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Minnesota Chapter Scientific Meeting 2011

Dr. Gantzer's photo

The Minneapolis Convention Center was the epicenter of Internal Medicine in Minnesota November 3-4, with 336 people attending the Chapter Scientific Meeting. Many thanks to Dr. John Bundrick and Dr. Mary Miley who chaired the meeting and to Executive Director Katherine Cairns who coordinated the event. The slides for all of the presentations are on the MN Chapter Web site for members to download.

Drs. Amit Ghosh, John Bundrick and Jason Szostek led the Pre-Course for Recertification on Thursday Nov 3. This allowed physicians to work through two SEP modules-Internal Medicine CO-L and Hospital Medicine 83-L-with group discussion on each question. By entering their responses directly on their laptop, tablet or smartphone, members were able to walk out at the end of the four hour session with CME credit and with 20 points in Medical Knowledge for their Maintenance of Certification acknowledged by the ABIM as being credited toward their recertification.

Friday morning began with the Women’s Breakfast, where Dr. Sally Berryman reviewed the Karen Siebert article “Don’t Quit This Day Job” which had appeared in the New York Times. She also analyzed some of the issues raised in the article and related them to Federal GME funding; and there was lively discussion about the value of physicians’ work, the meaning of that work and the evolving role of the physician. There were thoughtful comments from physicians at the breakfast who have practiced in rural communities, about the challenges and rewards that came from those practices, and from hospitalists, subspecialists and primary care internists.

At the Scientific Meeting, the lectures began with Dr. William T. Browne who reviewed clear recommendations for practical steps to take to reduce the mortality from sepsis. Dr. Bradley J. Benson shared some favorite medical apps for both physician and patient, and those specific apps are listed on his lecture slides which can be downloaded from the chapter Web site. Drs. Craig S. Roth and Charles P. Reznikoff had the audience spellbound with their discussion on navigating disagreements with patients, including a review of recommendations from the literature, a role playing episode involving a patient demanding an MRI of the knee, and an actual patient, formerly addicted to narcotics, who described to us the frustrations, panic, lies and fears an addict can suffer and who shared thoughts about how physicians and patients can work together in dealing with difficult issues.

There was timely advice from Dr. Rajiv K. Pruthi on the benefits and risks of dabigatran and other direct thrombin inhibitors. Dr. David Rippe described the recognition and management of autonomic dysreflexia in spinal cord patients, a condition well worth identifying promptly and managing aggressively. Dr. Kristen Kopski made a potpourri of acronyms understandable in her thoughtful assessment of the Minnesota perspective on the health care home. With the escalating number of bariatric surgeries being performed, Dr. Guilford Hartley clarified the care of the post-gastric bypass surgery patient. Dr. Salma Mohsin gave recommendations of the inpatient management of diabetes. A number of perplexing questions regarding osteoporosis therapy were addressed by Dr. Ann Kearns. The talks concluded with Dr. Steven D. Hilsson who thoughtfully analyzed significant papers in the medical literature in the past year.

Our visiting College Representative was Dr. Charles Cutler of the ACP Board of Regents, who left snowy Pennsylvania to visit our tropical Minnesota. He was very interested to hear what our chapter has been doing, he judged the final round of the poster competitions, and he updated us on ACP activities, particularly regarding the status of health care reform on the national level.

On Friday, 147 associates and 16 medical students attended the meeting, demonstrating a high level of excellence in their poster competition spearheaded by Dr. Charles Reznikoff. Physician ACP members from the community and from academia served as judges moderating the poster groups, with a peer judging process being used. The winners were Jesse Roske of the University of Minnesota for Clinical Vignette; John Coborn of Mayo for the Medical Student competitions; Kristina Krohn of the University of Minnesota for Quality Improvement; Ben Zhang of Mayo for Research; and Matthew Lieser of Abbott Northwestern for the People’s Choice award.

The Awards lunch honored four Minnesota physicians who have inspired us with their work. Dr. Rajiv Kumar, nephrologist at the Mayo clinic, has been named the Phillips Award winner by the national ACP and will be presented with this award in New Orleans. He joins an illustrious list of former awardees including Linus Pauling, Cecil James Watson, Helen Taussig , Eugene Braunewald and Jerome Kassirer. We announced that Dr. Timothy Wilt of the VA will be awarded Mastership at Convocation in New Orleans; he is well known to readers of the Annals of Internal Medicine, as well as local and national media, for his work on the evidence-based guidelines of the United States Preventive Services Task Force. The tireless work of Dr. Thomas McLeod of Rochester was recognized by our Minnesota Chapter with the Volunteerism and Community Service Award and a $1000 donation to charity; since 1996 he has volunteered at the Good Samaritan Medical Clinic, providing care to those in need, recruiting colleagues for the same, and inspiring medical students to serve. Our Chapter Laureate was Dr. Bradley Benson, of the University of Minnesota, who bridges the worlds of internal medicine and pediatrics and whose service to the Chapter has been so valuable.

