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Governor's Letter

This is my first newsletter since becoming Governor of the Nevada Chapter on Saturday, April 9, 2011, at the ACP Business meeting, which was held at the IM 2011 ACP Annual Meeting at the San Diego Convention Center. Many of our members were able to attend the IM 2011 meeting and our Chapter’s reception. I was delighted to be able to meet, greet, and chat with some of our Chapter’s attendees.

This newsletter will review our Chapter’s Annual Meeting, Scientific Session, and Associate and Medical Student Poster Competition. Three first place winners of the Poster Competition: Associate Research category, Associate Clinical Vignette category, and the combined Medical Student Research/Clinical Vignette category, attended the IM 2011 meeting in San Diego and competed in the National Poster Competitions. The three first place awardees won the opportunity to represent Nevada at the National Poster Competitions, along with a stipend to be used to reimburse registration, travel, room and meal expenses to the IM 2011 meeting.

A second newsletter will be posted on our Chapter website within the next several weeks. It will feature articles about the Spring 2011 Board of Governors (BOG) meeting, the Annual IM 2011 meeting, Nevada’s new Fellows, the Spring 2011 Convocation and hooding of some of Nevada’s new Fellows, a Governor’s letter, a past Governor’s letter, a report on the Nevada Chapter reception at IM 2011 and the following dinner of Chapter members at the San Diego Fish Market restaurant. We will also include a number of photos of the IM 2011and BOG meetings and photos from the Convocation and post Chapter reception dinner.

Volunteers Needed

Please feel free to contact me or our Executive Director Roberta Again for any concerns about our Chapter. We are planning to have an active Governor’s Council, consisting of representatives from northern and southern Nevada, the medical schools, and the Chapter’s councils. I am planning to establish or beef up Chapter Councils, on behalf of both the northern and southern Nevada areas, representing Young Physicians, Associates (residents), Medical Students, Hospitalists, Women Physicians, and possibly International graduates. These will require the assistance of many volunteers. Please volunteer if you are able.

Thanks,

Warren H. Evins, MD, PhD, FACP
ACP Nevada Chapter Governor
wevins@yahoo.com
702-458-2362

Roberta Again
ACP Nevada Chapter Executive Director (part time)
Rae773@cox.net
702-285-9425

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Chapter Meeting Venues

The Nevada Chapter has held its last two Annual Meetings in 2010 and 2011 at the Rio All-Suite Hotel and Casino in Las Vegas. The 2009 Annual Meeting was held at the Golden Nugget Hotel and Casino in downtown Las Vegas. For the prior three Annual Meetings in 2008, 2007, and 2006, the meeting site was the Wynn Hotel & Casino. Previous Annual Meeting locations were the Four Seasons Hotel in Las Vegas and Sunrise Hospital Auditorium. Our earlier meetings were smaller, with fewer attendees, no Poster Competition, and fewer or no exhibitors.

Finding a location/venue for our Annual Meeting has proven to be a challenge. Las Vegas Hotels want to sell guest rooms. Our Chapter Meeting is not a very desirable event because we don’t contract to occupy a minimum of 30 guest rooms. When a hotel isn’t very interested in hosting an event, they will either offer very high prices for event functions or catering, not agree to rent rooms until the last minute (preventing adequate planning and publicity), or decline to rent at all. In the past, we have use RFPs (request for proposals) from the Las Vegas Convention and Visitors Bureau - with very few responders. Meetings with catering and convention staff of various hotels have not proven to be very helpful.

Contracts with the hotel are usually executed six to nine months in advance of the event, requiring a partial payment. In preparation for the 2009 Annual Meeting, in Spring 2008, we attempted to meet with the Rio Convention and Catering staff, but they expressed no interest in hosting our event. As Chair of the Chapter Planning and Programming Committee, I then contacted the National ACP Convention coordinator, Bobbi Turner, to express my frustration and request her assistance. She put me in touch with ACP’s east coast convention planning company, who contacted the Rio’s east coast contacts, who arranged a site visit at the Rio Hotel. The Rio was still not very interested in our event, but showed us around and offered us a very pricey contract.

The next year, the Las Vegas economy had plummeted and the Rio contacted us in the Spring of 2009 with a significantly better offer. We held our 2010 Meeting at the Rio in the Miranda Ballroom: exhibitors, breakfast, and refreshment breaks in Miranda 1 and 2, the Scientific Session lectures in Miranda 3 and 4, the Poster Competition in Miranda 5 and 6, and the luncheon directly across the hall in Rio Pavilion 3 and 4.

