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Governor's Newsletter

December 1997

Chapter Meetings

The 1997 Chapter Scientific Meeting, November 20-22, was highlighted by a record attendance, a record number of Associates' presentations, presentations by the newly formed Associates' Council, the Briefing Breakfast for Women and state-of-the-art discussions about clinical and practice issues. Many thanks for the work of the Program Planning Committee, Mary Olhausen and the OHSU-CME staff!

Bob Gluckman, MD, FACP, of Providence St. Vincent Medical Center in Portland, Chair of the Scientific Program Committee for the 1998 meeting, has already begun planning for our return to Eugene, November 5-7. By that time, the Eugene Hilton will be remodeled and the ACP-ASIM merger will be completed. As in the past years, the Chapter meeting will be preceded by the annual meeting of the Infectious Disease Society of Oregon on November 5. If you have ideas for the 1998 meeting, please contact Bob at 503-216-7451.

Each year, there is discussion about moving the site of the Chapter meeting from Eugene, where it has always been held, to another venue. Such a move requires advance planning. Other sites which have been suggested include Portland, the coast (Newport/Salishan), Central Oregon (Sunriver/Inn of The 7th Mountain), and Skamania Lodge in Stevenson, Washington. The earliest such a move could be made would likely be the new millennium, 2000. Arguments against leaving Eugene have included the fact that the meeting has grown each year. Arguments for a move include the possibility that a "destination-type" setting with other associated benefits (e.g., theater, golf, etc.), might attract a larger audience. We could also consider alternating annually between Eugene and another site.

We need your input about this important issue. Please contact Jim Reuler with your thoughts/comments.

Annual Session

The 1998 ACP Annual Session will be held in San Diego, California, April 2-5 with pre-session courses March 31-April 1. Register by January 30 for the best rates (1-800-523-1546, ext 2600).

New Fellows of the Chapter who attend the meeting will be inducted at the convocation on April 2. A reception sponsored by the OHSU School of Medicine Alumni Association will be held the evening of April 4.

Chapter Web Site

OR-ACP now has its own home page on the Internet. THANKS to Peter Embi, MD, ACP Associate, and Heather Calvert, ACP Chapter Liaison, for launching this exciting new project. The Web site contains information about National and OR-ACP activities, the Associates' Council, Portland training programs, the Oregon Health Plan and the State of Oregon.

Let us know what you think and what ideas you have for expanding the site's support of the Chapter members.

ACP-ASIM Merger

In August 1997, a negotiating team from the American College of Physicians (ACP) and the American Society of Internal Medicine (ASIM) agreed on the principles that will form the foundation for a merger of the two organizations in the latter half of 1998. This fall, the ACP Board of Governors and Board of Regents, and the ASIM House of Delegates and Board of Trustees voted to approve the principles for a merger between the two organizations. Formal recommendations for a merged organization will be submitted for approval in early 1998 to the ACP Board of Governors and Board of Regents and to the ASIM Board of Trustees. A formal business plan for the proposed merged organization will be submitted for approval to the ACP Finance Committee meeting in February 1998.

At the state level, discussions have already begun between leaders of OR-ACP and OSIM to assure a smooth and positive transition. A planning meeting is scheduled for January 9 to move forward and frame issues. If you have ideas or questions about the merger, please contact:

Dan Mangum, DO, President, OSIM (503-968-1515)
Jim Reuler, MD, OR-ACP Governor (503-220-8262, ext 5582)

Public Policy

Public policy formulation and advocacy have become increasingly important components of ACP's portfolio. Examples include policy papers published in Annals, ACP's participation in numerous coalitions, ACP Legislative Days held in Washington, DC, and in State capitals and the resolutions hearings held twice yearly at the Board of Governors meetings. As ACP and ASIM merge, the expanded resources and energy in the public policy area will give internal medicine a louder and clearer voice.

At the local level, OR-ACP's Public Policy Committee is chaired by Martin L. Jones, MD, ACP Member, of Eugene. Martin's work with the OMA, County Medical Society and the initiative process in the State will help us to move in new directions with policy efforts and our merger. If you are interested in working on public policy, please contact Martin (503-484-2911).

Career Corner

Our second Career Corner column is written by David Fleming, MD, of Lake Oswego. After completing medical school at SUNY-Upstate (Syracuse) and internal medicine residency at OHSU, David was a commissioned officer in the Epidemic Intelligence Service of the CDC in Atlanta where he also completed a preventative medicine residency. David returned to the Oregon Health Division and is presently the Oregon State Epidemiologist. One of the most highly respected public health officials in the country, Dr. Fleming is a Diplomate of both ABIM and the American Board of Preventative Medicine and a member of the DHHS Advisory Committee on Immunization Practices.

