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Governor's Newsletter, Spring 2000

Chapter Meeting

The Missouri Chapter Fall Meeting will convene at Marriott's Tan Tar A, beginning September 22 and concluding September 24. Dale Everett, MD, FACP, of the University of Missouri - Columbia, has put together the Friday update, which will be on Infectious Disease. Saturday and Sunday will be a mix of topics including: women's health, history of medical education, federal legislation, and a session with spouses entitled, "Self-Renewal: A Strategy for Managing Physician Stress."

According to the analysis of last year's meeting, 89% of the attendees graded the overall quality of the program as very good or excellent and 10% graded it as good. We were very fortunate to have a superb faculty, and in fact, the individual grades from the audience for the speakers were all quite high. The highest mean score possible for a speaker is 5 points, the speakers in this program, for their overall score concerning their presentation, ranged from 4.1 to 4.5.

We anticipate more of the same this year and look forward to seeing you there. Come and participate in your Missouri Chapter. You will find excellent CME, good food and pleasant surroundings. See you there. Call 800-826-8272 for reservations.

Chapter Begins Focus on the Humanities

The Missouri Chapter has embarked on a new focus for part of our Annual Meeting - specific attention to the humane - sensitive - caring of medical care. The Council began to suggest possible speakers and topics as we plan to devote part of Sunday morning to this material. Many of us began to rekindle our own feelings about why we were drawn into medicine in the first place. Thoughts that began to surface included:

  • How precious and yet sometimes endangered is an individual human being;
  • This person is unique - different from all others, even identical twins are each unique in some way;
  • This human is complex - made up of physical and chemical parts, but very importantly influenced by experience, emotions and by life itself;
  • What an enormous privilege it is to provide direct care to a fellow human being by preventing illness or death, by actually curing some illnesses, by alleviating suffering, or simply by establishment of a caring bond of doctor to patient;
  • As humans, we all share in whatever life offers, both good and bad, health or illness, transient or long-term; and
  • Complete care for any person requires awareness and sensitivity to these issues, and incorporation of a set of related principles into daily medical life;

While the Missouri Chapter is in effect experimenting with an annual program by devoting time to these issues, we feel they are so seriously important that we must plan further programs that highlight sensitivity issues, as well as, scientific ones.

Missouri ACP-ASIM Charter Profile Report

Each year the College supplies each Chapter with a profile report, which in effect, is a large cluster of data relating to demographics of Chapter members. The information can be used to track changes in membership and so, as an example, could be used to point out areas of strength, or areas in need of some improvement.

Of particular interest was our 86% membership among the 2770 board certified internists in Missouri. Interestingly, 39% of all of our Chapter members are age 36 or younger. Only 7.3% were 56-65 years and 8.1% were over age 65. Thus, it appears that we are growing substantially in our younger colleagues. Over the past five years, the Chapter has grown by 45%, but this coincides with a substantial increase in the number of medical students and Associates involved in our Chapter. These numbers are good, yet there remains room for improvement.

If one looks at the percentage of the various categories of membership, 25% of Masters, 6% of Fellows, 20% of Members, and 27% of Associates are female. If we then look at representation on our Missouri Council, we find that 29% were women during the period 1998-1999, which compares favorable among other chapters in the College where the average is 21% for female Council members. The Chapter's Women's Committee chaired by Doctor Sara Aydt of Cape Girardeau, has begun working with the Education Committee to assist in identifying topics for the Annual Meeting.

Finally, it was not specifically described in this profile, but our Chapter, as many of you know, has made substantial progress in the general area of communications between and among members, even though we are scattered geographically. It is important to me, for all Missouri members to have access to our Chapter. It is useful for me at this point to remind the reader of our newsletter

that there is a system by mail, by phone and by web site or e-mails, that minimizes the hassle involved in communication. There are several members scattered around the state who have been willing to post letters and or e-mails in conspicuous sight for members of the medical profession, particularly Internal Medicine physicians to enlarge our communication system.

Richard B. Whiting, MD, FACP, Governor
richard.whiting@medcast.com

Chapter Recognized By ACP-ASIM

Governors Richard B. Whiting, MD, FACP, and Warren Lovinger, MD, FACP, accepted the ACP-ASIM Chapter Management Award on behalf of the Missouri Chapter on April 19, during the College's Annual Session, in Philadelphia. This award recognizes those Chapters which have met a comprehensive list of criteria indicating the Chapter is active and working to meet the needs of its members.