For the January 2011 meeting, we contracted again with the Rio, after preliminary meetings in Spring 2010. Our contract designated the same rooms in the Miranda Ballroom for all functions, except the luncheon would be around the next corridor in Miranda 7 and 8, instead of across the hall from the Scientific Session lectures. We sent in our partial payments and all was going well until about one week before our event, when we were informed that we had lost our luncheon room. An unknown someone in the Caesar’s (the owner of the Rio) convention or catering staff, had given away our luncheon room to another event, and the Rio was fully booked. So we could still hold our meeting at the Rio, actually we had a contract requiring our meeting to be held or else we would be responsible for full payment of the event (even if it didn’t occur), although we couldn’t have a luncheon.

Our luncheon is a big event for our Chapter. An Awards Ceremony and a Town Hall meeting occur during the luncheon. The Rio looked around for another room for a luncheon and found a small room at the other end of the Hotel, able to hold about half of our attendees - if people were able to stand up for the Awards ceremonies. Or people could be packed in like sardines, not be able to stand up once seated, with the buffet serving lines in another location, and we could get more - but not all - of our anticipated attendees in the room. What a dilemma!

Dr. Speck, I (Warren Evins), and our Executive Director Roberta Wideen Again (a previous Rio department head - under previous ownership) all lobbied strenuously for a reprieve. I was prepared for a sit down in the Rio general manager’s office. Fortunately, one or two days before our event, our luncheon room was restored. The luncheon proceeded adequately, although my visit to the room two hours before the luncheon showed that no room setup at all had begun, and we had to contact catering services.

Additionally, we had a precipitous decline in the sponsors and exhibitors for our Chapter Annual Meeting. The meeting cost around $34,000. Sponsorship, exhibitor and registration fees fell to around $10,000. So the Chapter lost around $24,000 on the meeting, an amount approximating all of our annual dues (the money we get from National ACP). The Poster Competition, judging, awards, books, prizes, free registration to all our associates and medical students cost $16 to 20,000. So we are wondering where to have our 2012 meeting. Any suggestions?

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Nevada Chapter Annual Meeting

The Nevada Chapter of the American College of Physicians held its 2011 Annual Meeting at the Rio All-Suite Hotel and Casino in Las Vegas on Saturday, January 15, during the Martin Luther King Holiday weekend. The meeting consisted of several parts.

The Annual Poster Competition included Chapter Associate members (Residents) and Medical Students members presenting posters featuring either a Research project in which the presenter played a significant part or a Clinical Vignette highlighting an unusual clinical case with a literature review. Awards were presented after the posters and abstracts were reviewed and the presenters were examined by a judging team headed by a Master of the College from the Rochester, Minnesota Mayo Clinic. A summary of each winning awardees poster was presented at the afternoon meeting of the Scientific Session.

ACP President J. Fred Ralston, MD, MACP
ACP President J. Fred Ralston, MD, MACP

ACP Senior Vice President for Government Affairs and Public Policy Robert B. Doherty
ACP Senior Vice President for
Government Affairs and Public
Policy Robert B. Doherty

The Scientific Session featured a report to the College membership of what is new and what is happening at the ACP, given by the 2010-2011 ACP President J. Fred Ralston, now MACP. Senior Vice President for Government Affairs and Public Policy, Bob Doherty, came from Washington, D.C. to clue us in to the Congressional agenda and update us about the Patient Protection and Affordable Care Act and Accountable Care Organizations. We heard an excellent interactive ethics discussion about organ procurement and donation conducted by Dean Mitchell Forman, DO, and Professor Don Havins, MD, JD, of Touro University-Nevada.

Professor T.Brian Callister, MD, from Reno and the University of Nevada School of Medicine instructed us how to correctly code for the proper optimum professional fees. Brian A. Berelowitz, MD, gave us insight into the scientific basis of diabetes management and featured a 2011 advances in diabetes update.

T. Brian Callister
T. Brian Callister, MD, FHM

Brian A. Berelowitz
Brian A. Berelowitz, MD

Matthew Fouse
Matthew Fouse, MD, MPHTM

Orthopedist Matthew Fouse, MD, from the Las Vegas Desert Orthopedic Clinic presented a Sports Medicine update, instructing us when to refer, what surgical procedures are available, and how to care for sports injuries in our offices. He spoke about knee, shoulder, and general sports injuries. Closing our program was ACP President J. Fred Ralston, MACP, speaking of how his practice has implemented the “Medical Home”. Concluding remarks were made by outgoing Governor, Gene Speck, MD, PhD, FIDSA, FACP, and Governor-Elect Warren Evins, MD, PhD, FACP, then the drawing for door prizes including medical books and gift certificates was conducted.

