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April 2012 Julie A. Blehm, FACP, ACP Governor

From the Governor

Dr. Blehm

First I must apologize for not having done a newsletter for quite some time. Secondly I want to thank all of you for the calls, cards and support after my husband's death in November. I so appreciated all of it. I realized again how many good friends I have who are part of the American College of Physicians.

I am looking forward to the 2012 Internal Medicine ACP meeting in New Orleans April 19-21. As usual the courses being offered cover a variety of topics and will help keep us up to date and broaden our knowledge. Please let me know if you are attending the meeting. If any of you are walking in the convocation ceremony for your fellow ship I will see you there. It would be helpful if you would send me an email letting me know if you will be in the ceremony. I will be staying at the New Orleans Marriott. Do not hesitate to contact me.

Leadership day is in Washington, DC on June 6 and 7. Jennifer Raum, an internist from the Sanford Health System in Fargo, will be representing our chapter. I will be in Washington, DC on Monday, June 4 attending a meeting of the ACP Medical Practice and Quality Committee so I plan on staying for Leadership Day.

Our state ACP meeting will be held in Bismarck at the new Southwest Campus UND School of Medicine building (the new Family Practice Center) on October 12. We are excited to be back in Bismarck. The meeting will be cosponsored with the ND Medical Directors Association and North Dakota Health Care Review. We will be covering several topics including Transitions in Care, Palliative Care, Hepatitis C, osteoporosis and a very interesting case presentation. The North Dakota Medical Association will be meeting the same day and we are all invited to the dinner they are having the evening of October 11. Please join us in Bismarck!

As always please let me know if you have ideas for meetings or membership. I appreciate hearing from all of you. We are still hoping to start some CME webinars in the next year.

Below are 2 articles that you may find of interest.


Use of Quality Indicators in Patient Care
A Senior Primary Care Physician
Trying to Take Good Care of His Patients

Bruce E. Landon, MD, MBA, MSc, Discussant

DR REYNOLDS: Dr A is a senior primary care internist who recently moved from a small private practice to a larger group model practice. He is adjusting to his new practice structure and feel she is struggling to take high-quality care of his patients. Dr. A began practicing primary care more than 30 years ago. In his small private practice, shared with 1 to 4 other physicians during the past decades, Dr. A worked with a single nurse and a small office staff. He used an electronic prescription program, had paper records, and did not have any income dependent on “pay for performance.” As his practice coverage pool shrank, he took more and more call for his practice and his income dropped; life in a small practice became untenable.

Read the entire[PDF] discussion.


Implications for the Affordable Care Act


The Affordable Care Act (ACA) will fundamentally change access to health insurance coverage in the United States through a combination of a Medicaid expansion, subsidies offered for coverage provided through new health insurance exchanges, health insurance market reforms, and other policies such as the individual requirement to obtain coverage. Under the ACA, Medicaid eligibility will be expanded to a mandatory minimum of 138 percent of the federal poverty level (FPL) for all nonelderly citizens starting in 2014. The law also calls for the establishment of state-based health insurance exchanges. The exchanges will be organized markets where individuals and small businesses can purchase health insurance coverage that is subject to new regulations intended to promote greater transparency and competition in the market for health insurance.1 Low- and moderate-income individuals and families with incomes up to 400 percent of the FPL will also be eligible for federal subsidies to purchase coverage in the exchanges if they do not have affordable access to employer-based insurance. With these new options in place, most individuals will be required to obtain a minimum level of coverage or pay a penalty.-2

Read the entire [PDF]article.


New Master

Congratulations to Dr. Robert D. McCartney of Saint Thomas, North Dakota who has been selected to become Master of the College (MACP) in April 2012. To be considered for Mastership, the candidate must have made a notable contribution to medicine. This includes but is not limited to teaching, outstanding work in clinical medicine (research or practice), contributions to preventive medicine, improvements in the delivery health care, or contributions to medical literature.


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Contact Information

Julie A Blehm, MD FACP
ACP Governor
North Dakota Chapter

Pam Heisler
North Dakota Chapter Staff
Phone: 701-780-6129
Email: pheisler@altru.org