"Uh... So what does a state epidemiologist do, anyway?"

As you might guess, this is one of the more common questions in my line of work. Often it's preceded by pregnant pause as folks try to figure out whether admitting they don't know is embarrassing to them or insulting to me. Of course, it's neither. (After all, there aren't many of us state epidemiologists around!) Most people, including many physicians, have only a vague notion of what medical epidemiologists do, other than it's different from mainstream clinical practice.

So what's the answer?

First things first. Outbreak and Andromeda Strain notwithstanding, "medical detective" work is only a small part of the job. Thankfully. While outbreak investigations are challenging and sometimes high-profile, they are also more frustrating and less glamourous than Hollywood might lead you to believe. So as I head for work each morning, I'm not hoping for an epidemic to spice up the day.

Most of my time is spent trying to improve the effectiveness of public health programs in Oregon using the science of epidemiology and my internal medicine training. One current example—creating the statewide tobacco prevention program funded last year by Measure 44's cigarette tax increase. (In fact, there are tobacco coalitions forming in every county in the state right now. Call your local health department if you want to know more). I also spend a fair amount of time serving as a public health advocate and spokesperson to the medical community, policy makers, media, and others. Administratively, my position oversees Oregon Health Division programs in acute and communicable diseases; environmental, occupational, and injury epidemiology; HIV, STD and TB; health promotion and chronic disease prevention; and Vital Statistics. As you might guess, most of the real work is done by the skilled people I work with.

While I work closely with clinical providers in Oregon, my peer group is really other state epidemiologists (every state has at least one), and federal medical epidemiologists at the Centers for Disease Control (CDC) in Atlanta. As a consequence, I spend a fair amount of time traveling and providing an Oregon perspective to the development of regional and national solutions to problems.

This job is not without its challenges. First, although we have some of the best people in the country working here, it often remains difficult to convince our private partners that "government competence" is not an oxymoron. Second, the nature of public health sometimes makes advocacy and celebration of success difficult. It is easy to draw attention to the plight of a child with cancer who needs a bone marrow transplant. Public health's successes, however, are often marked by "nothing" happening. Drawing attention to all of us who did not become sick last year because our drinking water was rendered safe is difficult. The result—it is sometimes hard to obtain ongoing funding for our most successful programs. Third, in many aspects, the science of public health practice is still in its infancy. Historical successes have resulted in a new set of leading problems. The "best practices" that will result in the adoption of healthy lifestyles and prevent violence, HIV, drug and tobacco use are not established, but rather "under development". It's often a challenge to both recognize the bounds of our knowledge and simultaneously to allow science rather than politics to drive decisions.

All in all, however, this job is a great one, (although not for the hours or salary). On days when I can keep the mindset that trying to juggle a lot of balls allows for diversity rather than chaos, the opportunity for mixing advocacy with science, working with great people and making a difference is a whole lot of fun.

Associates' Council

The OR-ACP's Council of Associates, announced in the August newsletter, has been, like BP, "on the move". The Council, meant to promote morale, public service and networking among Oregon's internal medicine residents, sponsored a table at the OR-ACP Scientific Meeting November 20-22 where informational material was distributed. Future educational and community service initiatives and social events are being planned. The Council meets monthly and wants to hear from you. Contact the Council via the Chapter's Web site.

Internists/Media

With this issue, we begin a new initiative focusing on work which internists do with the media in its many forms. If you, or someone you know, might consider writing a column for a future newsletter, please contact Jim Reuler.

Our first column is authored by Robin Miller, MD, ACP Member, from Medford. After graduating from the University of Illinois-Chicago Medical School and OHSU's internal medicine residency, Dr. Miller completed both Kaiser and Mellon Fellowships at Johns Hopkins where she was a General Medicine Fellow and received a Masters in Health Sciences degree. At the OR-ACP meeting, November 21, Robin was interviewed by two Eugene television stations and the Eugene Register-Guard newspaper as an ACP representative for the Doctors For Adults campaign.

I have been a practicing internist for 14 years. The first half of my career, I was an academician focused on preventative cardiology at the State University of New York at Stony Brook. The second half, I have spent in private practice as an Urgent Care physician in a large multi-specialty clinic in Medford, Oregon.

