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December 2011 Richard M. Dupee, MD, FACP, AGSF, Governor


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Governor’s Message
Richard M. Dupee, MD, FACP, Governor

Dr. Dupee

Dear Massachusetts ACP Colleagues,

It has certainly been an interesting and challenging year, as we begin to see the implications of the Affordable Care Act, signed 20 months ago, a law in which Americans are deeply divided. As Don Berwick, (no longer CMS chief), said: “It’s a complex, complicated law. To explain it takes a while. To understand it takes an investment that I’m not sure the man or the woman in the street wants to make or ought to make.”

And therein lies the rub. We are only learning what is in the law after it has already passed!

Medicine is at a crossroads, and we are in the thick of it. Here in Massachusetts, Governor Patrick and Secretary Bigby are expressly concerned that our present system of reimbursement simply does not work. Contracts with organization in this commonwealth have led to significant disparities in payment for hospitals and physicians. For example, a hospital in one organization is paid considerably more for the same service than another, yet with the same outcome. And a physician in one hospital system is paid 95% more, for the same procedure, than a physician in another hospital system. It makes no sense, and clearly our legislators know it. Thus, the time has come to level the playing field, and it is to that end that the Massachusetts Chapter of ACP is closely involved in the debate over how we can solve this dilemma.

In response to the Governor’s plan to alter hospital and physician payment, which is heavily reliant on the ACO and AQC concept, our council has produced an important document on physician payment reform. Please review the document in this newsletter, and let me know your thoughts. We are also working on a similar document for subspecialists.

The congressional “super” committee's failure to agree on a deficit-reduction plan has left physicians once again on the brink of a dramatic cutback in Medicare reimbursements.

The American College of Physicians has used an e-mail campaign to urge legislators on the super committee to "go big" and repeal the sustainable growth rate, which was enacted in 1997 as a means of controlling costs by linking Medicare payments to the nation's economy, but has instead dangled like a sword over doctors' heads for a decade.

But the collapse of the super committee's efforts now means that Medicare payments to doctors will be cut by 27.4 percent unless Congress intervenes before Jan. 1. We are hoping that the current bill being legislated in the House, which again extends the “Doc Fix,” will give some breathing room, but it is part of a bill which calls for extension of the payroll tax reduction, and approving the Keystone oil pipeline. Stay tuned, but in the meantime, please contact your legislators!

Finally, we had a terrific annual meeting in November, with record attendance and an excellent program of speakers, posters, reviews, and our annual “Town Hall” meeting and of course a lively Medical Jeopardy, this year won by the Residents at St. Vincent’s. We are proud of all of our poster and oral presenters, and Jeopardy winners, who will now compete at the ACP Annual Meeting in April in New Orleans!

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Priorities for Payment and Practice Reform with a Focus on Primary Care

Massachusetts Chapter, American College of Physicians
A Policy Statement

Preamble: As the professional society representing over 3500 primary care and specialty internal medicine physicians and trainees in Massachusetts, we put forward the following policy positions and recommendations which we believe are essential to achieving health system reform. The following statements concentrate on (but are not limited to) primary care, which, as the foundation of our health care delivery system, requires urgent revitalization and prioritization.

  1. There must be a new net investment (of money and other resources) in primary care practices to enable their transformation to high performance entities; the investment needs to be prospective.
  2. Payment to primary care practices and its professionals should be sufficient to enable and incent achievement of desired primary care outcomes and reflect the actual value created; it should not be based on existing RVU determinations (which undervalue primary care services), though RVU-based payment may remain relevant for some specialty and procedural providers.
  3. Payment for primary care should transition from fee-for-service to increasing degrees of bundled, comprehensive, or capitated payment over time and be complemented by performance-based, practice reinvestment/bonus payment for achieving desired goals in quality, patient centeredness, and efficiency as practices transform and develop the capacity to manage performance risk.
  4. Any bundled, global, or performance-based payment for primary care must be robustly risk-adjusted, taking into account not only demographic and clinical factors, but also psychosocial determinants.
  5. Payment reform for primary care should be offered uniformly across payers.
  6. Performance metrics and standards used for payment must be scientifically validated, evidence-based, clinically meaningful, and vetted by practices before being implemented.
  7. Loan forgiveness and other recruitment and retention incentives should be built into payment reform measures for primary care
  8. Liability reform must accompany payment and practice reform for primary care. Reform should include but not be limited to:
    1. expert-panel pre-review of claims with a majority of panel members being practicing, same-specialty experts
    2. no opt-out for claims deemed of low merit
    3. a prejudgment interest rate equal to the national annual inflation rate or a similar statistic.
    4. safe-harbor provisions against law suit for practice of evidence-based medicine
    5. cooling- off period with opportunity for non-admissible apology and communication between parties.
  9. Primary care physicians and practices participating in an ACO or other integrated, risk-sharing care network must:
    1. occupy at least 50% of seats on the organization’s board when its performance metrics and goals are heavily weighted towards primary care outcomes
    2. choose and approve the mode of payment for primary care and have oversight authority for its implementation and ongoing operation
    3. participate in the design, selection, implementation, and analysis of performance metrics
    4. specify and be provided in timely fashion the systems, collaborations, and data necessary to fulfill their responsibilities within the organization
  10. Practices that choose not to join a formal ACO structure yet commit to and achieve its overall goals of high-value, patient-centered, coordinated care should not be penalized for remaining outside the ACO and should be able to interact with its participants in the delivery of care.