Governor Eugene L. Speck
Governor Eugene L. Speck, MD, PhD, FIDSA, FACP

Governor-elect Warren H. Evins
Governor-Elect/Planning and Programming Chair, Warren H. Evins, MD, PhD, FACP

Pathways to Fellowship

The morning sessions started off with an enhanced breakfast buffet. Our program included an ACP prepared slide presentation on how ACP members can follow one or more pathways to qualify for Fellowship. There was a second slide presentation about Advancement to Fellowship, with the opportunity for interested members to hook up with mentors and coaches. There are four pathways for Fellowship. A member may advance to Fellowship by meeting the requirements of any of the four pathways, or by mixing the pathways’ requirements and qualifying in parts of more than one pathway. It has never been easier to qualify for Fellowship. Attendance at chapter meetings can help all ACP members in meeting the qualifications for advancement to Fellowship. It is especially important for those applying under that pathway calling for 5 years of activity as a Member. Chapter officers were and are still available to discuss advancement qualifications, answer questions, and provide mentorship and coaching opportunities on request. Completion of one full pathway or portions of two or more pathways is allowed. Additionally, highly qualified non ACP members may be proposed for Direct Fellowship, bypassing the normally required minimum two years of membership before being eligible for Fellowship.

The opportunity for mentorship still exists: contact Governor Warren Evins or Executive Director Roberta Again for details.

The Nevada Chapter received two grants from Novo Nordisk Pharma and Astellas and had several exhibitors participate in our conference: Pfizer Pharmaceuticals, Premier Physicians, Nevada State Bank, Preferred Homecare, Quest Diagnostics and HealthInsight. Additionally, the Chapter received door prizes donated by United Blood Services, CVS Pharmacy and Office Depot.

A buffet luncheon, Awards ceremonies, and a Town Hall meeting occurred during the mid day break in the Scientific Sessions. Attendees asked questions of Governor Gene Speck, Governor-elect Warren Evins, President Fred Ralston, and Senior Vice President Bob Doherty. In all, it was a very successful meeting attended by over 125 registrants, 43 poster presenters, 4 staff, and a variety of family, friends, and medical school faculty. To view pictures of the annual meeting you can go to 2011 Chapter Meeting slides.

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ACP President Visits Nevada

J. Fred Ralston, MD, MACP, 2010-2011 President of the American College of Physicians visited our Nevada Chapter for our Annual Meeting, Scientific Session, Associate (Resident) and Medical Student Poster Competition, and Town Hall Meeting with the Chapter members on Saturday, January 15, 2011, at the Rio All-Suite Hotel and Casino. President Ralston arrived in Las Vegas from his home in Tennessee on Thursday, two days earlier, in order to attend and lead several functions with local Internal Medicine Residents and Medical Students. Earlier in January 2011, Dr. Ralston spent about 10 days visiting Internal Medicine leaders in India, in preparation for the establishment of a new ACP Chapter there. The College has a number of International Chapters throughout the world, including most Canadian provinces, Mexico, Central and South America, Europe, Asia, and a new Chapter in Saudi Arabia.

On Thursday, January 13, 2011, Dr. Ralston addressed the Internal Medicine Interest Group (medical students) at Touro University - Nevada. Also attending and speaking at this function were Eugene L. Speck, MD, PhD, FIDSA, FACP, Nevada ACP Chapter Governor, Dean Mitchell D. Forman, DO, FACR, FACOI, FACP, a Nevada Chapter Chair, and Nevada Chapter Governor-Elect and Planning & Programming Chair, Warren H. Evins, MD, PhD, FACP.

Friday morning, January 14, 2011, ACP President J. Fred Ralston, MD, MACP, presented Medicine Grand Rounds at University Medical Center of Southern Nevada (UMC) to faculty, staff, community physicians, residents, medical students and other attendees. He then met with faculty of the Department of Internal Medicine, University of Nevada School of Medicine (UNSOM) - Las Vegas, attended morning rounds, and met with residents and students of the Internal Medicine Department.

