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June 2011 Alan D. Forker, MD, MACP, Governor

Message from the Governor

Dr. Forker

It is my pleasure and honor to say Hello to all Missouri Chapter members, Fellows, and Masters, since this is my first Newsletter as your new Governor. It’s a tough act to follow, that Dr. David Fleming. David was an outstanding Governor for our Chapter, so good that he is now the Chair of the ACP Board of Governors, for all 81 Chapters. Thanks, David, for all the personal and professional advice, expertise, and leadership.

At the Annual Meeting in San Diego, April 2011, I was fortunate to walk with the new Fellows of the American College of Physicians into the Convocation. Once again, I want to congratulate each of them for their dedication to our profession and especially to internal medicine. I encourage each of you to get involved with your Missouri Chapter’s activities. I hope to see each of you at our Annual Meeting, Tan-Tar-A, September 15-18, 2011. More news about the meeting later.

I also encourage each and all of you to speak to me directly, call me (913-579-3990), e-mail me aforker@att.net (sorry, I don’t do Facebook) and tell me how you would like to be involved with your Chapter. We need your input. Would you like to write a personal story about your life and practice that would have a teaching point for all of us? Similar to our Annals of Internal Medicine, ie On Being a Doctor, I would like to publish them in our Newsletter. Only on one condition though: this would not be a platform to voice your political opinions, especially if opposite to that of the policy of the ACP. I can voice my personal opinions in private to any/all of you; but when speaking as your Governor, I am representing the policies of ACP, which I strongly support.

We had a reception at the Annual Meeting in San Diego for our new Master, Warren Lovinger, MD, MACP. What a well deserved honor for such a role model in internal medicine. I have known Warren for close to 20 years, and never ceased to be amazed at his dedication to our profession and his patients in Nevada, Missouri. This is the kind of competent, compassionate physician that our internal medicine training programs in Missouri need to train. And that health care/payment reform needs to vigorously support.

Dr. Lovinger
Dr. Warren Lovinger and his family

Some of my priorities as your Governor over the next four years include:

  1. more involvement from each Board Member in the Chapter, including membership on at least one Committee
  2. creation of a Strategic Plan. The Board had a Retreat on March 5, 2011, led by an outside consultant/adviser. A preliminary draft is in process, with a final version presented to the Board at our Annual Meeting in September, 2011.
  3. creation of an Associates (ie internal medicine residents and fellows) Council for the MO Chapter, with representation from most/all Missouri IM training programs.
  4. creation of a Medical Student Council, with representation from all Missouri medical schools.
  5. creation of a new Membership Committee: Yippee, already done, with the leadership of Dr. Keith Starke, St John’s IM Dept Chair. The Missouri Chapter has recruited new members in the past primarily through ad hoc efforts of Board Members. We are now really focusing our efforts on new Young Physicians, fresh out of training, and those who are under age 40 who just never got around to joining.
  6. creation of a new Young Physicians Council: Bingo! As a corollary of the above, Dr. Sarah Florio, an internist in Kansas City/Lee’s Summit, has volunteered to chair this new committee this past year.
  7. improve communication from ACP and your Governor to you by a monthly blast e-mail, ie to all membership simultaneously, on whatever topics you provide to me, and/or what I interpret that our society, profession, and ACP should want us to discuss.
  8. ACP has a program entitled LEAD, which means Leadership Enhancement and Development. As a Chapter, we have not utilized this resource as much as we could/should for development of our future leaders. We need to send some Chief Residents and other Young Physicians to this course held at the Annual Meeting each year. Here are some of the topics discussed at San Diego in April, 2011:
    • Residents as Teachers
    • Leadership Skills for Internists: Ten Tenets of Leadership
    • Evolution of Diversity in Medicine
    • Five Tips for Effectively Managing Work/Life Balance
    • Patient-Centered Medical Home: Building and Coordination of a Practice
    • Internal Medicine Workforce: Challenges and Solutions Meeting Demand
    • Internists’ Role in New Payment and Delivery Models
    • Physician Accountability: Profession Police Thyself?
    • Addressing Harassment: Spoken and Unspoken
    • Get Involved: Volunteerism After Health Care Reform

    • Leadership Enhancement and Development Program Information
  9. I would like to see us feature a Board Member in each Newsletter. This would mean not just a review of your curriculum vitae, but a perspective on what you consider important now and in the future for yourself and internal medicine.