Adopted by the MA Chapter, American College of Physicians
Governor’s Council
6/17/11

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MA ACP Annual Scientific Meeting –
November 19, 2011

morning presenters
Morning Session Presenters (left to right): Elaine M. Hylek, MD, MPH, Richard S. Irwin, MD, FACP, Master FCCP and Anthony L. Esposito, MD, FACP

award winners
Award Winners (left to right): Laureate Award: John T. Harrington, MD, MACP, Chapter Leadership Award: Phoebe Cushman, MD, MA Governor, Richard M. Dupee, MD, FACP and Young Leadership Award: Sarah Turbett, MD

moderators
Town Hall Meeting Moderator and Panelists (left to right) MA Governor, Richard M. Dupee, MD, FACP, Secretary of MA Health and Human Services, Judy Ann Bigby, MD, Massachusetts Medical Society President, Lynda Young, MD, and CEO of Atrius Health, Gene Lindsey, MD

MA ACP Annual Scientific Meeting – Oral and Poster Presentations

On Saturday, November 19 at the Annual Scientific Meeting of the Massachusetts Chapter of the American College of Physicians, we had a near record attendance and saw another dazzling display of scholastic achievements in the form of 49 brilliant posters, along with oral presentations. The winners from among the medical students and residents were:

Oral Presentation Winners

Clinical Vignette: Uday Lele, MD, MetroWest Medical Center
The Role of MTHFR 677TT Genotype in a Case of Recurrent Thrombotic Thrombocytopenic Purpura (TTP)

Research: Aparna Raj, MD, Massachusetts General Hospital
Quality of Breast Cancer Care in a Boston Area Patient Navigator Program

Resident Poster Competition

Clinical Vignette – Winner: Poster # 1 Anju Bhagavan, MBBS, BayState
Frozen Blue Toes

Clinical Vignette – Honorable Mention: Poster #17 Abbas Rupawala, MD, UMass
An Unusual Cause of Acute Kidney Injury and Nephromegaly

Clinical Vignette – Honorable Mention: Poster #33 Annie Daniel, MBBS, St. Vincent Hospital
An Unmasking of Celiac Disease

Research – Winner: Poster # 5 Arash Bedayat, MD, MetroWest Medical Center
Characteristics of Uncertain Acute Pulmonary Embolism Diagnosis on CTPA Images: Review of 1660 Cases

Student Poster Competition Winner: Poster #47 Xibei Jia, Tufts Medical School
Safety of Midlines vs PICC Lines for Home Intravenous Antibiotic Therapy

Medical Jeopardy

That same day, in another tight fought, nail-biting competition, the Saint Vincent Hospital Jeopardy Team, as returning champions, blasted through an array of Massachusetts’ best teaching programs. Their players – Drs. Praveen Sudhindra, Dhaval Shah, Karthik Gnanapandithan, and Atul Palkar, and coached by Drs. Joel Popkin and Saurbha Dani (last year’s captain) performed at a simply astonishing level of knowledge and speed. For their efforts they will for the second year in a row travel to New Orleans, courtesy ACP, to compete at the annual meeting in April. Last year, representing Massachusetts in National Jeopardy, they came in second place!

team
Medical Jeopardy Team from Saint Vincent Hospital (left to right): Drs. Karthik Gnanapandithan, Dhaval Shah, Praveen Sudhindra, and Atul Palkar

Visit us on Facebook for more photos from the Annual Meeting.

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Welcome to our Newest Governor’s Council Members

At the Annual Meeting on Saturday, November 19, 2011, the MA ACP membership elected two new Governor’s council members, Dr. Elisa Choi and Dr. Stuart Mushlin. Drs. Choi and Mushlin will join the council for the first time at the next meeting in January. We look forward to their active participation!

