more actively involved with the HPPC Network that is an easy electronic way for Chapter HPPC members to communicate with their counterparts in other states.

Indiana Chapter 2000-2002 Council Member Roster

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
1l0l W. lOth Street
Indianapolis, IN 46202
Phone: 317-630-6262
Fax: 317-630-7522
E-mail: rkohler@iupui.edu

Secretary/Treasurer
(Elected by Council)

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-At-Large
Michael Buran, MD
1701 N. Senate Blvd.
Indianapolis, In 46202

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.1Oth 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 Ave., #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
Pager: 212-0563
E-mail: mcsha@iupui.edu

Chapter Committees

Credentials & Membership Committee

(Governor plus 3-4 more members)
Clay Molstad, MD

Scientific Program Committee

Mary Ciccareili, 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 Irick, 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

To Medicaid Meetings

Cheryle Southern, MD

To the ISMA Section at the Annual Meeting

Caitilin Kelly, MD
Cheryle Southern, MD

To the ISMA Legislative Commission Meetings

Cheryle Southern, MD

Board Of Regents Action Taken On Fall 2000 Resolutions

At the October 27-29, 2000 meeting of the Board of Regents, Dr. Rowen Zetteman, Chair, BOR, presented for discussion and vote the eight resolutions forwarded from the Board of Governor's Fall 2000 meeting, along with recommendations for their referral and implementation. The results of the BOR's discussion and action taken on the Fall 2000 BOG resolutions are outlined below.

Resolution 1-F00: Voting Privileges for Associates. The BOR voted to adopt and refer this resolution to the Bylaws Committee for implementation.

Resolved, that the BOR amend the ACP-ASIM bylaws to permit Associates after two years of Associate membership to have the same voting privileges as afforded Members, Fellows and Masters.

Resolution 2-F00: Medicare Reimbursement for Oximetry. The Board of Regents voted to adopt and refer this resolution to the Washington staff for implementation.

Resolved, that the BOR continue to urge HCFA to reinstate Medicare coverage for portable oxygen saturation testing done in physician offices.

Resolution 3-F00: Internal Medicine Preference for the RBRVS System for Fee-Schedule Reimbursement. The BOR voted to refer this resolution to the Medical Services Committee for study and recommendation to the BOR regarding adoption. This resolution asks the BOR to advocate that private insurers use the Medicare RBRVS in determining payments to physicians; recommend any improvement in HCFA's payment policies as are needed to assure that the RBRVS as utilized by Medicare as well as private payers, is as accurate as possible; and recommend that private payers use a single dollar conversion factor with the RBRVS that is sufficient to assure fair and adequate payments to physicians.

Resolution 4-F00: Board of Governors Resolution Process. The BOR voted to adopt and refer this resolution to the Membership Division Staff for implementation and report due back to the BOG regarding the evaluation of the outcome of this resolution.

Resolved, that the BOR and BOG along with the support of the appropriate College staff continue to reevaluate the current BOG resolution process with the goal of reducing the time from action by the BOG to approval and implementation of resolutions.

Resolution 5-F00: Use of Medical Education Numbers in Continuing Medical Education. The BOR voted to adopt and refer this resolution to the Health and Public Policy Committee as lead committee for implementation with input from the Education Committee.

Resolved, that the BOR oppose the use of Social Security account numbers as file identifiers by providers of continuing medical education, certification boards and similar entities, widely known and recommend that such policy be adopted by other organizations, e.g. AMA, national certification boards and similar entities.

Resolution 6-F00: Tobacco Use Prevention. The BOR voted to adopt as amended and refer this resolution to the Membership Division Staff for implementation.

Resolved that the BOR urge ACP-ASIM Governors to encourage their members to contribute their expertise to community and school programs aimed at preventing tobacco initiation and addiction.

Resolution 8-F00: Streamlining and Simplifying the Fellowship Application Process. The BOR voted to adopt and refer this resolution to the Membership Division Staff for implementation.

Resolved, that the BOR request that the Membership Committee continue to investigate ways to simply and streamline the application process for becoming a Fellow.

Resolution 11-F00: Negative Drug Formularies. The BOR voted to refer this resolution to the Medical Services Committee for study and recommendation to the BOR regarding adoption. This resolution asks the BOR to encourage the deletion of drugs from Negative Drug Formularies for which there exist medically equivalent generic substitutes.