As an Urgent Care physician, I was shocked to find that I was seeing two to three victims of domestic violence each day that I worked. The realization caused me to become quite vocal about our community problem. I began speaking to any group that would listen to me. No matter who was represented in the groups, there were always another one or two victims in the audience.

One day, a local talk show host approached me to be on her show called "Adventures in Medicine" to talk about domestic violence. The show is seen on KOBI/NBC which reaches Southern Oregon and part of Northern California. I was thrilled to be able to reach a larger audience and consented. The producer was impressed with my performance and ideas and asked me if I would like to fill in as a host on an intermittent basis. I thought it would be a good experience and began hosting the show.

This happened about three years ago, and I continue to host "Adventures in Medicine". I have done a wide variety of shows dealing with topics such as childhood sexual abuse, teen pregnancy, and physician assisted suicide. I choose the topics based on what is timely. For example, if it is Breast Cancer Awareness month I will try and do a show on breast cancer for that month. I research the topics various ways. To prepare, I do interviews before the show. I also search the Internet, and I often do Medline searches depending on the topic. I have had no formal training, but you might say that I have had a big mouth most of my life so some of this comes naturally. It is a continual challenge to remain impartial on some of the subjects that are discussed. I try to do this by taking the view of the impartial observer.

In addition to being personally rewarding, the show has reached a wide local audience. I believe we have enlightened many viewers on how to improve their health and well being. I am hoping that the use of the media in a constructive way can improve public health.

In the future, I would like to continue my broadcasting work. How often can you provide a public service that is this much fun?

Women's Committee

The Chapter's first Briefing Breakfast for Women was held November 22 at the Annual Scientific Meeting. Coordinated by Jocelyn White, MD, FACP, of Legacy Good Samaritan Hospital in Portland, the meeting attracted over 40 medical students, Associates, Members and Fellows and featured a presentation by Sara Walker, MD, MACP, ACP Regent and College Representative to the meeting. Plans are already underway for a Chapter Women's Committee, next year's Briefing Breakfast, a gathering at the ACP Annual Session in San Diego, Fellowship Applications and an electronic mail linkage to facilitate communication and networking. Look for updated agendas on the OR-ACP Web site. For information, contact Dr. Jocelyn White at 503-413-8423 or whitejo@ohsu.edu.

Community Service

With this issue, we launch a new feature highlighting community service activities of OR-ACP members. If you, or someone you know, might consider writing a column for a future newsletter, please contact Jim Reuler.

Our inaugural Community Service column is written by Martin L. Jones, MD, ACP Member, from Eugene. Since completing medical school at Tulane and housestaff training at Boston University and OHSU, Martin has practiced general internal medicine in Eugene. In recognition of his community advocacy leadership, Dr. Jones was the recipient of the OMA's 1997 Doctor-Citizen of the Year Award.

For the last four years, I have been a volunteer facilitator at the Conflict Resolution Center located in Eugene. Founded by my wife Gayle Landt, the Center's philosophy is that new solutions to controversial issues can arise out of collaborative dialogue between previously alienated leaders and groups. In a respectful and compassionate atmosphere where listening to and exploring others' views are at least as important as expressing one's own views, creative and shared answers to divisive questions emerge.

The principles upon which the work of the Conflict Resolution Center are based are: 1) We all live in this community together; 2) The means are the ends in the making; and 3) Every behavior has a positive intention. The first application of the Center's New Community Meeting model was to the "gay rights" issue in 1994 when conservative Christians and members of the gay and lesbian community met for six months. The resulting agreements and recommendations were disseminated to the entire community. The present application is to the issue of the economic growth and sustainable development in Eugene-Springfield and nearby communities. To reach meaningful agreement takes time: the current project has 17 community leaders (developers, business, environmentalists, others) meeting for 3 hours each week for a year, plus 3 weekend retreats.

For me, this work parallels my full-time medical practice. It is holistic: healing community rifts, striving for harmony. It's intellectually challenging: applying psychology, monitoring group dynamics, analyzing subject content. It is sacred: it is a deep privilege to witness participants discard the "blame frame" and earnestly struggle to reconcile their opposing views in order to find solutions acceptable to the entire community. It's life-affirming: recognizing that we share so many of the same values and underlying interests, realizing again that we are far more alike than different.

