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Governor's Newsletter-Fall, 1997

1997 Missouri ACP-MSIM Combined Regional Meeting

More than 225 registrants from across the state attended the 1997 Regional Meeting held at the Lodge of Four Seasons on October 17-19, 1997. The meeting included a day-long subspecialty update on Allergy and Rheumatology, discussions of drug therapy of diabetes, dermatology, therapy of osteoporosis, and re-envisioning health care in America. ASIM representative, Robert D. McCartney, M.D., spoke on the "Use of Physician Extenders in Clinical Practice" and Oscar E. Edwards, M.D., FACP, ACP representative, spoke on "Shared Responsibilities: A Synergistic Relationship Between Generalists and Subspecialists in Patient Care."

During the meeting there was much discussion about the proposed merger of the American College of Physicians and the American Society of Internal Medicine, and a straw poll indicated that an overwhelming majority of attendees were in favor of the merger. The merger also was the topic of a Town Hall Meeting on Sunday, October 19. At this meeting the pros and cons of the proposed merger were discussed at length by Drs. Edwards, McCartney, Rogers, and Lovinger. Again, there was a strong consensus in favor of the merger.

Election of a New Governor for Missouri Chapter

An election will be held in November to select a new Governor for the Missouri Chapter of the American College of Physicians. Two outstanding candidates have been nominated: Loretta S. Loftus, M.D., FACP, Professor of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri and Richard B. Whiting, M.D., FACP, Professor of Internal Medicine, Saint Louis University School of Medicine, St. Louis, Missouri. You will be receiving a ballot soon. Please vote. Below are statements from the candidates.

Loretta S. Loftus, M.D., FACP

I am honored by my nomination for Governor-Elect of the American College of Physicians, Missouri Chapter. Dr. Coy Fitch and his predecessors have demonstrated outstanding leadership and innovations in the development of new programs and activities for the Chapter. I will strive to continue their good work.

Continuation of the summer externship program for medical students, that has been enthusiastically and favorably evaluated by students and preceptors, should be encouraged. Many students are applying for or have started residencies in internal medicine after participating in this program. Likewise, the continuing education programs at locations around the state have been a tremendous success and should be expanded. I have been attending the annual meetings in the Ozarks for years, and I have been impressed at the quality of the programs and the increase in attendance. It has also provided a forum for physicians around the state to meet in a collegial manner and to share ideas on the status of internal medicine in our state. The poster competition for the Associate members has encouraged research productivity for a new generation of physicians, and it has also afforded an introduction for them towards ACP membership.

Medicine has undergone considerable socioeconomic change. Initially, the greatest impact has been on the physician in private practice; however, physicians in academic medical centers are now confronted with similar challenges. The recent proposal for the merger of the American Society of Internal Medicine and the American College of Physicians and their respective state chapters is a timely and positive maneuver. I am a member of both organizations, and I have also served on both Councils. The Missouri Chapter of the ASIM has outstanding leadership, committed and hard-working members with innovative ideas, and tremendous resources to deal with these important socioeconomic and political issues. Their expertise and involvement can only enhance the ACP.

The American Board of Internal Medicine sponsored a program, Project Professionalism, that is important to me. I have been involved at my medical center in developing a program to promote professionalism for medical students. I also use cases from Project Professionalism to educate residents and students when I am the attending physician on the internal medicine service. Integration and promotion of ethical and professional practice of medicine should become an issue for our Chapter. Additionally, methods to improve electronic communication should be explored and implemented to keep the membership informed and involved. Efforts should be continued to increase membership and to assist present members to advance to fellowship.

I am board certified in internal medicine, hematology, and medical oncology. I have served the ACP Chapter as Secretary, Council member, Women Physicians Committee member, Summer Externship Committee member, Nominating Committee member, judge at the Associates poster competition, and mentor to students at the annual meeting. My background includes patient care, teaching professional students at all levels, research, and administration as Assistant Dean and Chief, Hematology/Oncology Section. If elected, I promise to serve the Chapter with enthusiasm, to listen to your comments, and to provide service to the organization. I would greatly appreciate your vote.