New College Text Book For Office Preceptors

By: Patrick C. Alguire, MD, FACP

Teaching in Your Office: A Guide to Teaching Medical Students and Residents is an ACP-ASIM resource for physicians interested in improving their skills in office-based teaching. The reason that we need such a book is the very nature of ambulatory teaching. Ambulatory medical education takes place in a fast-paced, chaotic environment in which there is little opportunity for teaching, observation and feedback. The office practice, in particular, offers little time for reflection and collaborative learning or teaching. Office-based preceptors often believe they have no occasion to observe others teach and to receive feedback on their own teaching skills. Consequently, preceptors mistakenly consider the opportunity for self-improvement to be limited.

This eight chapter, 145 page soft-cover book intends to help office-based physicians improve their own teaching while maintaining the efficiency of their practice. The design allows busy clinicians to identify and read only those chapters that address their specific needs. In other words, Teaching in Your Office does not need to be read cover to cover, rather it can be read selectively. Additionally, summaries of the major topic areas provide a quick review in the appendices. Similarly, if summaries are read first, the page locations of the associated text are indicated after the summary headings.

Teaching in Your Office: A Guide to Teaching Medical Students and Residents is now available through customer service (800-523-1546, ext. 2600) for $20.00 a copy (nonmembers $25). Discounts for 20 or more copies are available.

Annals.org Launched

Annals.org, the new Annals of Internal Medicine Web site, is up-and-running. The new site has its own URL address www.annals.org, and can also be reached through ACP-ASIM Online. The site features a new home page with an easy-to-navigate directory and a variety of new services, including:

  • Access to the full text of all articles and Adobe Acrobat PDF files for most articles that allow the article to be viewed exactly as it appears in the print version of the journal;

  • Enhanced search capabilities (by author, title, date, and by keywords such as medical condition or other MeSH terms);

  • Direct links from bibliographic references inAnnals articles to abstracts in the National Library of Medicine's PubMed database. From there, readers can access all of PubMed's services;

  • "Summaries for Patients" non-technical explanations of Annals original research articles written for lay readers (formerly known as "non-technical summaries");

  • Interactive features that allow users to evaluate articles and to write comments and letters to the editor, which will provide feedback to the authors and will help editors choose future content; and

  • Personae a link that takes visitors to an online photograph gallery.

Accessing the full text articles and PDF files of Annals.org is restricted to ACP-ASIM members and Annals subscribers; however, the public will have access to each issue's table of contents, as well as all abstracts and Summaries for Patients. Full text articles and PDF files will be available to the public on a pay-per-view basis.

Fellowship Advancment Made Easy (FAME)

By Marc Shabot,
Texas Southern Governor

Prerequisites

  • ABIM, RCPSC, or AOBIM certified †

  • Licensed practitioner

  • Formal training completed, Member at least 2 years, in practice or teaching for at least 2 years

  • Proposed/seconded by 2 Masters/Fellows

  • Commitment to lifelong learning and professional development

†May be waived in extraordinary circumstances

Then, Qualify by 1 of the 4 Pathways*

Pathway 1 - Academician

  • Holds academic appointment as teacher, researcher, administrator, writes scientific papers, scholarly reviews, book chapters, etc.

Pathway 2 - The Scholar/Teacher/ Multiple Certification

  • Active in community as teacher in Continuing Education and Professional Development activities

  • Re-certified or dual boarded, or MKSAP for score

Pathway 3 - The Active ACP-ASIM Member

  • 10 years membership in the ACP-ASIM

  • Active in ACP-ASIM meetings and Committees at local and national level

Pathway 4 - The Senior Physician

  • May have been a longstanding Member or have joined ACP-ASIM later in life

  • Has demonstrated longstanding professional activity in the community, in teaching, in patient care or in service; acts as a role model for other physicians and health professionals

Note: Community service, especially the voluntary provision of medical care, and ACP-ASIM activities significantly enhance the likelihood of advancement, under all four pathways.

*Pathways are not mutually exclusive; "combinations" are permissible

Indiana Associates Council Update

The Indiana Associates Council has been working hard on the behalf of Indiana residents and fellows. The past several months has been an exciting period for the Associates Council as we hosted the 2000 Indiana Associates Meeting and plan several upcoming projects.

The Associates Meeting was a success. Attendance by residents, fellows and medical students all improved. The level of satisfaction with the meeting's workshops and lectures continues to be very high. The lunchtime Doctor's Dilemma Competition was very exciting with IU again pulling out a last minute upset of St. Vincent. The Job Fair Exhibit again provided residents an opportunity to network and explore job opportunities. And, lastly, the casino event and prize raffle were thoroughly enjoyed. All around, it was a very successful meeting.