So, let’s share stories, volunteer our time to ACP, take care of our patients with the best humanitarian, cost-effective approach possible, and have some fun along the way. Looking forward to getting better acquainted with students, associates, members and fellows who I know only superficially now. I would love to find a good fit for each of you as a volunteer for ACP.

Please join me at the Missouri Chapter meeting in September as we honor David Fleming, MD, FACP as our Laureate Awardee for outstanding service to the Missouri Chapter of the ACP.

Alan Forker, MD, MACP Governor


New Fellows

We welcome eight Missouri physicians as new Fellows since the first of the year.

Fred J Balis, MD FACP, Creve Coeur
Carla A Dyer, MD FACP, Columbia
Syed K Hussain, MD FACP, Ballwin
Uzma Z Khan, MBBS FACP, Columbia
Brian P Miller, MD FACP, Arnold
Nora L Porter, MD FACP, Saint Louis
Clay F Semenkovich, MD FACP, Saint Louis
Chokkalingam Siva, MD FACP, Columbia

If you are interested in learning more about Fellowship you may attend the Fellowship Tutorial held during the Chapter’s annual CME meeting at Tan Tar A. If you cannot attend then, please contact Patrick Mills pmills@msma.org and we will find someone in your area to offer guidance prior to submitting your Fellowship application.


Report of Leadership Day, May 24-25, 2011, Washington DC

For those of you who have never experienced ACP Leadership Day, let me tell you about it. Around 400 internists, associates, and medical students attended from 44 states and DC. Missouri was represented by a team of 9 - our largest contingent - Alan Forker, MD, MACP – Missouri Governor; David Fleming, MD, FACP – Chair ACP Board of Governors; Sarah Florio, MD – Kansas City; Vanessa Kuwajima, MD – MU resident; Nazir Lone, MD – MU resident; Kenneth Poole, MD –St John’s resident; Christopher Wieland, MD – IM Wash U / Barnes resident; Anita Sarathi MD –Wash U / Barnes IM resident; Brandon Johnson - MU student; Amanda Turner - MU student; and Nathan Moore – Wash U student.

We made 10 congressional visits on May 25, following a full day of information sharing on May 24. The four key priority issues for ACP are:

  1. Eliminate the Medicare Sustainable Growth Rate (SGR) formula. ACP published a white paper on May 5 which is available on the Advocacy section of ACPonline, www.acponline.org/advocacy. It recommends five years of stable payments with further evaluation of new payment models, such as the Patient-Centered Medical Home. Then followed by a 2nd Stage of implementation. Good chance for bi-partisan support, but no money in the FY 2012 budget currently.
  2. Keep supporting discretionary Workforce Programs, such as: a) the National Health Service Corps (which has grown from 3,600 to 7,530 doctors since implementation of the ACA; b) Training in Primary Care grants, especially in ambulatory internal medicine residencies; c) continued funding of Community Health Centers, up to $18 million with ACA.
  3. Keep funding mandatory programs of ACA to Strenthen Access to Primary Care, Improve Quality, and Lower Costs, with a) specific support of the Medicare Primary Care Incentive 10% bonus, if meeting meaningful use guidelines: b) raise Medicaid payments to the level of Medicare (the current Medicaid/ Medicare ratio in Missouri is 65%); c) support for the Center for Medicare and Medicaid Innovation: needed to accelerate broad pilot-testing and adoption of new payment and delivery models, such as the Patient-Centered Medical Home and Accountable Care Organizations (ACOs).
  4. Support key policy changes with current bills in the House and Senate, such as the Help, Efficient, Access, Low-cost, Healthcare (HEALTH) act of 2011 (S.218, H.R.5) which would cap awards for non-economic damages, plus support funding of pilots of health courts, in which Medical Liability claims would be heard by expert judges, not presented to less knowledgeable lay juries.

I have now participated in ACP Leadership Day four times. I never thought I would participate in the political process: no impact; I’m too busy being a doctor; can’t be bothered; and takes too much time and money. Please let me know aforker@att.net if you are interested in 2012 Leadership. We will likely know who is attending from Missouri by September 1. The Chapter pays a portion of the expense. It’s worth it—you have a feeling of participation in the political process. One specific experience: Representative Vicky Hartzler (R-4th District) was over at the Capitol attending a meeting. She had an aide bring us to her and met us in the hall. She was a model of graciousness, and willing to listen to both sides of the story, ie not a closed mind/only one approach. Plus, we got a tour of the Capitol, including the Rotunda and Statuary Hall. You should try it—you might have as much fun as our group/team did sharing stories about medicine and life. Good way to mentor the next generation of internists.