Richard B. Whiting, M.D., FACP

The time has come to elect the next Governor for Missouri of the American College of Physicians or of the ACP-ASIM if the proposed merger occurs. That proposed union itself is testimony that we have profound hope and confidence in the future of medicine in general, and in our specialty, Internal Medicine, in particular. Internists have always been marked by a desire for knowledge acquisition, meticulous attention to details, and inherent compassion for our fellow humans. The Internist was always a specialist in "Primary Care" even before the term became popular. Now, we must guard carefully the higher values of the medical profession: the inherent worth of every human being, the beauty of man serving fellow man, and the primacy of the doctor- patient bond. For my view, values such as these are pivotal and yet they are threatened by changes in health care delivery systems. The proposed union of ACP and ASIM is clearly an indication that Internists of wide interest and geography still recognize deep rooted common values and goals. The future of our patients, our profession, and this combined organization depends on all of us working together.

That brings me to the election of Governor. Let's all vote, but let each ballot be a commitment to come together in support of the ideals of medicine, our patients' best interests, and of each other in the Missouri ACP-ASIM. I have been committed to the ACP and our Missouri Chapter for over 12 years. I will continue to be involved whether I am elected Governor or not. I always knew, even from childhood, that I wanted to be a doctor. Over the years I have been extremely fortunate to receive excellent educational opportunities, both in St. Louis and in Boston. Here in Missouri, I have been on the Faculty at Saint Louis University School of Medicine and then at the University of Missouri in Columbia. Since 1984, I have been Chairman of Internal Medicine at St. Mary's Health Center in St. Louis with an appointment at Saint Louis University in the Department of Internal Medicine, Division of Cardiology. My patient office is adjacent to St. Mary's Health Center but once a week I volunteer at the Vietnamese Immigrant Health Center in south St. Louis. I have deeply enjoyed my association with members of the Missouri ACP, as well as those of MSIM. I look forward to the future.

New Councillors for the Missouri Chapter

During the past summer, an election was held to fill the position of six Councillors who complete their terms on December 31, 1997. The new Councillors are:

Steven D. Atwood, M.D., FACP, Springfield, Missouri

Richard W. Burns, M.D., Columbia, Missouri

Daniel M. Goodenberger, M.D., FACP, St. Louis, Missouri

Mary S. Muscato, M.D., FACP, Columbia, Missouri

Richard B. Whiting, M.D., FACP, St. Louis, Missouri

Sandra K. Willsie, D.O., FACP, Kansas City, Missouri

We look forward to working with these new Councillors as we plan for the merger of the Missouri Chapter of the American College of Physicians and the Missouri Society of Internal Medicine.

The outgoing Councillors are:

Nancy Abdou, M.D., FACP, Shawnee Mission, Kansas

Jean A. Chapman, M.D., MACP, Cape Girardeau, Missouri

William M. Fogarty, M.D., FACP, St. Louis, Missouri

Donald C. Gerhardt, M.D., FACP, Columbia, Missouri

Jim R. Waterfield, M.D., FACP, Springfield, Missouri

Megan E. Wren, M.D., FACP, St. Louis, Missouri

We wish to express our sincere appreciation to this distinguished group of outgoing Councillors for all their work on behalf of the American College of Physicians.

Task Forces Named to Work on the Proposed Merger of the Missouri Chapter and ASIM

On October 16, 1997, just prior to the combined meeting of the Missouri Chapter of the ACP and the ASIM, the Councils of the two organizations met in joint session. The major topic of discussion was the proposed merger of the ACP and ASIM. As an outcome of this discussion, Task Forces were named to deal with various transition issues. The Task Forces and their memberships are:

Task Force on Bylaws

Loretta S. Loftus, M.D., FACP (Chairperson)

Jean A. Chapman, M.D., MACP

D. Douglas Westhoff, M.D.

Richard B. Whiting, M.D., FACP

J. Michael Zylka, M.D., FACP

Task Force on Committees

Carl F. Strauss, M.D., FACP (Chairperson)

Paul R. Eisenberg, M.D., FACP

William M. Fogarty, M.D., FACP

Alan D. Forker, M.D., FACP

Anne C. Goldberg, M.D., FACP

Warren C. Lovinger, Jr., M.D., FACP

Task Force on Finance

Sara E. Walker, M.D., MACP (Chairperson)

David A. Fleming, M.D., FACP

Patrick J. Mills, CPA

J. H. Morris, M.D., FACP

James T. Rogers, M.D., FACP

Task Force on Communication

Steven D. Atwood, M.D., FACP (Chairperson)

Coy D. Fitch, M.D., FACP

Warren C. Lovinger, Jr., M.D., FACP

James T. Rogers, M.D., FACP

Robert W. Scott, M.D.