President Ralston had lunch at Valley Hospital with the residency faculty from the Touro University - Nevada (TUN) College of Osteopathic Medicine, Department of Medicine. Later that afternoon, President Ralston attended some Medicine Department clinical rounds and met with Touro University residents and medical students. Nevada Governor Gene Speck, MD, PhD, FIDSA, FACP shadowed President Ralston and met with the same constituencies. Friday evening, ACP President J. Fred Ralston attended a dinner with the Annual Scientific Meeting speakers, ACP Nevada Chapter leadership, the Poster Competition Judges, and the Internal Medicine Program Directors, Department Chairs, and Medical School Deans from Nevada.

ACP President Presents Chapter Excellence Award to the Nevada Chapter

During the Awards Ceremonies on Saturday, January 15, 2011, at the Luncheon, ACP President J. Fred Ralston, MD, MACP, presented a Chapter Excellence Award to the Nevada Chapter Governor, Eugene L. Speck, MD, PhD, FIDSA, FACP.

The Nevada Chapter is grateful to President J. Fred Ralston, MD, MACP, for his many endeavors, contributions, and advice to our Chapter, members, and local medicine residents and medical students. We greatly appreciate his attendance at our Meetings.

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Poster Competition Winners

The Nevada Chapter held its 2011 Annual Poster Competition on Saturday, January 15, 2011, at the Rio All-Suite Hotel and Casino, starting at 6:30 am. Forty three abstracts were submitted, but one participant dropped out at the last minute. Judging commenced at 7:30 am and continued into the afternoon. Alan Greenberg, MD, FACP, was the Poster Competition Chair.

There were two teams of judges, both headed by former Chapter Governors from Minnesota. One was headed by Scott C. Litin, MD, MACP, Associate Professor of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, and the other by Tanya L. Repka, MD, FACP, Chief, Section of Oncology, St. Luke's Oncology and Hematology Associates, Duluth, Minnesota. Also serving as judges were Evan Klass, MD, Interim Chair of the University of Nevada School of Medicine (UNSOM), Reno, Department of Internal Medicine, and Michael Nasiak, MD, Associate Program Director, Las Vegas, Department of Internal Medicine. In order to prevent a conflict of interest, no judge evaluated a poster from his own program. The judge’s reviewed all abstracts, looked up relevant literature citations, and researched the areas identified in the abstracts before the meeting.

For ACP Nevada associate members (residents) there was a Clinical Vignette and a Research category. Medical students had their own competition that combined both of these categories. All entrants in the Research category are required to be actually involved in the planning and/or analysis of data, and to not only have participated in a purely technical capacity such as might be performed by a salaried technician or data entry person. Clinical vignettes illustrated a novel or unusual observation, or demonstrated an important clinical lesson. Every listed author must have participated in the development of the Clinical Vignette poster.

There were monetary awards for the top three posters in each category: $300, $200, and $100 respectively. First place winners can choose to have their posters compete at the National ACP Meeting and receive up to $1000 stipend to help cover cost of registration and travel to that meeting.

In the Medical Student category, the first place winner was Kim Chau of Touro University-Nevada (TUN), Title: Alterations in Intracellular Oxygen Stress Pathways due to Changes in Environmental Oxygen Concentration, second place went to Keith Habeeb of TUN , Title: Osteopontin Modulates NKT Cell Responses to RSV Infection in Neonates and Alter subsequent Differential Adaptive Immune Responses and Susceptibility to Asthma, and the third place recipient was Sean Linstedt, of UNSOM-Reno, Title: Lemierre’s Syndrome: an unforgettable case of the forgotten disease.

For the Associate Research category, first place went to Nirmal Sunkara, MD, of UNSOM, Las Vegas, Title: CATCH CAD – 1, the second place winner was Subodh Devabhaktuni, MD, of UNSOM, Las Vegas, Title: Lithium Toxicity Associated Myocarditis – A Case Report and Review of Literature and Sara Ashraf, MD, of UNSOM, Reno, received the third place award, Title: The Effect of a Low Fat Diet on Muscle Mass in Women with Obesity.

In the Associate Clinical Vignette category, the first place awardee was Olena Lineberry, MD, of UNSOM, Reno, Title: Wunderlich’s Syndrome as the First Manifestation of Renal Artery Fibromuscular Dysplasia, second place went to Shamoona Fawaz, MD, of UNSOM, Las Vegas, Title: H-Pylori and the Etiology of Immune Thrombocytopenic Purpura (ITP), and Nicole Davey-Ranasinghe, MD, of UNSOM, Las Vegas, received the third place prize, Title: Hidden in the Gut: Revealing Lupus Enteritis.

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