Health Literacy & MOC Points

The Center for Health Policy at MU has a new program that helps internists use good health literacy techniques in their clinic practice and importantly it was recently certified by the ABIM and will provide 20 MOC points to those who complete the program. If you are interested you may contact EdisonK@health.missouri.edu or go to http://healthpolicy.missouri.edu/projects/hlmoc.shtml for more information.

Web sites you should know



Missouri Chapter of the ACP 2011 Council

The following is a list of your governing council for the Chapter. If you have questions and/or comments please contact Dr. Forker; a council member in your area; or Patrick Mills (573-636-5151 / pmills@msma.org).

Alan D. Forker, MD, MACP – Governor – Kansas City
Brent Beasley, MD, FACP – Kansas City
Melvin Blanchard, MD, FACP – St Louis
Tom De Fer, MD, FACP – St Louis
Bishnu Devkota, MD, FACP – St Louis
Carla Dyer, MD, FACP – Columbia
Andrew L. Evans, MD, MBA, FACP – Springfield
David Fleming, MD, FACP – Columbia
Sarah Florio, MD – Kansas City
Kim Jamison, MD, FACP – Columbia
Pradeep Kapoor, MD, FACP – St Louis
Caroline Kerber, MD, FACP – Columbia
Robert Lancey, MD, FACP – Columbia
Bridget McCandless, MD, FACP – Kansas City
Joseph J. Muscato, MD, FACP - Columbia
Tracy Norfleet, MD – St Louis
Thomas J. Olsen, MD, FACP – St Louis
Miguel Paniagua, MD, FACP – St Louis
Chris Perryman, MD, FACP – Kansas City
Naveed Razzaque, MBBS, FACP – St Louis
Keith Starke, MD, FACP – St Louis
Bill Taylor, MD, FACP – Springfield
Adam Whaley-Connell, DO, FACP – Columbia
Richard B. Whiting, MD, MACP – St Louis
Anne Winkler, MD, PhD, MACP – Springfield
David Wooldridge, MD, FACP – Kansas City
Megan Wren, MD, FACP – St Louis
Patrick Mills – Executive Director – Jefferson City


Get Ready for HIPAA 5010 and ICD 10

As part of new Health Insurance Portability and Accountability (HIPAA) legislation, all covered entities must submit claims under the new Version 5010 transaction standards by January 1, 2012. Claims will only be processed by payers under this new format. End-to-end testing must be complete and successful well in advance of the December 31, 2011 deadline. The change to 5010 is needed prior to the ICD 10 format due October 2013.

For a checklist of how to get ready, go to: www.cms.gov/Versions5010andD0/Downloads/w5010PvdrActionChklst.pdf

To understand all the reasons for the standard format upgrade, go here: http://www.cms.gov/Versions5010andD0/Downloads/w5010BasicsFctSht.pdf

Missouri Medicaid FAQs


PQRS Feeds into CMS Physician Compare

CMS has launched its Physician Compare website www.medicare.gov/find-a-doctor. The site currently allows individuals to search for a physician or other healthcare professional by specialty, type of professional, and location. The site also includes information about physicians and other professionals who satisfactorily participated in the Physician Quality Reporting System (formerly known as Physician Quality Reporting Initiative or PQRI). The Web site does not yet contain physician and eligible professional performance information. CMS is required to implement a plan for making information on physician performance publicly available through Physician Compare by January 1, 2013. The reporting period can begin no earlier than January 1, 2012. Many physicians have inaccurate information on this website. If your information is not correct, then check your data in the PECOS database.


Chapter Meeting

Poster contest

The Missouri chapter poster contest has limited its total number of posters at 110, all submitted by Associates, for the past few years. This year we plan to add 20 poster slots for students. We are communicating with the clerkship directors at each school in an effort to expand this already successful competition. If you are attending the meeting and want to assist with poster judging, contact pmills@msma.org.

Doctors Dilemma

During our chapter meeting at 7am on Saturday morning we will have four teams of Associate members face off in a medical Jeopardy format. The teams will represent IM training programs from MU, SLU, St Luke’s (STL) and Wash U.

Meeting Schedule – 22 hours of CME Tan Tar A in Osage Beach

ACP Missouri Chapter Meeting Brochure


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