Governor's Newsletter
Winter 2002

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

Governor's Column

Members of your Chapter Council continue to try to represent your interests and your views on health care matters to your National ACP-ASIM Organization. Unfortunately, the disaster of September 11th led to the cancellation of the Fall Board of Governor's Meeting. This resulted in rather perfunctory consideration of resolutions submitted for that meeting. The results of the approved Consent Calendar of Resolutions is on the ACP-ASIM website.

The Spring Board of Governor's Meeting has been lengthened one day to deal with matters leftover from the canceled fall meeting. We need your input, both positive and negative, as to how your Indiana Chapter and National ACP-ASIM can best serve you. To correspond with either your Chapter Representative or the National Office, go to the College website (http://www.acponline.org).

Fall Scientific Meeting

We had over 100 registered attendees, plus many Associates and Students at the October 19th and 20th meeting at the Westin Hotel in Indianapolis. Excellent presentations on a variety of subjects were well received by the attendees with high ratings of all speakers.

The College Representative, Dr. Barbara Schuster, Chair of the Department at Medicine at Wright State University Medical School, and a Regent of ACP-ASIM, presented the current activities of the College, including negotiations with the ABIM over the contentious issue of re-certification, and fielded questions and suggestions from the attendees.

All who attended the Friday evening social affair enjoyed the dinner and comedian-magician. Next year's meeting will be November 15th-16th at the Westin Hotel. Mark your calendars now.

Honorees

Dr. Walter Daly and Dr. George Lukemeyer were awarded Laureate Medals at the October meeting for the many contributions over the years to the Indiana Chapter, ACP-ASIM, medical education, and Indiana Medicine. Dr. George Sarosi, a full-time member of the Indiana University School Of Medicine, Infectious Disease Faculty, was recently honored by the College as Teacher of the Year, and named him a Master of the College. Please congratulate these honorees personally when you have the opportunity.

Dr. Lindley Wagner is now Chairman of the Awards Committee, assisted by Drs. Lukemeyer and Daly. Please direct any nominations for Laureate Awards or Mastership to Lindley Wagner.

Indiana ACP-ASIM Chapter List Serv

E-mail and Snail-mail addresses often change making it difficult to keep track of our membership. Our list serve is our quickest way to keep you informed. Please keep us updated with your current addresses by e-mailing us at (cdowning@ismanet.org).

Treasurer's Report

Those who pay state dues with their annual national dues may wonder where your money goes. We have included a recent treasurer's report on page 5. If you have questions or concerns, let us know.

Health And Public Policy Committee

Your HPPC Committee, chaired by Caitilin Kelly, continues to meet regularly to address primarily state health concerns, such as Medicaid reimbursement, health legislation, and domestic child and spouse abuse. Linda Abels continues to attend the Carrier Advisory Committee meetings to present your concerns.

The committee hopes to have the new Medicare Medical Director, when appointed, attend the next meeting to share concerns with him. The committee again submitted a resolution to the ISMA asking for specialty organization delegates to have voting rights at the State Delegates meeting. This again was defeated, but we will keep trying. All members of the Indiana Chapter are encouraged to attend the Conference Call meetings. We will notify all of the meeting schedules by list serv.

ACP-ASIM Membership

The old axiom that "There is strength in numbers" applies to our organization. The ACP-ASIM is the largest specialty organization, but there are many internists who are not members. Women, international graduates, and other minority internists are under-represented in our membership. Medical subspecialists have concerns unique to their subspecialty, but share many concerns with all other internists. Please encourage your associates and friends in the above groups to join the ACP-ASIM.

Also, I encourage those members who have not yet applied for advancement to Fellowship to do so. There are several routes to advancement. One of these should facilitate most members' advancement to Fellowship with the attendant privileges.

IMSIG

Our Internal Medicine Student Interest Group continues to be active. They have regular meetings with speakers on various Internal Medicine subjects and aspects of Practice. At a recent meeting, Fred Frick, MD, FACP, talked about private practice and an I.U. faculty member talked about academic medicine.