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Early Career Physicians’ Corner*

The Massachusetts Chapter’s Council of Early Career Physicians has enjoyed a successful and productive fall quarter. The Council has now created and approved its mission and bylaws, elected a panel of 12 officers and members-at-large, and enlisted a group of interested actively participating physicians. If you are interested in joining the Council of Early Career Physicians, please contact Chairperson Dr. Phoebe Cushman.

The Council’s first formal endeavor was to present a panel discussion at this year’s Annual Scientific Meeting (held November 19, 2011) entitled, “Careers in Primary Care and Hospitalist Medicine: Sustainability versus Burnout.” The Council’s members were quite pleased with the turnout and enthusiasm, and hope that the attendees found the conversation useful.

ecp
Dr. Phoebe Cushman moderates the ECP Session on “Careers in Primary Care and Hospitalist Medicine: Sustainability vs. Burnout”

The Council also created the Massachusetts Chapter’s Facebook page-- thanks to all those who contributed posts and photos to help keep the page current. The Council’s goal is to continue to develop the page, so that it may be utilized effectively by the Massachusetts Chapter as a whole.

Please SAVE THE DATE for a social and professional networking event for all early career physicians (physicians who graduated from medical school within the last 16 years and who are NOT currently in residency or fellowship training):

THE MASSACHUSETTS ACP COUNCIL OF EARLY CAREER PHYSICIANS
IS PROUD TO HOST
A WINTER KICKOFF EVENT
FOR ALL MA ACP EARLY CAREER PHYSICIANS

FRIDAY, JANUARY 27th, 2012
7:30PM to 10PM
The Metropolitan Club (“MetBar”) in Chesnut Hill
1210 Boylston St.
Chestnut Hill, MA 02467
Hors d’oeuvres and cash bar
Spouses/significant others welcome
Questions? Contact Lynda Layer or 781-434-7317

*According to ACP, a “young physician” or “early career physician” is defined as a physician member of ACP who is within sixteen years of graduating medical school and who is not currently in residency or fellowship.

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Mark Your Calendar

Wednesday & Thursday, June 6-7, 2012 (new date for 2012)
ACP Leadership Day on Capitol Hill, Washington, DC

Saturday, November 3, 2012 2012 Annual Scientific Meeting

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ACP Announces Awardees for 2012 from Massachusetts
Congratulations!

Edward R. Loveland Memorial Award for a Distinguished Contribution to the Health Field

Award Established: 1961
In honor of: The late Edward R. Loveland, the first Executive Staff Officer of the College. This award is bestowed to a layperson or lay organization for a distinguished contribution in the health field.
2012 Recipient: CRUDEM Foundation, Ludlow, Massachusetts

Joseph E. Johnson Leadership Award

Award Established: 2003
In honor of: The late Dr. Joseph E. Johnson III, former ACP Governor, Regent, Treasurer, Interim Executive Vice President, and Senior Vice President for Membership.

The award recognizes an Associate member of the College who has demonstrated qualities that exemplify the College’s mission “to enhance the quality and effectiveness of health care by fostering excellence and professionalism in the practice of medicine.” For each year considered, nominees must be Associates as of June 30th of that year. Nominees may have outstanding achievements in any of a wide variety of areas, including leadership, medical practice, research, teaching, publications, advocacy, and/or volunteerism.
2012 Recipient: Andrew B. Trotter, MD, Jamaica Plain, Massachusetts

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Congratulations to the New Fellows of the MA Chapter

Charles E Cavagnaro, MD, FACP
Scott M Halista, MD FACP
Carey D Kimmelstiel, MD, FACP
Mark Krivopal, MD, FACP
Tony Makdisi, MD, FACP
Ashish Verma, MD FACP
Ramnik J Xavier, MD FACP
Maria A Yialamas, MD, FACP

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Welcome to the New Members and Associates of the MA Chapter

Members:

Deep Adhikari, MBBS
Charlotte Atiemo, MD
Scott M Barnett, MD
Durga Bhavani Bathini, MD
Eugene J Boss, MD
Daniel L Bourque, MD
Danielle L Brook, MD
Nathaniel F Brown, MD
Bharanidhar Chandrasekaran, MBBS
Aditi R Chittety, MBBS
Ryan C Chua, MD
Richard Chung, MD
Alicia Clark, MD
Rosemary E Corderi, MD
Kristin A Cox, MD
Paul C Cremer, MD
Gwen C Crevensten, MD
Shaji P Daniel, MD
Christian A Dankers, MD
Fabian Delgado, MD
Deborah Derderian, DO
Bishnu P Dhakal, MD
Jefferson H Dickey, MD
Mustafa M Dohadwala, MD
Katherine A Dudley, MD
Elena Eberle, MD
Joseph D Feuerstein, MD
Amy Francis, DO
Cassie Frank, MD MPH
Mercedes Freije Ibanez, MD
Shachi Gupta, MD
Puncho Gurung, MBBS
Luba Hafkin, MD
Mohmmad F Hajjiri, MBBS
Ardeshir Z Hashmi, MBBS
LeRoi S Hicks, MD
Rebecca N Hutchinson, MD
Guibenson Hyppolite, MD
Aqueel Imran, MBBS
Diana A Israeli, DO
Simon L Jacobs, MD
Emmanuel F Kanyi, MD
Stephen C Kaplan, MD
Jinesh Kochar, MD MPH
Indira Doris Konanur, DO
Steven Lamontagne, MD
James D Laudate, MD
Calvin A Lee, MD
Teli Leung, MD
Margaret Lippincott, MD
Eva Liu, MD
Kyaw M Lwin, MBBS
David B Macdonald, MD
Syed K Mahmood, MBBS
Madhavi Manchikalapati, MBBS
Ilia Manevich, MD
Victoria Mark, MD
Manish R Maski, MD
Eric Jeffrey Matthews, DO
Janine M McCauley, MD
Francis V McDermott, MD
Sarfaraz Memon, MBBS
Elna M Nagasako, MD
Azadeh Nasseh, MD
Ernesto J Negron, MD
Elizabeth Keating O'Donnell, MD
Amanke Chigozie Oranu, MD
Phyllis Owusu-Griffin, MD
Kumar Pallav, MBBS
Cecilia Pena-Sisto, MD
Naureen Raja-Shafiq, MD
Vidya Raju, MD
Yamini Ramakrishna, MBBS
Deepa Lal Ratwani, DO
Nishal Cholapurath Ravindran, MBBS
Madhab Ray, MBBS
Eva B Reitschuler-Cross, MD
Hilda Rivera-Rivera, MD
Douglas A Rubinson, MD PhD
Mohamed Sageer, MBBS
Lipika Samal, MD MPH
Frantisek Sandor, MD
Mayu Sekiguchi Runge, MD MPH
Qaiser Shafiq, MD
Ruta Shah, MD
Lily Shen, MD
Alex Sica, MD
Manavjot S Sidhu, MBBS
Jennifer Rose Siegel, MD
Amrita Singh, MBBS
Lisa Sonia Starobin, MD
Elizabeth K Stevenson, MD
Natasha Surette, MD
David B Sykes, MD PhD
Nestor G Tarragona, MD
Helen C Taylor, MD
Deepu A Thomas, MBBS
Ryan W Thompson, MD
Laxmi N A Thummalakunta, MBBS
Andrew B Trotter, MD
Prakrita B Udas, MD
Alexander V Uihlein, MD
Venu Madhav Velagapudi, MD
Charlotte A Wu, MD
Jean N Yeung, MBBS BSc
Ryan D Zaklin, MD
Jeffrey A Zesiger, MD

Associates:

Noormuhammad Oosman Abbasakoor, MBBCH
Srinath Adusumalli, MD
Tokunbo O Ajayi, MD
Rahana Aju, MD
Sora Al Rowas, MD
Neha Alang, MBBS
Fadi Aldaas, MD
SHAHID ALI, MBBS
Satya B Allaparthi, MD
Andrew Allegretti, MD
Joshua W Allen-Dicker, MD MPH
Curtis K Andrews, DO
George L Anesi, MD
Mansoor Arif, MBBS
Mariam H. Ayub, MD
Samia Ayub, MBBS
Sanggyu Bae, MD
Anushka Bagga, MD
Yan Bai, MD
Dahlia Banerji, MD
Janelle V Baptiste, MD, MPH
Basim A Baragaba, MD,MBBS
Tomer Barak, MD
Ian J Barbash, MD
Abdul Basit, MD
Kristin Beaver, MD
Arash Bedayat, MD
Sarath Bhimineni, MD
Lindsay E Brown, MD
Kathleen Mary Buchheit, MD
Anjali Budhathoki, MD
Monique C Carreno, MD
Samuel Chakola, MD
Aditya Chandrasekhar, MD
Joseph P Charpentier, DO
Surya Teja Chaturvedula, MBBS
Biswashree Chaudhury, MD
Deborah C Chen, MD
Wendy M Chiang, MD
Kalpana Chilukuri, MBBS
Sridhar R Chitti, MBBS
Eunice Y Chuang, MD
Wanda Marie Colon, MD
Fernando M Contreras-Valdes, MD
Annie Shaji Daniel, MBBS
Koushik Kumar Das, MD
Nadya S Davila Lourido, MD
Aretha D Davis, MD
Shilpa Desai, MD
Kunal V Domakonda, MD
Benjamin Jacob Drapkin, MD PhD
Aleh Dzedavets, MD
Fahad Y Edrees, MD,MBBS
Umar Farooq, MBBS
Vivek K Gag, MD
Leila Ganjehei, MD
Hong Jenny Gao, MD
Neetika Garg, MBBS
Katharine A Germansky, MD
Christopher James Gibson, MD
Karthik Gnanapandithan, MD
Raj K Gopal, MD,PhD
Sujeet Govindan, MD
Kelly L Graham, MD
Daniel M Halperin, MD
Christina Harding;MD
Aaron Harman, MD
Kamran Hassan, MBBS
Zena Hassan, MD
Jennifer T Higa, MD
Jonathan Dwyer Holdorf, MD
Yamen Homsi, MD
Lihong Huo, MD
Abu Hurairah, MD
Tanvir Hussain, MD
Layli Jamali, MD
Muhammad Janisar, MBBS
Ahmed Jawad, MBBS
Zhenghui Gordon Jiang, MD
Kimberly G Kallianos, MD
Yugandhar kandimalla, MD
Nancy Kang;MD
Mohammad Amin Kashef, MD
Anas M Khalil, MD
Austin Kim, MD
Georgios KITSIOS, MD, MS, PHD
Ravi K Kshirsagar, MD
Jason Lake, MD, MPH
Mary T LaSalvia, MD
Jaeyoung Lee, MD
Shin Yin Lee, MD
Sean D Levy, MD
Robert Coleman Lindsley, Jr MD, PhD
Angela M Lo, MD
Katayoun Lotfi, MD
Kristin L Macarthur, MD
Hoyoung Maeng, MD
Carmela Mancini, DO, MPH
Paolo L Mascari, MD
Shihab Masrur, MBBS
Mallika Lakshmi Mendu, MD
Roeland J. W. Middelbeek, MD MSc
Daniel Miller, DO
Parisa Momtaz, MDCM
Randall J Morse, MD
Shveta Motwani, MD
Syed Hussain Muqqadus, MD
Firas Y Naji, DO
Iva Neupane, MBBS
Michael S. Newman, DO
Robert F O Connor, MD
Joshua Charles Obuch, MD
Chidimma I Okoli, MD
Ariela Orkaby, MD
Eric D Osgood, MD
Atul Vijay Palkar, MD
Sanket Patel, MD
Jonathan Peled, MD
William F Pendergraft III, MD,PhD
Mary Linton B Peters, MD
Christina Pham, MD
Prince A Philip, MD
Andrea Lynn Poisson, MD
Husain Poonawala, MBBS
Divya Prabhu, MBBS
David Ozzie Rahni, MD
Aparna Raj, MD
Alison B Rapoport, MD
Masooma Rehmtulla, MD
Kenneth Roach, MD,PhD
Giulio R Romeo, MD
Christopher G Roy, MD
Jonah N Rubin, MD
Robert Salazar, MD
Pooja Sareen, MD
Relffa Jacho Sathe, MD
Stavros Savvas, MD
Zienab Sawan, MBBS
Jessica Sheehan, MD
Sandeep R Somalaraju, MBBS
Young-Soo Song, MD
Rahul Nitin Sood, MD
Erick R Soria Galvarro Duran, MD
Roy Sriwattanakomen, MD
Sean D Stanhope, DO
Amanda M. Staples, DO
Anna Stepczynski, MD
Diana Suris, DO
Walter Sussman, DO
Hannah K Swayze-Quinn, MD
Rafeel O Syed, MD
Nazbeh Taghizadeh, MD
Elliot B. Tapper, MD
Arpankumar V Thaker, MD
Jaclyn Therrien, DO
Ahmet Toprak, MD
Jason Touhey, DO
Kathleen A Townes, MD
Katrina E Traber, MD
Indumathy Varadarajan, MBBS
Sebastian A Varas Garcia, MD
Jianfeng Wang, MD
Robert E Weir, MD
Annalee Wells, DO
Suzanne Wheeler, DO
Haishan Xu, MD
Justin L yamin;MD
Xiaoyu Yang, MD
Abena Yankah, MD
Jungwon Yoon, MD
Cindy Yu, MD
David J Yuh, MD
Nargiza Yuldasheva, MD
Khalid Ramadan Zarug, MD
Xiaosong Zhang, MD PhD

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Happy Holidays from the Massachusetts Chapter, American College of Physicians

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