Contact Your Legislators Through the Legislative Action Center

To make participation in grassroots advocacy easier for its members, ACP-ASIM established a Legislative Action Center (LAC), which may be accessed from ACP-ASIM Online. The LAC allows you as an ACP-ASIM member to view the most current ACP-ASIM Legislative Alerts, find out who your federal legislators are, and send e-mails or faxes to your members of Congress. It also provides you with the status of key legislative issues of concern to ACP-ASIM, Congress' schedule, and tips on communicating with your legislators. ACP-ASIM encourages you to try the LAC by sending an e-mail to your members of Congress in response to the current Legislative Alert posted on the LAC.

You can access the Legislative Action Center through the "Where We Stand" section of ACP-ASIM Online or by going straight to the LAC. To send a message to Congress, you are prompted for your zip code and are then matched to your federal legislators. You will then be asked for your name and address (so that congressional offices can identify you as a constituent). ACP-ASIM encourages you to send a message based on the sample message posted for you, with your own personal anecdotes added. If you have any questions about the LAC or ACP-ASIM's Key Contact program, please contact Jenn Jenkins, Associate for Grassroots Advocacy, at jjenkins@acponline.org, or at 800-338-2746, x4536.

Missourian Wins National Poster Contest

Karan D. Singh, MD, a resident in the Department of Cardiology at the University of Missouri - Columbia, won first place at the College's Annual Session Poster Contest, in Philadelphia. Dr Singh previously won the Missouri Chapter contest last fall with his poster, "A 73 years old man with a rash, rapidly progressive renal failure and abrupt onset of dyspnea." An abstract of this poster may be viewed at www.acponline.org/chapters/mo/99abstracts/.

Missouri Chapter Poster Contest Goes Online

The submission process for the Missouri Chapter Poster Contest is now completely electronic. Steve Atwood, MD, FACP, the Chapter's very own web guru, developed a web-based submission form which sends the entries by e-mail to the chair of the contest - George Reisz, MD, FACP.

Missouri Chapter Book Awards

Graduating seniors, planning a career in internal medicine, are recognized annually by the Missouri Chapter with awards named for faculty members. In addition to being mentioned at graduation, each awardee received a certificate signed by the Governor, accompanied by a $200 check.

This year's Book Award winners are:

  • Ali Husain, Washington University - Alison J. Whelan, MD
  • Michael O. Barry, University of Missouri, Columbia - Richard Burns, MD, FACP
  • Smitha Chadaga, University of Missouri, Kansas City - Loretta S. Loftus, MD, FACP
  • Anna Chang, Saint Louis University - Adrian M. DiBisceglie, MD, FACP

Bio-Terrorism Seminar Held in St. Louis

A top-flight cast assembled at St Mary's Hospital in St. Louis on March 18 to discuss Endocarditis, Hematology and Bio-Terrorism. The faculty included Larry Baddour, MD, FACP, of Knoxville, TN; Thomas DeLoughery, MD, of Portland, OR; and Lt. Col. George Christopher, MD, FACP, of Fort Detrick.

"Access to Healthcare: What is the Profession's Responsibility?"

In November, the ACP-ASIM together with the American Board of Internal Medicine, published a small booklet entitled, Access to Healthcare: What is the Profession's Responsibility? This was a direct result of a task force on physician advocacy to help the uninsured, set up by ACP-ASIM and the ABIM. In April 1997, there was a leadership retreat involving the College and the ABIM where it was clearly recognized there is a growing problem involving access to healthcare for an increasingly large number of Americans.

I think it would be appropriate for all of us to read through this booklet, Access to Healthcare. Copies are available by contacting Linda Blank, c/o ABIM, 510 Walnut Street, Suite 1700, Philadelphia, PA 19106-3699. For those of you adept at e-mail communication, she can be reached at Lblank@abim.org.

At this point I leave you with a quotation from John D. Stobo, MD, MACP, and President of the University of Texas Medical Branch in Galveston, Texas: "It is unconscionable that the United States is the only developed country in the world where 20% of the population (under the age of 65) can't get the healthcare they need and deserve, simply and solely because they don't have health insurance. As public trusts, academic health centers have the responsibility to address and fix this health crisis."