The Associates Council plans to build on our past successful Habitat for Humanity Projects. Photos of our first two Habitat projects are available on the Chapter's website. We are extending an invitation to all Chapter members to participate in our May 2001 Habitat Project, which will take place in Indianapolis. This is a terrific opportunity to help those less fortunate to help themselves. More details will be forthcoming!

Work continues on the Student Mentoring Program. The Associates Council is also working on a T-shirt project to create more visibility for the Chapter and create more cohesiveness among the residency programs. Plans are also afoot for sponsoring a group of residents in an athletic event in Summer 2001.

Lastly, Michael and I would like to extend a hearty welcome to the Associates Council's new Co-Chair-Elects Jeff Kreher and Roger Eagan. Jeff is a PGY2 Medicine-Pediatrics resident at IV, and Roger is a PGY2 Categorical Medicine resident who is also at IU. They are strong and enthusiastic leaders who lead the Associates Council to further achievements. Congratulations!

Grant McDougal, MD
Co-Chair, Indiana Associates Council
E-mail: gemcdoug@yahoo.com

National Council of Associates Update

The National Council of Associates (COA) has been representing the interests of internal medicine and medicine-pediatric residents. The last COA meeting in October was productive on several fronts.

Plans were finalized for the creation of "The Mahogany Council of Associates Leadership Award." This is an award that seeks to recognize Associates for outstanding achievements, which are of service to the College and further the defined College's Goals. The first Mahogany Award will be awarded at the 2002 Annual Session.

In terms of advocating on behalf of our Associate members, the COA is addressing several issues. The Council will be issuing a position statement that supports the College's efforts to revise the ABIM's recertification process, which is termed Continuous Professional Development (CPD). This is an issue that is especially pertinent to Associates since the CPD in its current implementation is redundant, poses a significant financial burden and lacks relevance to practicing physicians. The Council of Associates is also attempting to clarify the current ABIM position on resident vacation time and leaves of absence.

I would also encourage both Members and Associates to attend the 2001 Annual Session in Atlanta. The COA is hosting several workshops such as heart and lung sounds, reading EKGs, Internet medicine and contract negotiations. Additionally, the "Caucus 2001: Associates Forum" will provide an opportunity to learn of important Associate issues, to raise topics of concern, and to hear from your colleagues from across the country.

The National Council of Associates is the resident voice within the College and on a national level. Your input and concerns are important and always welcomed.

Michael Sha, MD
Midwest Representative, National Council of Associates Co-Chair, Indiana Associates Council
E-mail: mcsha@iupui.edu

Internal Medicine Student Interest Group (IMSIG) News

The IMSIG has been busy this semester providing information for students about preparing for careers in Internal Medicine. We kicked off the year in August at the annual Student Activities Fair for incoming first year students. This event encouraged students to join our group and become ACP-ASIM student members. Throughout the rest of the semester, we had large group presentations about Med-peds residency training and careers, IU Department of Medicine's Kenya Program, and a panel discussion of IU residency training including curriculum and lifestyle.

Our major event of the semester was our 2nd Annual student-organized Westside Health Fair held at the Clarian Westside Clinic on Michigan Street in Indianapolis, which took place during National Primary Care Week. Our group in conjunction with the Family Medicine Interest Student Group and Pediatrics Student Interest Group, established the health fair last year. This year, we were very excited to have several other student groups participate including OB/Gyn, Dermatology, Student National Medical Assoc., Allied Health Science (Nutrition & Dietetics and Occupational Therapy), and School of Dentistry. We offered free glucose, cholesterol, blood pressure, prostate, vision, and hearing screening for the residents of the local community. In addition, we provided information about smoking cessation, obesity, bicycle and dog bite safety, women's health, osteoporosis, tooth care, and much more. The Bloodmobile was also available for blood donations. We had many student volunteers and the health fair was a great success. We would like to thank the Westside Clinic for their help and allowing us to use their facility. We would also like to thank the ACP-ASIM Governor's Council for their support of this project.

Next semester, we have several discussions planned. The topics include Ethical Legal Decision Making, Handling Stress, Domestic Violence, and Giving Bad News. We have also planned small discussions about IM sub-specialties including Hematology/Oncology, Geriatrics, Cardiology and Sports Medicine. In May, our group will work with the ACP-ASIM Associates to build a house for Habitat for Humanity.

Michelle L Strong
ACP-ASIM Student Representative

How To Contact Us

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

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