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Governor's Newsletter, Summer 2002

Evelyn V. Hess, MD, MACP
Governor, Ohio Chapter

Governor's Column

ACP-ASIM Ohio Chapter Scientific Meeting—The Ohio Chapter 2002 Annual Scientific Meeting will be held Friday and Saturday, October 11th-12th at the Hyatt Regency Hotel in Columbus. We expect it to be even bigger and better than last year's meeting.. The theme of our meeting is "The Best of Internal Medicine." We have planned an incredible program with well-known and respected speakers in the field of Internal Medicine: rheumatology, infectious diseases, obesity, patient safety, hospital medicine, and clinical skills modules on skin biopsies and sports medicine. Look for the meeting brochure in your mailbox by mid-July. Please register early (before 16 Sept., $10 additional charge for Onsite Registration). There will be 11.25 CME credits for the meeting. Some highlights of the meeting will include:

  • A new Associates Game Show "Who Wants to Be a Board Certified Internist?" on Thursday evening
  • Plenary Sessions on Obesity Management, Joints and Genes, Workup of Recurrent Infections
  • Clinical Skills Modules on Sports Medicine and Skin Biopsy
  • A new Patient Safety: Medical Errors Module
  • Medicine in the Palm of Your Hand: Handheld Computers
  • Associates and Medical Students Lunchtime Information Sessions and Abstract Competition

Our Visiting Speaker this year will be Roland W. Moskowitz, MD, FACP, Professor of Medicine and Director of the Arthritis Research Institute at University Hospital/Case Western Reserve University School of Medicine. Dr. Moskowitz will do the Friday morning plenary session "Joints and Genes" and will also be our dinner speaker on Friday evening speaking on "Musings of an Academician: Serendipity and Life." Patrick Hope, Esq. of the DC Office will provide the Health and Public Policy Update. Joseph Silva, MD, FACP, Regent, Dean, School of Medicine, University of California, Davis Medical Center, will provide the College Update and present the Plenary Session: How to Keep those Bugs Away: Workup of Recurrent Infections. The meeting will lend with the very popular MKSAP Reviews, this year on Hospital Medicine and Rheumatology.

Also, there's a lot to see in Columbus. Be sure to visit "sites" our capitol city sites. Full meeting details are available on our Chapter Web site where the program and registration form can be found. The registration form can be duplicated and mailed along with payment to Janet Matheson, Ohio Chapter ACP-ASIM, UC Medical Center, and 231 Albert Sabin Way, Cincinnati, OH 45267-0563. We are looking forward to the best meeting yet and hope to see you there.

**Reminder: Ohio Medicine-Pediatrics Association, Annual Luncheon Meeting, Saturday, Oct 12th at 12:30-3:00 pm. Thomas Webb, MD of University of Cincinnati will present "Genetics in Primary Care". For more information, contact Dr. Cynthia Ledford, President, Ohio Medicine-Pediatrics Association at (ledford.5@osu.edu) or by phone (614-293-8589).

Outstanding Senior Medical Students Entering Internal Medicine Award

Congratulations from Governor Hess and the Ohio Chapter to 2002 Recipients

Dahlia Awais, Case Western Reserve School of Medicine—Dahlia rated by her attendings as one of the finest students with whom they have worked. She is noted as the ideal candidate for this award with her strong commitment to Internal Medicine and impressive clinical performance. Dahlia plans to do her residency training at the Hospital of the Univ. of Pennsylvania in Philadelphia.

Orlando Gutierrez, Medical College of Ohio-Toledo—Orlando's record in Internal Medicine was characterized by outstanding subjective and objective evaluations of his performance. He received and Honors grade for his clinical rotation.Orlando will begin his residency in Internal Medicine in July 2002 at Massachusetts General Hospital.

Nitin Khosla, Northeastern Ohio Universities College of Medicine—Nitin received Honors in IM Clerkship in junior year along with Honors in three out of four modules in the second-year Principles of Medical Science Course. In addition, Nitin received Honors in two senior medicine electives-Nephrology and Infectious Diseases. Nitin was selected from a group of 18 students entering IM from NEOUCOM in a highly competitive contest involving input from the Chairs of IM at our affiliated hospitals. Ms. Khosla is pursuing an Internal Medicine Residency at Rush-Presbyterian, St. Luke's Hospital in Chicago, Illinois.

