Fall 1998 Governor's Newsletter
Mark Your Calendar
May 7, 1999- Associates Day --Hosted by: OHEP
(DMC/William Beaumont/Oakwood, Providence)
The Westen Hotel- Southfield, Southfield, MI
Details Forthcoming
Annual Session
April 22-25, 1999
New Orleans
Chapter Reception Friday Evening, April 23, 1999
Governor's Notes
Jan Rival, MD, FACP
Our Chapter meeting in Traverse City September 24-27, was a resounding success. We had a record attendance including 70 students from our Michigan Medical Schools. We had an opportunity to learn, to teach with some free time for collegial interaction during the three and one half-day meeting. I would like to take this opportunity to thank the Program Committee as well as all the active and passive participants. Kudos to Dr. Ken Fisher who did a yeoman's work as the Chairman of the committee. As a result of Scott Kaatz' diligent and hard work, there were over 300 posters selected and presented by our members and associates. Thanks again to both of you as well as to the support staff headed by Darlene Gompers.
It is hard to imagine that we can improve, nevertheless we are asking our resourceful membership for new ideas. According to the Market Research Report from ACP-ASIM, decision making factors for attendance of our meetings are: 1) location of meeting; 2) dates; 3) topics to be covered; 4) faculty; 5) cost; and 6) coverage of practice (but not necessarily in this order). Let us know your thoughts -- call us or speak to one of the council representatives.
We need a strong and growing organization and to this end I encourage your personal involvement. There is no doubt that the 90's have brought rapid change to the practice of Internal Medicine. Also the past is not necessarily the prologue for the future, there are some key signs of what the future may hold in store for us. There is continuous pressure from general corporatization of healthcare and it is hard to believe that the clock can be turned back. Therefore again, we need your feedback and support.
I would like also to use this opportunity to urge those of you who are qualified for advancement to fellowship to start with your application process. Please review the last newsletter or call my office about available pathways for advancement.
Laureate Awards
The chapter had an impressive and elegant awards banquet where Drs. Carravallah, Hoppe, Rival and Wakulat introduced the Laureates of the Michigan Chapter -- (left to right) Drs. John Penner, Gilbert Bluhm, Joseph Weiss and John Papp.
Congratulations
Following the presentation of the Laureate Awards, Raymond H. Murray, MD, FACP, past Governor of the Michigan Chapter, Richard H. Wakulat, MD, FACP, Past President of MSIM and Park Willis, MACP, newly elected Master of the College were recognized for their outstanding service and dedication to the College.
Awards Committee Chairman, Gilbert Bluhm, MD, FACP is again soliciting proposals for the Michigan Chapter Laureate Award. Please get in touch with Dr. Bluhm or contact the Chapter office for information.
Summary from ACP-ASIM Regional Meeting, September 24-27
Joseph J. Weiss, MD, FACP
For those who were unable to the attend, the following is a summary of several of the major presentations:
Comprehensive Care of the Dying
Dr. John Finn, Executive Medical Director, Hospice of Michigan
Dr. Finn traced the roots of the hospice movement from its origins at the dawn of Christianity to its status today. In taking the audience through that journey, he showed how the premise of hospice care -- giving aid to the physically and emotionally weary -- has remained unchanged today. Hospice care as he pointed out, is not only for the final journey of the patient, but care extends to the family of the terminally ill patient.
Dr. Finn explained how the hospice movement has gained experience in best use of opiates to relieve pain, how to inform and support family of the patient, how to make most of home care, and how to determine when transfer to a hospice facility is most appropriate. Dr. Finn enlightened the audience on the financial obstacles that confront hospice, and called for support to overcome physician and public under-utilization of this important advance in care for the terminally ill patient.
Update for ACP-ASIM
Mary Herald, MD, FACP, Regent, ACP-ASIM
Dr. Herald presented an update on activities of the College on a national scene.
She pointed out the expanding of ACP since the merger with ASIM. The ACP-ASIM plans to implement programs to recruit and retain women, to stand with international graduates to end inequities in the newly required Clinical Skills Assessment Test, and to investigate why minorities are not as well represented in the ACP-ASIM as in the profession.
She pointed out the position papers by ACP-ASIM on these topics and on Medical Manpower needs. She brought to the attention of the audience that all this information and more are available on the ACP-ASIM web page (http://www.acponline.org). She noted that merger with MSIM had brought up a new area: The Center for Competitive Advantage.
She brought out that ACP-ASIM, through representation by her, now networks with the JCAHO and HCFA. Dr. Herald then noted that the ACP-ASIM is lobbying vigorously in Congress against bills that would severely restrict use of opiates by physicians in caring for the terminally ill and would create user fees for our submission for reimbursement to Medicare.
Dr. Herald and Dr. Richard Wakulat, past President MSIM, then fielded questions on the effect of the merger for both organizations. Both speakers emphasized the political clout that comes from this move.
Chairman's Forum
Robert Ernest, MD, FACP representing University of Michigan, Daniel Havlichek, MD representing Michigan State and John O'Connell, MD, FACP, Chair of Wayne State University, Department of Medicine
Each gave a review of their residency programs. For each program, the challenge remains to create the proper blend of teaching, research, personal medical care, while keeping a financially efficient operation. All the while, each program chief must respond to the impact of managed care. Common agreement within each program was that behind the resident's knowledge of today's drugs and procedures, must lay an understanding of basic physiology. The drugs and procedures will change whereas the need by the resident to evaluate their worth will rest on basic understanding of the underlying life processes affected.
Physician Work Force Issues for the Year 2000 and Beyond
Giles Bole, MD, FACP, Immediate Past Dean, University of Michigan Medical School
Dr. Bole noted that at present there are 750,000 physicians in the U.S. with 103,000 in training and 16,300 new graduates entering graduate medical education programs each year augmented by over 7,500 Internal Medical Graduates.
