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Governor's Message

Dr. Gantzer's photo

Minnesota ACP Mission: To foster excellence, education and professionalism among all internists in our community and to work together to shape the future of healthcare in Minnesota.

Minnesota ACP Vision: To be Minnesota’s recognized leader for patient care, advocacy and education and to enhance career choice, satisfaction and collaboration for specialists and subspecialists in internal medicine.

Over the past six months, how is Minnesota ACP progressing toward these goals set in the Vision?

Steps in leadership in patient care: Participating in the Learning Collaborative in the Patient Centered Medical Home, (PCMC) and meeting with the MN Commissioner of Health regarding PCMC and other patient care issues such as continuing the efforts to reduce tobacco abuse in the state.

Steps in advocacy: Dr. Mark Liebow, our Public Policy lead on MN ACP Council, sent a monthly Public Policy update to ACP members who have opted to be on the FAN list (email Katherine Cairns at minnesota.acp@gmail.com if you wish to be on this list;) four Internal Medicine residents from Mayo attended Minnesota Medical Association Day at the State Capitol January 2011; twenty-three U of M Med-Peds residents attended Peds Day at the Capitol; on April 25 a conference call open to all MN ACP membership was held with guest speaker Eric Dick, Manager of State Legislative Affairs for the Minnesota Medical Association discussing current issues relevant to internists being contemplated in the Minnesota Legislature; and joint communications were held between the MN ACP , the Minnesota Academy of Pediatrics and the Minnesota Academy of Family Practitioners.

Steps in education: CME plans are afoot- Dr. John Bundrick and Dr. Mary Miley are cochairing the Annual Scientific Meeting to be held in Minneapolis Friday November 4 with topics pertinent to ambulatory and hospitalist internists; and there will be a session for completing two SEP Recertification modules Thursday November 3.

Steps in career choice: Dr.Charlie Reznikoff is coordinating the resident and medical student poster session event for the November 4, 2011 meeting; the chapter sent four poster winners (out of 147 posters) from the 2010 state meeting to Internal Medicine 2011 in San Diego; and MN ACP has strongly supported the Internal Medicine Interest Groups of the medical students at the University of Minnesota (with a Student and Faculty Reception on campus April 22) and the Mayo medical students (with the famous Crawfish Boil May 7 at the home of Dr. James Newman.)

Steps in career satisfaction: Engaging in the above activities to support internists in their professional lives; inducting eight new Fellows from Minnesota at Convocation in San Diego in April; and currently requesting nominations for the Laureate Award and Community Service/Volunteerism Award which will be presented at the November meeting. (submit nominations with a letter and CV of the nominee to to Katherine Cairns at minnesota.acp@gmail.com.)

Steps in collaboration for specialists and subspecialists in internal medicine: In the past six months internists of a wide variety of specialties have joined the MN ACP; some of them were in San Diego and we look forward to meeting with our new members in Minneapolis in November.

If you have thoughts of additional ways the ACP can serve Minnesota internists and their patients, and if you would like to be further involved in these efforts please email me at Heather.Gantzer@parknicollet.com.

Heather E. Gantzer, MD, FACP
Governor, Minnesota American College of Physicians

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ACP and the Patient Centered Health Care Home in Minnesota

You have heard about the Patient Centered Medical Home (PCMH), but what is it, will you and your practice be involved, how does it relate to specialty care, can it be financially viable, and what are the steps to make it actually happen? The national ACP has an excellent resource on their website (click Running a Practice, then Patient Centered Medical Home.) There is also quite a bit of activity on the local front as well.

On the state level, the Institute for Clinical Systems Integration (ICSI) has the contract from the state of Minnesota to establish the Learning Collaborative. Participants include the MN American College of Physicians, the MN Academy of Pediatrics, the MN Academy of Family Practitioners, the MN Nursing Association, the Society of Aging, payers and others. Our MN ACP representative to the Learning Collaborative, Dr. Kristen Kopski, MD, Ph.D, regularly meets with the group sharing new ideas and lessons learned in the health care home development process.

At this point there is agreement that the state will work to streamline the certification and recertification process necessary to be a health care home. There will also be several groups in the Learning Collaborative. One group will be for physicians and their practices in the “contemplative phase” interested in the pros and cons of becoming a health care home, and in the mechanics of how to do this. A second group will focus on those who are certified and are working to maintain certification in a continuous process. A third group will emphasize networking and innovation in established healthcare homes. Involvement in this group is anticipated as engaging in conference calls and webinars, to facilitate participation by physicians across the entire state. It is also recognized that the details of the patient centered medical home model may well be different for rural as opposed to urban areas; and that some smaller practices may benefit from sharing some components of the team, such as a care coordinator.

As Governor of the Minnesota ACP I met this week with Dr. Ed Ehlinger, MN Commissioner of Health, along with leaders from the Minnesota Academy of Family Physicians, the Minnesota chapter of the American Academy of Pediatrics, and Minnesota Medical Association. The discussion centered on the Minnesota Department of Health-commissioned report on HCH Care Coordination and Payment, and strategies to resolve issues identified by physicians in the implementation of the PCMC, particularly relating to payment.