Christopher Sankey, Ohio State University School of Medicine—Christopher Sankey, as indicated by his nominators, is the type of student the ACP-ASIM student award was designed to honor. Chris was noted as enthusiastic, compassionate and very knowledgeable as demonstrated by his grade of Honors in all four of his third and fourth year rotations. He is an exceptional medical student who is already performing on an intern level. Mr. Sankey will enter the Internal Medicine Residency Program at Yale after graduation in June.

Deborah Bradley, University of Cincinnati College of Medicine—Deborah, a strong advocate for the field of Internal Medicine at the Univ. of Cincinnati, is an outstanding medical student with exceptional clinical skills. She is an active researcher in ocular sarcoidosis and has had her work presented nationally. Ms. Bradley plans to do her Internal Medicine residency at the Univ. of Cincinnati.

Sarah D. Carothers, Wright State University School of Medicine—Sarah is noted as an excellent student who, prior to medical school, spent several years as a research assistant in the Center for Neuroscience at New York Univ. During her time at Wright State, Sarah was very active in volunteer work, served as the ACP-ASIM Student Representative, and was awarded the Ohio Medical Education and Research Foundation Leadership Award. Ms. Carothers is entering a Combined Medicine-Pediatric residency at the Univ. of Cincinnati and will start her program July 1, 2002.

2002 Annual Session—National Abstract Competition Winners

The following winners presented award-winning work at the 2002 ACP-ASIM Annual Session. Congratulations!

Associates Abstract Competition:

Paper Winners/Research Category—

  • Claudia Panzer, MD, Cleveland Clinic Foundation, Cleveland, Ohio, Association of Fasting Plasma Glucose with Heart Rate Recovery in Healthy Adults - A Population-Based Study.

Medical Students Abstract Competition:

Paper Winners/Research Category—

  • Srinivas Vourganti, Ohio State University College of Medicine, Treatment of Epstein-Barr Virus Transformed B-Cell Lines with the Histone Deacetylase Inhibitor Depsipeptide (FR901228) Results in the Induction of a Viral Thymidine Kinase and Enhanced Susceptibility to Antiviral-Induced Apoptosis

Paper Winners/Clinical Vignette Category—

  • Amber S. Podoll, Ohio State University College of Medicine, Unique Mandibular Manifestations of Secondary Hyperparathyroidism.
  • Nathan Walker, University of Cincinnati College of Medicine, Hemophagocytic Lymphohistiocytosis: A Rare Manifestation of Epstein- Barr Viral Infection.

Poster Winner/Research Category—

  • Craig N. Burkhart, Medical College of Ohio, Clinical and Laboratory Assessment of NIT Sheath of Head Lice.

Congratulations To Our Newly Elected Fellows

John S. Andrews, Jr., MD, Cincinnati
Carol A. Burke, MD, Cleveland
Ronald D. Crock, MD, Canton
Joan M. Duggan, MD, Toledo
Augustus K. Eduafo, MBChB, Dayton
Nabil F. Fahmy, MD, Canton
Joseph A. Girgis, MD, Westlake
Steven M. Gordon, MD, Cleveland
William L. Horvath, MD, Toledo
Thomas I. Kanomata, MD, Miamisburg
Susan B. LeGrand, MD, Cleveland
Anthony J. Linz, DO, Sandusky
Bhupendra H. Mahida, MD, Fairfield
Gregory A. Otterson, MD, Upper Arlington
Kara J. Quan, MD, Cleveland
Edward Rosenthal, MD, Garfield Heights
Roger S. Stienecker, MD, Lima
Lu A. Sun, MD, Mason
Abdul Wase, MBBS, Dayton
John J. Young, MD, Cincinnati
Adel I. Youssef, MD, Warren

Fellowship Reminder—Next deadline is December 1, 2002

It is important to remember that there are 4 established Pathways:

Pathway 1: Members must have demonstrated skill in written medical communication.

Pathway 2: Members must have significant and continuing certification activities and/or teaching (both institutional and community-based), and/or community activities that indicate professional achievement and scholarship; they must have undergone recertification, or they must have participated in the Medical Knowledge Self-Assessment Program (MKSAP) with a passing score. In addition, subspecialty certification or certificates of special competence in adolescent medicine, critical care medicine, clinical cardiac electrophysiology, geriatrics, or sports medicine can qualify a candidate for this pathway, but are not adequate by themselves.

Pathway 3: Members must have been active members in ACP or ASIM for at least 10 years, with substantial participation in programs and activities, as well as demonstration of other professional accomplishments. **Note: Outstanding candidates who have been active Members for fewer than 10 years may qualify by combining Pathways 1 and/or 2 with Pathway 3.

Pathway 4: Members must have distinguished professional activity in teaching, patient care or professional service over many years.