With group discussion, lectures, competition, and inspiration, the members of the Minnesota American College of Physicians had a gathering which in every way supported the Chapter Mission of fostering excellence, education and professionalism among all internists in our community.

kumar winner
Dr. Charles Cutler, member of the Board of Regents of the ACP, Dr. Heather Gantzer, MN-ACP Governor, Dr. Rajiv Kumar, ACP Phillips Award winner

mcleod
Dr. Thomas McLeod of Rochester Volunteerism and Community Service Award

wilt
Dr. Timothy Wilt of the VA will be awarded Mastership at Convocation at the ACP 2012 meeting in New Orleans

benson
Dr. Brad Benson, MN-ACP Laureate award winner

roske
Jesse Roske, MD of the University of Minnesota for Clinical Vignette

krohn
Kristina Krohn, MD of the University of Minnesota for Quality Improvement

zhang
Research winner, Ben Zhang, MD

coborn
John Coborn of Mayo for the Medical Student competitions

vignette finalists
Clinical Vignette finalists

winner
The lucky Ipad2 winner

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“A Medical Student's Perspective", by Aaron Crosby, second year medical student at the University of Minnesota

“You know I have someone in my family who’s going to be a doctor – just starting his second year of medical school as we speak, in fact,” said a relative of mine as they sat waiting for a colonoscopy, paper gown crinkling at the draft coming down from the vents.

“Is that so?” began the Doc, “Here at the U? Man, I thought we took on a lot of debt when we went through school, but that’s nothing compared to the schools these days. Does he know what specialty he wants to go into?” “He doesn’t have to choose yet, but I think he said Internal Medicine – does that sound right?” The Doc laughed as he stood at a tray with a nurse as she sorted varied sterilized, disposable plastic accoutrements. He looked up over the top of his glasses, “Well, you tell him to rethink that right now if he wants to have a nice, happy career.”

Unfortunately, the attitude of this Doc and his dissatisfaction with internal medicine does not shock me, and I would go so far as to say it would not most medical students either. In the coming years, the case load for primary care internists in particular is projected to increase dramatically, and the supply of fresh-faced internal medicine residents is expected to increase modestly if at all.(1) One of the factors influencing this general lack of enthusiasm of medical students toward internal medicine as a specialty is the lack of enthusiasm they perceive in internists for internal medicine as a specialty.(2) So where does this leave medical students who are interested in the pursuit of the challenges and rewards provided by a career in internal medicine?

Every year at holidays and graduation parties, my family likes to ask me questions about the direction of my (to them) never-ending journey through our nation’s educational system: How many years until you are a doctor? How much debt will you have? How much time will you have for family?

However, those things that everyone seems to think I should be worried about I actually don’t much. There are two reasons for this. First, I feel there are far more things to be excited about in medicine than there are to be worried about. Take the last twenty years as an example. In the last two decades, we have seen phenomenal increases in success in treating both acute conditions like respiratory failure and chronic conditions like rheumatoid arthritis. While internal medicine physicians have always had a reputation as master diagnosticians à la television’s House, MD, medicine has more substantial, efficacious treatments than ever. Additionally, the last few years has seen our country finally address the issue of health care reform, and even if you do not personally endorse the changes made thus far, I think that any physician should view the beginning of the process of improving the way we deliver and pay for care as a necessary and positive step.

The second reason I am excited for my future in medicine is that I look forward to having thoughtful mentors and role-models to help me find my way. If I were allowed just one concern as a student, it would be that I hope that older, experienced physicians continue to maintain an optimism and passion for medicine that they can share with students of my generation. I do not want to look to a senior physician as a role model if they are an individual who gives in to tired cynicism and calls it realism.

I know that many of the physicians young and old reading this love medicine and are thrilled to get up and come to work every morning, and my message to them is one of thanks and encouragement. I have been fortunate to have some of you as mentors already, and if you did not know it at the time we students have tried to take your wisdom and words of encouragement to heart. To those doctors that are beginning to feel the drag of disillusionment, I would like to say this – we students and young learners of medicine know that the system can be frustrating, the hours long and the work never-ending. We are aware of how inexperienced and naïve we are. But we are watching you; we want to admire and emulate you. We hope that you can be as excited and passionate and hopeful about coming to work every day as we want to be, and that together we can give every patient a reason to be excited about medicine too.

REFERENCES
(1) Schwartz MD, Durning S, Linzer M, Hauer KE. Changes in medical students' views of internal medicine careers from 1990 to 2007. Arch Intern Med. 2011;171(8):744.
(2) Hauer KE, Durning SJ, Kernan WN, et al. Factors associated with medical students' career choices regarding internal medicine. JAMA: the journal of the American Medical Association. 2008;300(10):1154.

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Chapter Vital Statistics

There are 2,222 members of the Minnesota American College of Physicians. We include 19 Masters, 567 Fellows, 950 Members, 461 Associates, 222 Medical students, and 3 Affiliated members. This represents steady growth of our membership in the past five years.