Task Force on Program Funding

Jean A. Chapman, M.D., MACP (Chairperson)

Steven D. Atwood, M.D., FACP

John E. Morley, M.B., B.Ch.

J. Chris Perryman, M.D., FACP

Neil R. Schwartzman, M.D., FACP

Please contact any of these Task Force members and give us the benefit of hearing your concerns and suggestions.

Mark Your Calendar for the 1998 ACP/MSIM Combined Regional Meeting

The meeting will again be held at The Lodge of Four Seasons from October 16 through 18, 1998. The subspecialty update will focus on Geriatrics. The program will be planned by Dr. John E. Morley, Dammert Professor of Gerontology at Saint Louis University. We will, of course, have the Saturday Socio-Economic Session and the Sunday Scientific Session. Please plan to attend. You will be receiving information in the Spring of 1998.

Poster Competition at the Regional Meeting

Fifty-eight abstracts were accepted for presentation by the Associates. Eight of the abstract entrants were unable to attend the competition. The remaining fifty presented their posters during the Poster Competition, which was held on Friday evening in conjunction with a wine and cheese reception. There were 39 posters presented in the Clinical Vignette Category and 11 posters presented in the Research Category. The winners of the poster competition are as follows:

Clinical Vignette

First Place:
Yoon Kang, M.D., Washington University School of Medicine
Case Report: Pott's Disease

Second Place:
Sandeep Sen, M.D., St. Luke's Hospital
Delayed Onset and Prolonged Recovery of Intranasal Heroin Induced Pulmonary Edema

Third Place: (tie)
Antoine Adem, M.D., University of Missouri-Columbia School of Medicine
Branch Renal Artery Stenosis Causing Malignant Hypertension

Gautam Jha, M.D., St. Luke's Hospital
Metastatic Cutaneous Angiosarcoma Presenting as Pericardial Tamponade, Recurrent Pneumothorax and Multiple Cystic Lesions on Computerized Tomography: A Case Report

Alka Kapoor, M.D., St. Luke's Hospital
Fulminant Community Acquired Pneumonia Caused by Acinetobacter Baumanni

Atul Katyal, M.D., St. Luke's Hospital
Association of AntiHu Paraneoplastic Syndrome with Multiple Cranial Nerve Involvement and Prolonged Survival

Anurag Misra, M.D., University of Missouri-Columbia School of Medicine
Acute Myocardial Infarction Due to Dynamic Coronary Ostial Occlusion

J. Sreenarasimhaiah, M.D., Washington University School of Medicine
Duodenal Somatostatinoma and Von Recklinghausen's Disease: A Rare Combination

Research

First Place: (tie)
Raman Puri, M.D., University of Missouri-Columbia School of Medicine
Ehretianone, A Novel Quinoid Xanthene with Antisnake Venom Activity from Ehretia buxifolia Roxb: Elucidation of Its Structure by 1D and 2D Nuclear Magnetic Reasonance

Klaus Hollmig, M.D., University of Missouri-Columbia School of Medicine
Interleukin-6 in Patients with Multiple Myeloma Stimulated with Granulocyte-Colony Stimulating Factor for Peripheral Blood Stem Cell Separation

Second Place: (tie)
S. R. Basireddy, M.D., Saint Louis University School of Medicine
A Comparative Study on Efficacy of a New Dry Powder Inhaler in Patients with Asthma

Paulina A. Essah, M.D., University of Missouri-Kansas City School of Medicine
A Comparison of Treatment for African-American and Caucasian Women with Breast Cancer

Third Place:
George S. Saman, M.D., University of Missouri-Columbia School of Medicine
Effects of S-Nitrosohemoglobin on the Conductance and Resistance Coronary Vasculature

Each of the three First Place winners will receive an expense paid trip to San Diego in April of 1998 to present their posters at the National Meeting.