The students took a very active role in a health fair at the West Side Health Center October 19th, giving out healthcare information, immunizations and doing health screening. They worked under the supervision of Mary Ciccarelli, Director of the Internal Medicine-Pediatrics Residency at Indiana University Medical Center.

The health fair coincided with our Fall Scientific Meeting, which allowed Dr. Barbara Schuster, our ACP-ASIM Regent, to see the students in action.

Michael Emery, Chairman of the IMSIG serves on our Chapter Council providing helpful student perspectives.

Chapter Contacts And Commitees

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 N. Senate Blvd.
Indianapolis, IN 46202
Phone: 317-962-5178
Fax: 317-962-3065
E-mail: mburan@clarian.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 Fl.
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

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

Scientific Program Committee:
Mary Ciccarelli, MD, Chairman
Cheryle Souther, MD
Richard Kohler, MD
Robert Lubiz, 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

Awards Committee:
Lindley Wagner, 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

Indiana Academy of Physicians Assistants News

Jeremy Heinerich, PA-C

I am the Communications Director of the Indiana Academy of Physician Assistants. I am writing to tell you about a new service we have available to your members. We have started an email list group called IAPAnews to disseminate information to our members. This list is available to physicians who are interested in hiring a physician assistant. If they want to post a message about an upcoming opening they just need to send an email to (IAPAnews@yahoo) groups and it will be sent to all of the PAs in the State of Indiana who have email addresses. If there are any problems sending a message to this address then a message can be sent to Jeremy Heinerich at (jeremyheinerich@aol.com). We hope this service will be of benefit to your members and would appreciate you disseminating this information to your members via email, newsletter, or website. Thank you in advance for your time and consideration. If you have any questions please don't hesitate to contact me: Jeremy Heinerich, 7931 Lower Huntington Road, Fort Wayne, IN 46809, 219-747-0315

Board of Regents Action Taken on Fall 2001 Resolutions

At the October 26-28, 2001 meeting of the Board of Regents, Dr. Lynne Kirk, Chair, Board of Governors, presented for discussion and vote six Fall 2001 Resolutions from the Board of Governors, along with recommendations for their referral and implementation.

The Board of Regents voted to adopt and refer Resolution 1-F01, Declining Public Health Infrastructure , to the Health and Public Policy Committee as the lead committee for implementation, with input from the Education Committee. The Board of Regents also referred this resolution to the Task Force on Biological and Chemical Weapons of Terrorism for implementation: RESOLVED, that the Board of Regents take a leadership role in advocating for a drive to comprehensively improve our country's public health system and its integration with the rest of our medical systems; and be it further RESOLVED, that this drive include such measures as education of physicians and the public about our current shortcomings and true needs in the area of public health, political lobbying and appropriate promotional and public relations efforts toward building a stronger public health system that will benefit our entire country.

The Board of Regents voted to adopt and refer Resolution 2-F01, Evaluation and Regulation of Supplements, to the Health and Public Policy Committee for implementation: RESOLVED, that the Board of Regents actively explore all options to work with the leaders of Congress as well as other medical societies to permit the FDA and other appropriate organizations to objectively evaluate and regulate supplements (especially those already considered dangerous in anecdotal terms) as they do prescription medications.

The Board of Regents voted to adopt and refer Resolution 3-F01, Reduce Associates Dues, to the Membership Committee for implementation: RESOLVED, that the Board of Regents recommend to the Membership Committee that Associates dues be reduced to as much as is reasonable.

The Board of Regents voted to consider Resolution 5-F01, Inclusion of Medical Students on Governors' Advisory Councils, a reaffirmation of current College Policy and referred it to the Chapters Subcommittee for follow-up with the Governors: RESOLVED, that the Board of Regents support and encourage the inclusion of medical student representatives as members of the Governors' Advisory Councils.