Community-Based Teaching

The College has sponsored a community-based teaching (CBT Course) program basically to help all of us who are involved in education of medical students and/or residents in our offices. This program should also be of interest to those who would like to take part in precepting a resident or student, but have been hesitant to get involved. In general, this is a very enjoyable activity that always serves to stimulate the physician and his or her office staff simply through the educational efforts involved. It is certainly worthwhile and very much appreciated by the student or resident who is the recipient of the educational effort.

There is a web site established for this program. There also is a community-based teaching textbook available entitled, Community-based Teaching; A Guide To Developing Educational Programs For Medical Students And Residents In The Practitioner's Office. The CBT Program offers a variety of ideas and sources of help for those who are interested. There is a quarterly newsletter that is sent to CBT Practitioners and there is a CBT Speakers Bureau to facilitate local development of faculty for this kind of activity. This bureau provides names and contact numbers of national experts in the area of ambulatory education and faculty development.

There also is a physician recognition award program that provides certificates of recognition to physicians who participate in CBT Programs for two or more years. Such an award would be highly regarded at the time of advancement to fellowship. Finally, there is a CBT "Excellence In Teaching" award designed for the individual who puts substantial effort and time into educational efforts in their office or clinical setting. This particular award requires involvement in a CBT Program for seven out of ten years, with at least three years at the same sponsoring institution and an average fifty hours annually of direct trainee contact.

It is important for us to describe this program for several reasons. First, there are already very many members and fellows scattered around Missouri who have played an active role in educating students and residents in their office settings. It would be very appropriate if these teachers and volunteers could at least be recognized for their efforts. In addition, it is clearly important to develop improved educational programs, particularly in ambulatory care.

Chapter Continues Internet Efforts

If you have not begun using the Internet and e-mail, then perhaps it is time you did. Most medical schools are now providing classes on computer software and basic Internet skills and it has become a requirement at most universities.

The Missouri ACP-ASIM Council voted to build our own web site. Five members have been selected to form the Internet Committee (IC), which will oversee and build the web site. Soon, we hope to provide links to top-quality CME produced at Missouri institutions and links to our Missouri universities and their educational and research programs. Physician-to-physician communication via e-mail will continue to grow rapidly. If you have an e-mail address that ACP-ASIM could use, please pass it along. If your office has a web site, please let us know and in time we will probably have a section that provides a list of office web sites.

Hopefully, our Chapter web site at www.acp-asim-missouri.org will become a tool to help Missouri ACP-ASIM profile our activities in Missouri and increase our services to the public and all Missouri physicians.

Reading Retreat

A regional meeting of a different nature was held March 17-18, at The Elms, a Bed & Breakfast, outside of Kansas City. Those participating began by seeing a theatre production of "Wit" on Friday night. The group reconvened on Saturday for a discussion about the play and their reading assignment, Kitchen Table Wisdom.

Regional Meetings Flourish

So far this year, the Missouri Chapter has sponsored meetings in Cape Girardeau, Kansas City, St Louis and Springfield. Last year, the Chapter decided that we needed to reach a larger number of our members. We will continue to have our major CME meeting in the Fall at Tan Tar A, but watch for a meeting coming to a town near you.

Second Annual Southwest Missouri Regional Meeting

The Second Annual Southwest Missouri regional meeting of the ACP-ASIM was held Thursday evening, April 27, in Springfield. Participants enjoyed the fellowship, meal, and presentations.

Drs. Curt Schreiber and Anne Winkler made CME presentations and Dr. Warren C. Lovinger, Transitional Governor from Nevada, MO, discussed our Chapter, the College and the importance of advancing to Fellowship.

Cape Girardeau Review Continues

The oldest of the regional meetings is the Internal Medicine Review held this year on April 1. It is a full day's event designed to bring primary care physicians up to date in a number of fields.

How to Reach Us

Richard B. Whiting, MD, FACP
St. Mary's Health Center
6420 Clayton Road
St. Louis, MO 63117
Phone: (314) 768-8887
Fax: (314) 768-7101
E-mail: richard.whiting@medcast.com
Pat Mills
Missouri Chapter Administrator
PO Box 1028
Jefferson City, MO 65102
Phone: (573) 636-3366
Fax: (573) 636-5882
E-mail: pmills@sprintmail.com