Student Awards Presented to Outstanding Medical Students

The 1997 Junior Clerkship Award was presented to one student at each of the four medical schools in Missouri who turned in outstanding performances on general internal medicine clerkships. The winners were:

Saint Louis University School of Medicine: Barbara Jost

University of Missouri-Columbia School of Medicine: Erika Rabeni

University of Missouri-Kansas City School of Medicine: Rani A. Sharma

Washington University School of Medicine: Heather McGuire

Eight students, two from each of the four medical schools, received the 1997 American College of Physicians Excellence in Physical Diagnosis Award. The award is presented to students based on their effort and achievements in physical diagnosis courses. The Missouri Chapter also honors eight runners-up from each of the four medical schools. The winners for 1997 are:

Saint Louis University School of Medicine: Andrea Atkinson, Pravnav Patel

University of Missouri-Columbia School of Medicine: Julie Busch, Rebecca Dillingham

University of Missouri-Kansas City School of Medicine: Bradley Garstang, Ann Hagedorn

Washington University School of Medicine: Jeffrey Brent, Amanda Cashen Fishbach

Megan E. Wren, M.D., FACP, Missouri Laureate for 1997

At the Awards Banquet on Saturday evening at the Regional Meeting, Megan E. Wren, M.D., FACP, received the highest honor that can be bestowed upon a member of the Chapter, the Laureate Award. The Laureate Award honors those Fellows and Masters of the American College of Physicians who have demonstrated by their example and conduct an abiding commitment to the excellence in medical care, education, or research, and in service to their community, their Chapter and the American College of Physicians. Dr. Wren was elected to the Council of the Missouri Chapter in 1991 and served two terms. She also served as Chair of the Associates' Committee and a member of the Associates' Council of the Student Awards Committee and the Summer Externship Committee.

Dr. Wren takes an active interest in stimulating medical student interest in and knowledge of the field of internal medicine and the role of the American College of Physicians. She is now leading the development of a new primary care internal medicine residency program at Barnes-Jewish Hospital and is the firm chief for the Shatz-Strauss firm.

We congratulate Dr. Wren on winning this most prestigious award.

The Missouri Society of Internal Medicine Presented the Following Awards at the Awards Banquet of the Regional Meeting:

Distinguished Internist of the Year: Dr. Maxwell G. Berry, MACP, was recognized for a life-long dedication to internal medicine. He was one of the founders of the American Society of Internal Medicine in 1956 and the Missouri Society of Internal Medicine in 1958, subsequently serving as president of both. Dr. Berry also served as Governor of the Missouri Chapter of the American College of Physicians.

Community Service Award: Dr. J. Michael Zylka, M.S., Ph.D., M.D., FACP, was recognized for his campaign against tobacco. As the Director of St. Louis County Health Department, he has initiated anti-tobacco programs for school age children. At the 1997 Missouri State Medical Association Annual Meeting, Dr. Zylka's resolution calling for legislation to create a forty cent increase in the tax on cigarettes in Missouri was approved by the MSMA House of Delegates.

Legislator of the Year: Representative Tim Harlan was elected to the House of Representatives in 1994. Less than two years after being elected to the House, Rep. Harlan was asked to serve as Co-Chairman of the Joint Interim Committee on managed Care. Under his leadership, that committee launched one of the most extensive investigations in the history of the Missouri General Assembly. The result was House Bill 335, the most comprehensive managed care reform package in the nation. Rep. Harlan co-authored that piece of legislation, and was the bill's primary sponsor. Earlier this year Rep. Harlan was named Chairman of the House Committee on Critical Issues, to which many important health care related bills are referred.

Dr. James T. Rogers, FACP, was recognized by The Missouri Society of Internal Medicine for his tenure as president. Under his leadership, MSIM has developed a president's newsletter, and has created a physician scholarship fund for the Effective Medical Manager - Self Assessment Program.