The Board of Regents voted to adopt and refer Resolution 6-F01, Reduction of Mailings to Governors, to staff for implementation: RESOLVED, that the Board of Regents implement a policy calling for the reduction in the use of paper mailings by staff and encouraging the use of the GIC for all communications to Governors.

The Board of Regents voted to adopt and refer Resolution 8-F01, Continuation of National ACP-ASIM Support for Governor's Newsletters, to Governor/Chapter Activities staff for implementation: RESOLVED, that the Board of Regents continue to fund the production and distribution costs of up to three Governor's newsletters per year per Chapter until such time that a sufficient percentage of members are reachable via e-mail and broadcast fax to render paper communications unnecessary.

ACP-ASIM Legislative Alert: Urge Legislators To Prevent Medicare Physician Payment Cut

REASON FOR THE ALERT: Legislative action is necessary this year to prevent an across the board cut in the Medicare physician fee schedule

BACKGROUND: Physicians are facing a significant cut in Medicare payments for all services, due to a serious flaw in the formula for updating the Medicare Fee Schedule. Under the current system, which was adopted by Congress in the Balanced Budget Act (BBA) of 1997, physician payment updates are tied to U.S. Gross Domestic Product (GDP) growth. ACP-ASIM opposed this formula when it was first proposed, and has repeatedly warned Congress that it would lead to deep and unacceptable cuts in payments for physician services if the economy went into recession. Unfortunately, Congress did not heed the College's recommendations to replace it with a more fair and appropriate update formula. Beginning January 1, 2002, if Congress does not intervene, Medicare payments to physicians will be reduced by up to 5.4% because of the recent economic downturn.

The assertion that there is a correlation between the GDP and the need for health care services is weak, and no other Medicare provider group is subject to payment reductions when the GDP declines. Physicians are also penalized by flawed estimates for components used to calculate the physician fee update. Since the formula is cumulative, errors that were never corrected are compounded with each year's update. Similarly, no other provider group is on a system in which payments can be reduced by up to 7% a year. The Medicare Payment Advisory Commission (MedPAC), a body that advises Congress, recognizes that this system of automatically reducing payments without regard to health status, aging, new technology or other factors affecting medical practice is flawed and has recommended that it be replaced. Further, administrative adjustments to the formula put physicians at a greater disadvantage than other providers. The Medicare Economic Index (MEI), which measures physicians' inflation costs and is the starting point for the fee schedule update formula, has been reduced by 27% since 1992 due to an excessive assumption of the extent to which physicians offset cost increases with higher productivity.

The Impending cuts in Medicare physician payments will certainly have a negative effect on patient access to physician services. Across the board cuts will force many physicians into early retirement, or make It difficult for patients to find physicians willing to accept new Medicare patients. Reducing physician payments will also affect Medicare+Choice plans negatively, causing more plans to withdraw from the program. Finally, the entire health sector will be affected by a Medicare payment cut, as numerous private plans and state Medicaid programs tie their physician fee schedules to the Medicare rates.

WHAT TO DO: Urge appropriate legislators to work to pass legislation as soon as possible to delay the 2002 Medicare physician fee schedule update until permanent changes can be made In the update formula. The attached page lists Members of Congress who serve on committees with jurisdiction over Medicare. The most effective way to communicate with your legislators regarding the need for change is to tell them how your ability to care for patients would be affected if cuts In physician payments are made. Contact your legislators toll-free through the ACP-ASIM Grassroots Hotline at 1-888-218- 7770. (The Hotline will prompt you for your 8-digit member number, which you can find on the mailing label of ACP-ASIM publications) You may also fax or email your legislators, rather than sending regular mail, in light of recent events. Go to (http://www.acponline.org/lac) to use the ACP-ASIM Legislative Action Center to see a sample letter and &aft your own correspondence. Please contact Amy Jenkins in the Washington Office at 800-338-2746, ext. 4552 with any questions or concerns.

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