Requirements:

  • Be certified by the American Board of Internal Medicine, the Royal College of Physicians and Surgeons of Canada or the American Osteopathic Board of Internal Medicine
  • Have been a member in good standing for at least two years in either ACP or ASIM and have held a position in practice or in academia for at least two years since completion of training
  • Have an active medical license in good standing (if in clinical practice)
  • Have confined professional activity to internal medicine or a subspecialty of internal medicine
  • Be proposed and seconded with detailed letters of support from two current Masters or Fellows with reference to character, ethics and medical activities, and outlining professional contributions and accomplishments
  • Be endorsed by the appropriate ACP-ASIM Governor
  • Have shown continuing scholarship and professional accomplishments
  • Document continuing professional activities, including teaching (both institutional and community-based); hospital committee work; public service and community activities; and participation in continuing medical education activities as both student and teacher.

For additional information contact the Ohio Chapter Governor's Office (513) 558-6218 or ACP-ASIM Customer Service (1-800-523-1546 ext. 2600) or vist the College website.

Chapter Update

1. Annual Session. The Annual Session held this past April was wonderful and well attended. The Convocation was held April 11th and is the yearly ceremony whereby the College recognizes and applauds its new Fellows and recipients of various honors. The Ohio Chapter was well represented at Convocation as Dr. David Bronson, our Governor-Elect, and I led seventeen Fellows. Annual Session 2003 is planned for April in San Diego, CA.

2. Leadership Day, Washington, DC, May 21-22, 2002. A very successful Leadership Day, organized by the College was especially important, this year, because of Medicare cutbacks and other serious healthcare issues. Your contingency, this year, was led by Dr. Mark Mayer, Chair of the Ohio Chapter's Health and Public Policy Committees, Dr. Barbara Messinger-Rapport, Dr. Brenda Lawson, and me. We met with both of our Senators, Mike DeWine and George Voinovich and five Reps. from Ohio. I was glad to be a part of this important event. Don't miss the Health and Public Policy Update, to be presented by Patrick Hope, Esq. of the DC Office, October 11th at our Annual Meeting in Columbus.

Legislative Action Center (LAC). ACP-ASIM has established a Legislative Action Center (LAC), which may be accessed from ACP-ASIM online. The site allows you to view current ACP-ASIM Legislative Alerts, find federal legislators and key legislative issues, and send e-mails/faxes to members of Congress.

3. Chapter Recognition. Our Ohio Chapter has received the Chapter Excellence Award for excellence in Chapter Management. This award raises the level of achievement above the Chapter Management Award, which we received last year. Our Chapter was nominated for an Evergreen Award for its Annual Meeting Photo Album on the Chapter Website in the 2002 Membership Enhancement Category.

4. New System for CME Certificates for Chapter Meetings. new system has been put in place to provide Chapter Meeting attendees with CME Certificates on-site. The two-part form will look similar to the Verification of Attendance (VOA) form, but will be the actual CME Certificate. Attendees will fill out the form indicating the number of hours attended, turn in the top (white) copy to the registration area and keep the bottom (yellow) copy. The yellow copy is the CME Certificate. The College is no longer issuing certificates suitable for framing. White copies need to be returned to the College (either turned into the registration area or mailed by the attendee).

5. Chapter Dues. Your chapter dues help support local activities, local staff and provide funding for new and existing chapter initiatives. When you receive your dues notice, please remember to include the chapter dues in your payment. You will be contributing to the success for many grass roots activities happening right here at home.

6. Governors Vote for Name Change. At our recent Board of Governors Meeting, which I attended, it was recommended the College change its name back to American College of Physicians (ACP). After discussion as to the pro's and con's, it was decided the recommendation be forwarded to the Board of Regents for further review. I will keep you posted.

7. Resident Work Hours. The new regulations regarding curtailment of resident working hours are now being instituted. The Governor's Office is interested in receiving comments you have regarding the new regulations. To comment, send an email to: (mathesja@ucmail.uc.edu) or fax (513-558-3799).

8. New Release from the College Books Program, "Expert Guide to Infectious Diseases." A new book in the "Expert Guide" series has been released and edited by none other than our former Governor, James Tan, MD, MACP. The book, Expert Guide to Infectious Diseases stresses efficient, cost-effective approaches to diagnosis and management of commonly encountered diseases. Its 40 chapters cover infections of the central nervous system, respiratory tract, heart and blood vessels, gastrointestinal system, bone and skin infections, bronchitis and pneumonia, genitourinary infections, as well as HIV and other viral infections. The appropriate use of diagnostic laboratory tests is covered in depth. The book is available to members for $44 (product #330300500) To order please call Customer Service (1-800-523-1546 ext 2513).