Minnesota is one of five states participating in the Medicare Advanced Primary Care Practice demonstration to pilot the development of PCMHs. The internists in our state have a tremendous opportunity in this window of time to innovate ways to care for patients as unique individuals and populations and deliver an even higher quality of care; to decrease care fragmentation; to care more efficiently for larger numbers of people; and to increase our own professional work satisfaction in practicing to our highest level of ability. Look for new information in the monthly MN ACP email updates.

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Internal Medicine 2011 San Diego Keynote Speech: Dr. Richard Baron, MACP

The keynote speaker for the Opening Ceremony April 7 was Dr. Richard Baron, MACP, founder of a private practice Greenhouse Internists in Philadelphia, former chair of the American Board of Internal Medicine and now Director of Seamless Care Models in the Center of Medicare and Medicaid Innovations in Design.

His article detailing the uncompensated work physicians do in a year was published in the New England Journal of Medicine in April 2010, and in the speech Dr.Baron discussed the realities of practicing medicine today. He described a condition he termed “RVU malignans,” which can produce resentment for the many duties a physician performs each day for which they are not paid. This causes confusion “between what we get paid to do and with how we contribute value to our patients.” Each doctor in the audience could relate to his descriptions of the afterhours work spent-completing driver license forms-a chore to the physician, a necessity of life for the patient-or the end of the day supportive personal phone call to the patient with a new cancer diagnosis-not billable but invaluable. “Relationships are the durable and unchangeable foundation of what we do in medicine” noted Dr. Baron, who advised the payment system needs to be aligned with the true value of the entirety of the work a physician performs on the patient’s behalf.

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Growing in Minnesota

Joining the Minnesota Chapter of the American College of Physicians means becoming a member of our professional home as Internists, both generalists and subspecialists. It means being part of the national ACP with all the resources offered-CME at the national annual meeting, Annals of Internal Medicine, patient advocacy, and online resources (including PIER for best practice guidelines, assistance with choosing and using an Electronic Health Record and building a medical home.) It also means being a part of the state chapter, with a CME Annual Scientific Meeting and resident poster session each fall, SEP Recertification Module Sessions, interactions with and support of medical students interested in Internal Medicine and Internal Medicine residents, and opportunities for advocacy for our patients and our profession in a rapidly changing environment. It means appreciating the breadth and depth of Medicine, in addition to our day to day (and night to night) work.

Individual person to person discussion means more than blast emails. Speak with your internist colleagues if they are not yet MN ACP members and encourage them to join. The more representation we have throughout our entire state and our spectrum of specialties, the stronger we become.

Go to Recruit-a-Colleague to find out how to receive a discount of $100 to $400 off your own dues.

Heather E. Gantzer, MD, FACP
Governor, Minnesota American College of Physicians

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Congratulations to the Minnesota Fellows Inducted at Convocation in San Diego April 2011!

Dr. Ahmed Abdairhim, FACP
Dr. Letitia Acquah, FACP
Dr. Casey Kulsum, FACP
Dr. Christopher Hook, FACP
Dr. Stephen Leenay, FACP
Dr. Jeffrey Mandel, FACP
Dr. David McFadden, FACP
Dr. Keith Swetz, FACP

Apply for Fellowship to march in Convocation as a new Fellow in New Orleans April 19-21, 2012 (or one of the subsequent two annual meetings; you have the option of participating in any one of the three years’ Convocation ceremonies after achieving Fellowship) To become a Fellow in time for the New Orleans meeting, be sure to apply. For more information, go to Fellowship.

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Minnesota Residents Win First Place at National ACP Poster Session Internal Medicine 2011 in San Diego

The poster “Improving Palliative Care Referral in Patients with Heart Failure” by a team from University of Minnesota Internal Medicine and Medicine-Pediatric’s Residency’s ambulatory care experience at Health Partners in St.Paul was presented at the national ACP meeting this spring, as it had won the Quality Improvement category at our November 2010 meeting in Minneapolis. The team analyzed the literature to determine which risk factors could help identify patients with heart failure who would benefit from referral to palliative care and then analyzed a cohort of patients from Regions Hospital to determine if these risk factors applied to their patient population. As a result of their project, palliative care referral is an option as part of the Heart Failure Order Set for admissions at Regions Hospital, with a decision support tool to help providers determine which of the patients may benefit.

The team was comprised of Andrew P.J.Olson, James McCabe, Simon Lick, Sandra Schultz, Malinda Jorgenson, Hamza Khalid, Yoel Korenfeld-Kaplan and advisor Paula Skarda. They won first place in the national ACP Quality Improvement poster competition, a certificate and $500. More than that, they gained experience in quality improvement in patient care, and were inspired by the interactions at the meeting. Minnesota ACP sponsored the opportunity for Andrew Olson to go to Internal Medicine 2011, and our chapter is proud that Minnesota placed first in this nationwide competition. We look forward to the posters at our November 4, 2011 meeting in Minneapolis

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Photo Gallery

poster presenters
Minnesota Residents presenting posters at Medicine 2011 in San Diego

com health
Meeting with the Minnesota Commissioner of health Dr.Ehlinger and others regarding Medical Homes

Mayo Medical Students

Mayo Medical Students 2
The Mayo medical students of the Internal Medicine Interest Group at the Crawfish Boil

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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