If you are now a member- become a Fellow by reviewing the Web link and find which pathway to Fellowship is appropriate for your career path.

If you have colleagues who are not yet ACP members-encourage them to join now, particularly anticipating the 2012 national ACP meeting April 19-21 in New Orleans. The link describes the Recruit a Colleague process by which you can have your dues for the next year reduced by $100 or more. A dues discount is always welcome! However, the real reason to encourage your peers to join is to encourage them to become engaged in the community of internal medicine in Minnesota and to strengthen the voice of our profession, increase lifelong learning, mentor medical students and residents, and take advantage of the professional resources national ACP has to offer including education at meetings and online, insurance benefits, the Annals of Internal Medicine, assistance with choosing an electronic health record and medical home, electronic medical decision making resources, and patient and professional advocacy.

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2011 Chapter Excellence Award

Chapter Excellence

I am pleased to announce that our chapter is in receipt of the 2011 Chapter Excellence Award! The award recognizes chapters which successfully meet the standards for managing a chapter. In order to achieve the Chapter Excellence Award, chapters must meet all basic criteria and seven optional criteria. Criteria include such activities as formulating an effective Governor’s Council and committees, communicating frequently with membership, providing educational opportunities, recruiting and advancing members and celebrating membership through local awards. I would like to extend a special thanks to those chapter members who assisted me in all of these endeavors! For their hard work and dedication, we received this award.

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2012 Call for Nominations

The Laureate Award is designed to honor a Fellow or Master of ACP for at least 15 to 20 years, who has demonstrated by their example and conduct an abiding commitment to excellence in medical care, education, research, and service to their community, to their chapter, and the ACP. A Laureate Nominee is a senior physician with a long history of excellence and peer approval in the specialty of internal medicine and served the chapter and community with distinction in some clearly definable manner.

The Volunteerism and Community Service Award recognizes a Master, Fellow, Member, or Associate of ACP who has provided volunteer service post-training. Self-nominations are not permitted. Performs services on a voluntary basis and not required for the completion of teaching, training, or position requirements. Volunteer work must have been done as a physician and be medically related. Awardees are eligible for the national award, Oscar E. Edwards Memorial Award for Volunteerism and Community Service.

Nominations for the 2012 MN-ACP Awards will be open in January. Contact Katherine Cairns for nomination forms.

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Upcoming Dates

  • Saturday, March 17, 2012 SEP modules in Duluth, MN
  • Thursday-Saturday, April 19-21, 2012 ACP Annual Internal Medicine Meeting in New Orleans
  • Thursday and Friday, Nov. 1-2, 2012 MN-ACP Annual Scientific Meeting in Minneapolis

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Become an ACP Key Contact

ACP’s Key Contact Program provides you with legislative updates and easy-to-use grassroots advocacy tools to communicate effectively and develop valued relationships with our elected federal officials and their staff. Sign up today.

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ACP Offers Guide to Adult Immunization

In an effort to assist physicians and their staff develop systematic process for incorporating immunization in their day-to-day practice, the ACP offers the “Guide to Adult Immunization”. You can access an electronic copy or order a print copy by contacting Cara Reynolds at 800-523-1546 ext. 2848.

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ACP Minnesota Thanks!

We want to recognize the tireless efforts of Drs. John Bundrick and Mary Miley, as 2011 Program Chairs who led the planning for the 2011 ACP Scientific Session in Minnesota. Special thanks to the Mayo Clinic for the use of their equipment for the ABIM SEP Module.

We want to also recognize our poster judges and oral vignette judges who helped determine our outstanding winners. Special thanks to Charlie Reznikoff, MD for chairing the competition. Kudos to all of our presenters and our judges.

Poster/Abstract Judges included: Drs. Anne Pereira, Bhan, Andrew Kummer, George Sarosi, Uma Thanarajasingam, Sally Berryman, Dietlind Wahnerroedler, Lawrence Kerzner, Caitlen Eccles-Radtke, Jeffrey Rubins, Thomas Martens, Cristina Baker, Mary Miley, John Misa, Heather Buum, Mark Liebow, Lindsay Byrnes, Aaron Rutzick, David Williams, David Tierney, Rob Haung, Robert Miner, Richard Adair, Vanessa Handler, Brianna Schultz, Clara Zamorano, Kathleen Lange, Amit Ghosh, Thomas Jaeger, Douglas Pryce, Kim Viskocil, Bryan Trottier , John Eaton, Adeyinka Taiwo, Loren Bosmans, Laxmana Godishala, Megan Dulohery, Sarah Lee, Tanya Tajouri, and Deepti Pandita.

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Contact Information

Heather E Gantzer, MD FACP, Governor, Minnesota Chapter

Chapter Staff:
Katherine Cairns, Executive Director
1043 Grand Ave. #215
St. Paul, MN 55105
651-492-1994
Fax: 651-699-7798
Minnesota.ACP@gmail.com