College Update

1. Recertification Update. Recertification in internal medicine became mandatory for all internists and subspecialists who originally certified in 1990 or after. ACP-ASIM members began voicing strong concerns about the program in 2000, when the College began negotiating with the ABIM for changes. The Board of Regents Recommendations are as follows: l The College will work with ABIM to establish multiple pathways to recertification, one of which would include a secure exam l ACP-ASIM will encourage subspecialists to recertify both in their subspecialty and general internal medicine and work to remove cost and time barriers to multiple recertification l The College will advocate that internists be allowed to substitute other educational resources—MKSAP or materials prepared by subspecialty societies—for all ABIM self-evaluation models. ACP-ASIM will also work to make ABIM's proposed continuous professional development program and patient evaluation module optional l The College will work to ensure that recertification is relevant to physicians in a variety of practice settings l To ensure member representation, the College's negotiating team with the ABIM will include the Chair of the Board of Governors, as well as a Governor who serves on the Education Committee l The College will work to make sure that all recertification components are tested for value.

The Regents approved a recommendation stating that if the College and the ABIM cannot reach consensus on a final recertification format, they will consider developing an alternative recertification process. Furthermore, the Regents approved a separate recommendation that endorses developing accountable, literature-based continuous medical education, which could be presented as a possible recertification pathway. That recommendation will be forwarded to the Education Committee for further study.

2. Match Shows Decrease in Interest in Primary Care. Results of the 2002 National Resident Matching Program residency match, released on March 21, 2002, suggest a continuing decline in interest in careers in primary care. Overall, internal medicine was the least negatively affected primary care specialty this year, according to Herbert Waxman, MD, FACP ACP-ASIM senior vice president for education. The three career-bound internal medicine program tracks—categorical, primary and medicine-pediatrics—matched 3,234 U.S. medical school seniors this year. Categorical, the track chosen by 85 percent of these seniors declined the least—2.2 percent—Since last year. Primary internal medicine residencies attracted 16 percent fewer U.S. seniors this year, and medicine, pediatrics residencies attracted 9 percent fewer residents than last year. In contrast, there was a sharp increase in US seniors matched to preliminary programs in internal medicine. These seniors will be entering other specialties such as ophthalmology and dermatology after first-year residency. The number of students matched to preliminary internal medicine programs was 1,398—the highest number since 1991.

3. Medicare Issues Update. The College's Public Affairs Office has mounted a campaign to educate the public about recent cuts in Medicare and what they will mean to future quality of care in the US. In mid-March, ACP-ASIM released a video titled "Medicare Cuts May Mean Trouble Ahead for Patients and Physicians Who Treat Them" featuring College President William Hall, MD, FACP that dramatizes the impact of excessive Medicare cuts on patient care.The College is working with Congress to avoid additional cuts that will force further reductions in services for Medicare patients between now and 2005. Members are encouraged to write op-ed letters to local newspapers. Physicians who are interested in lending their name and support to an op-ed piece my contact Carolyn Albert in the Public Affairs Office at (1-800 338-2746) or email: (calbert@acponline.org).

Dr. Hall also met n March 14, 2002 in Washington with Dr. Mark McClellan, a member of the White House Council of Economic Advisors and Dr. Paul Ginsberg, President of the Center for Studying Health System Change to discuss the future of Medicare reform initiatives. Dr. McClellan presented the White House view that while the physician fee schedule structure is due for reform, all proposals will be evaluated within the context for future budget stability. In exploring the difficulties of complying with Medicare regulations, Dr. Hall presented a compelling vision of the challenges a Medicare patient faces such as finding a participating physician and affording prescription drugs recommended by the physician. Mr. Ginsburg presented data that clearly pointed to a need for restructuring services and benefits as Medicare enrollment swells. College positions on Medicare reform presented during the briefing are available online by going to the College Web site.

The ACP-ASIM has provided recommendations in 16 key areas to the Regulatory Reform Initiative of the Department of Health and Human Services (HHS). The recommendations include revising the methodology for updating the physician fee schedule and reducing the overwhelming regulatory burden.

4. Prescription Drug Discount Card Initiative Supported. ACP-ASIM supports the creation of a Medicare prescription drug card program as a first step to providing seniors assistance with prescription drug costs provided that: 1.)The program is not a substitute for comprehensive Medicare prescription drug coverage; 2.) Pharmacy benefit managers (PBMs) are required to pass on rebates from manufacturers to pharmacies, and subsequently beneficiaries; 3.) Program costs for beneficiaries are minimal or free; 4.) Card sponsors publish complete drug pricing info., so that Medicare recipients can "shop" for the best card.