We are facing a physician/population ratio of 350/100,000 when the need requires 200-210/100,000. Dr. Bole discussed the basis for these numbers and to respond to argument that would challenge the importance of the figures he presents. He explained that he is convinced that this country must decrease its present supply of medical graduates and that the way to do so is to bring the country's 125 MD accrediting schools to cut down substantially on entering medical school freshman classes. He then went on to point out why his plan will have difficulty in achieving implementation.
As the reader may imagine, at the conclusion of his presentation, the audience asked numerous serious and emotionally charged questions.
Successful Health Care Systems in the Next Century and What It Will Take
Thomas Royer, MD, Chairman, Board of Governors, Henry Ford Health Systems
Dr. Royer began with a sketch of where health systems stand now. The health care environment is driven by conditions whipped up by government, whose stated policy is to cap funds it will provide for health, by employers paying for care and critical of the quality of care received, and by patients and their families who set ever higher standards for personal attention to their particular needs. At the same time, there is a realization that the role of health systems is not to treat illness but to maintain health.
Dr. Royer believes that the only way to fulfill these multiple responsibilities placed upon the health care system is for doctors to recognize they are part of a team that works from hospital to outpatient to home. Only in this way will the medical profession keep allocation of resources to ourselves.
Dr. Royer centered his final remarks on the point that: managed care is not a financial tool, but is a style of practice that will allow best use of limited resources.
This summary has not attempted to review the excellent breakout session or special interest breakfasts. The discussions of end-of-life issues were notable, the meeting of International Medical Graduates was not just instructive, but illuminating. Dr. David Scrases' Thieves Market was magnificent, and Dr. Marcus Zervos in giving the Annual Boy Frame Lecture combined his unique personal experience to the state of the art.
Finally, who can place a value on the individual conversations in the halls, at the receptions and during mealtime. These meetings were priceless.
This Fall meeting was superb; the planning is already underway to make next year's even better.
Tidbits
Jan Rival, MD, FACP
The Chapter's Council will be meeting in mid-January. Please relay to your representatives any items for the agenda for which you would like to be discussed. We hope that at the time of receiving this newsletter that the Chapter will have its own ACP-ASIM web page thereby enhancing communication and information. Please check for your council members and officers on the chapter's web page -http://www.acponline.org/chapters/mi.
Please keep the Chapter office informed about your activities and accomplishments. We would like to recognize you and have a "proactive" attitude.
Members of your council worked on our new bylaws. The merger of ACP-ASIM is progressing smoothly with no significant problems. For the first time, our professional organization is able to clearly speak with a single voice for Internal Medicine. Please be advised that according to recent communication from the National headquarters in Philadelphia, we need to send our completed draft of the bylaws after approval of legal counsel to insure that they are consistent with state law. The bylaws will be reviewed by the national staff and ultimately the board of regents must approve them.
Many chapter members have received "dues notices" for the 1998-1999 for the ACP-ASIM organization. Chapter dues were not raised and remain at $30 (one of the lowest in the nation).
The Chapter obtained the 1998 Chapter Management Award for meeting standards determined by the Chapters' Subcommittee to run the local chapter effectively.
| Membership Profile and five (5) year history of the Michigan Chapter | |||||||
| Class | 1993 | 1994 | 1995 | 1996 | 1997 | 1998 | % increase '93-98 |
| Masters | 3 | 3 | 3 | 3 | 3 | 5 | 66.67% |
| Fellows | 647 | 653 | 662 | 691 | 702 | 713 | 10.20% |
| Members | 1191 | 1275 | 1325 | 1384 | 1419 | 1703 | 42.99% |
| Associates | 729 | 917 | 908 | 1057 | 983 | 1190 | 63.24% |
| Med. Stud. | 120 | 302 | 470 | 648* | 114.24% | ||
| TOTALS | 2570 | 2848 | 2898 | 3437 | 3577 | 4259 | 65.72% |
| Yearly % Increase | 10.82 | 1.76 | 18.60 | 4.07 | 19.07 | ||
| *Thanks Dr. Joel Appel | |||||||
In Memoriam
The chapter wishes to express its sympathy to the families in the passing this past Summer of Charles Webb, MD, FACP, the chapter's ACEL who although seriously ill, maintained his dedication to his profession and activities in the College. Carolyn Kimmel, MSIM's Executive Secretary who, for many years was a dedicated and cherished individual was taken from us suddenly. Each one will be sorely missed by all that had any contact with them either on a professional or personal level. A moment of silence was held in their honor at our council meeting in Traverse City.
Ways to Contact Your Governor
Write:
Michigan Chapter ACP-ASIM
C/0 Henry Ford Hospital
2799 West Grand Blvd.
Detroit, MI. 48202
ATT: Room B-1540, K-15
Call: 800-247-2485 (Michigan residents only) or (313) 876-1403
Fax: 313-876-1409
E-mail: Jrival1@HFHS.org
Please let me know of your ideas, concerns, criticisms
I would like to close my newsletter with thanking the membership of the Michigan Chapter of ACP-ASIM for granting me the opportunity to serve you. I am deeply honored to be your Governor for the next four years. I would like to continue to the good already begun. I do realize that we must stay one step ahead of environmental changes. I would be naïve to think that I can identify all our priorities and that I can propose all the solutions for the turbulent times ahead. But I wanted to thank you for your confidence in me as well as my ability to serve you, and I promise you I will not let you down.
On behalf of the chapter I wish you a happy and peaceful holiday season to you and your loved ones.
What's New
Contact Information
Ruth Hoppe
Governor, Michigan Chapter
Marty Muth
Michigan Chapter Staff
Phone: 517-353-9548
Fax: 517-353-9604