5. Bioterrorism Resource Website Updated. The College's Bioterrorism Resource has been revised for easier navigation and features new clinical information, images, and support tools. The site has received praise from the Centers for Disease Control and Prevention and other viewers for its comprehensiveness and content. Recent additions include new support tools on cutaneous and inhalation anthrax, self-assessment questions on biological and chemical agents, and new information about biotoxins, nerve agents, and toxic gasses. Physicians are urged to visit the site to increase their knowledge of bioterrorism agents and learn how to deal with a suspected bioterroristic attack.

6. Online CME Transcripts. A new College member benefit is access to online CME transcripts. Members may view & print a transcript of their CME credit earned for participation in College activities. The transcript provides a 6-year listing & includes credit earned for:

  • Annual Session
  • Postgraduate Courses
  • Chapter/Regional Meetings accredited by the College (starting November 1999)
  • MKSAP and Related MKSAP Enhancements
  • MKSAP Audio Companion l Clinical Problem Solving Cases
  • Audio and Video Products.

Members can also print documentation of participation in sessions related to state specific CME requirements. If you have questions, please contact Customer Service at (800-523-1546 ext. 2600) or (custserv@acponline.org).

7. Questions About My Dues. I am still in training. Do I have to pay dues? Yes, but dues are lower for you than other members. Associateship is a temporary membership category limited to 4 years following graduation from medical school. Associate membership can be extended for as long as a physician is doing residency/fellowship training in internal medicine or a subspecialty. Full Members doing fellowship training may request the Associate rate while in training. (Requests must be renewed annually)

My spouse and I are both ACP-ASIM members. Must we both pay full dues? No, when couples are both members, they may request reduced dues for one member who will then waive subscriptions to all College publications. Please send a letter to Customer Service, 190 N. Independence Mall West, Philadelphia, PA 19106-1572.

What other circumstances would qualify me for a dues adjustment? At age 65, national dues are reduced automatically. Also, members 60 years or older who have fully retired from active practice may request "Emeritus" status, which permits a dues adjustment with publications or a permanent dues waiver without publications.

What happens if I don't pay my dues? All membership benefits will be suspended for any member whose dues are unpaid. Any member who is dues delinquent in annual dues or Fellowship initiation fees will be dropped and loses all membership privileges, including use of the initials MACP and FACP for Masters and Fellows.

Whom do I notify at ACP-ASIM about a deceased member? Please notify the Chapter Office by phone (513-558-6218) or Fax (513-558-3799). Call Member Records (1-800-523-1546 Ext 2700).

Who do I contact for more information? Customer Service, 190 N. Independence Mall West, Philadelphia, PA 19106-1572 Phone: (1-800-523-1546 Ext 2600) Fax: (215-351-2799) or Email: (custserv@acponline.org)

From the Desk of the Executive Director

Janet Matheson

The 2002 Ohio Chapter Annual Scientific Meeting to be held at the Hyatt Regency Hotel in Columbus Friday and Saturday, Oct 11-12, 2002 will be here before we know it. September 16th is the deadline for mail-in registrations and room reservations.Make plans to attend and register early. The meeting brochure will be out in mid-July. For hotel reservations call (800-233-1234) and identify ACP-ASIM Ohio Chapter for the room block. We have included the program for your review and the registration form on pages 6 and 7. Abstract presenters will be notified by mail in mid-July. Don't forget those who will be coming on Thursday evening, October 10th—we are planning to hold the Associates game show "Who Wants to be a Board-Certified Internist?" We will have snacks and drinks available at 7:00 p.m. and the show goes on at 8:00 p.m. Dr. Eric Warm will be facilitating the game, which will be held in the Franklin Room 2nd Level of the hotel. Poster set-up will be just across the hall in the Union Ballroom **Reminder: Members of the Governor's Advisory Council will meet at 2:00 p.m. on Thursday, October 10th in the Morrow Room 2nd Level of the Hotel.

Change of Address: If you have had a change of address, phone number, email recently please send your updates to the Ohio Chapter Office, 231 Albert Sabin Way, Cincinnati, OH 45267-0563 or fax (513-558-3799) or email (mathesja@ucmail.uc.ed)

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Please e-mail comments or suggestions about the Ohio Chapter website to Evelyn V. Hess, MD, MACP, MACR