For more information about the work of the Conflict Resolution Center, please write or call: 2300 Parkside Lane, Suite 200, Eugene, Oregon 97403 (541-485-0911). E-mail: gaylel@mail.ori.org

Fellowship

Fellowship in the ACP is an honor achieved by those recognized by colleagues for clinical competence, professional accomplishment, personal integrity and scholarship. In the recent months, the following Chapter members have been advanced to Fellowship:

  • Karen S. Basin, MD, FACP, Medford
  • Michael F. Bonazzola, MD, FACP, Portland
  • Thomas D. Harburg, MD, FACP, Portland
  • Martha S. Gerrity, MD, FACP, Portland
  • Lora L. Jasman, MD, FACP, Corvallis
  • Andrea M. Kielich, MD, FACP, Portland
  • Nancy A. Loeb, MD, FACP, Portland

Anyone who has been an ACP member for at least two years is eligible to be considered for Fellowship advancement. For more information, please contact Jim or Mary or the ACP National Office at 1-800-523-1546, ext 2694.

MEMBERSHIP

ACP locally and nationally continues to grow. Here is a breakdown from September 1, 1997:

Category OR-ACP National ACP
Students 36 10,002
Associates 183 23,705
Members 533 45,000
Fellows 179 23,543
Masters 2 323
Total 933 102,573

Tell your friends about ACP! For more information, contact Michelle George at ACP 1-800-523-1546, ext2716, or Mary Olhausen at 503-494-8676.

Kudos

Stephen R. Jones, MD, FACP—Recipient of the OR-ACP 1997 Howard P. Lewis Distinguished Teacher Award

Donald E. Girard, MD, FACP—Recipient of the OR-ACP 1997 Howard P. Lewis Distinguished Service Award

Kimberly Kisor, Neil Gross, and David Wager, ACP Student Members and OHSU medical students ('98)—Elected to AOA Honor Medical Society, Alpha Chapter of Oregon, at the Fall elections

Kelly D. Block, MD, ACP Associate—Elected as a Director of the National AOA Honor Medical Society

William M. Bennett, MD, FACP—President-Elect of the American Society of Nephrology and Representative of the Council of American Kidney Societies to the ACP's Council of Subspecialty Societies

Linda L. Humphrey, MD, MPH, ACP Member—Co-Chair of the Oregon Breast and Cervical Cancer Coalition of the Oregon Health Division

Thomas G. Cooney, MD, FACP—Chair of the Advisory Board preparing the 1998 National Study of Graduate Education in Internal Medicine, a joint project of AAMC and FCIM

Kathy Weaver, MD, FACP—Inducted into the George Weaver Society of ASIM (past-presidents) and appointed as Medical Director, Oregon Health Plan

Grover Bagby, MD, FACP—Appointed as Director, Oregon Cancer Center

M. Brian Fennerty, MD, FACP and D. Lynn Loriaux, MD, Ph.D., FACP—Contributions to MKSAP XI, ACP's award winning self-study program

Annual Associates Competition at the 1997 Chapter Meeting, November 20, 1997
    Douglas Shumaker, MD (Oral Presentation—First Place)
    Melinda Muller, MD (Research Poster—First Place)
    Lan Pham, MD (Clinical Poster—First Place)
    Marjorie Hrbek, MD (Oral Presentation—Second Place)
    Martina Kreutzer, MD (Clinical Poster—Second Place)

Please keep us informed of your activities and accomplishments. We want to recognize your good work!

Upcoming Dates

January 6-June 9, 1998 25th Annual Internal Medicine Review Course, Portland Providence Medical Center (503-215-111)
April 2-5, 1998 ACP Annual Session,San Diego, CA
June 1, 1998 Fellowship Applications due at ACP
July 28 -August 1, 1998 ACP Board Review Course. Seattle, WA
November 5, 1998 Infectious Diseases Society of Oregon Meeting, Eugene
November 5-7, 1998 OR ACP/OSIM Chapter Annual Meeting, Eugene
December 1, 1998 Fellowship Applications due at ACP
April 22-25, 1999 ACP Annual Session - New Orleans, LA

How To Reach Us

James B. Reuler, MD, FACP
Section of General Medicine
Veterans Affairs Medical Center (111)
PO Box 1034
Portland, OR 97207
503-220-8262, ext 5582
FAX: 503-721-7807
E-mail: reuler@ohsu.edu
reuler.james@portland.va.gov

Mary Olhausen
Department of Medicine
Oregon Health Sciences University
3181 SW Sam Jackson Park Road, L-455
Portland, OR 97201-3098
503-494-8676
FAX: 503-494-5636
E-mail: olhausen@ohsu.edu

Contact Information

Thomas G Cooney, MD, MACP
Oregon Chapter Governor

Mary Olhausen
Phone: 360-892-1814
Fax: 360-326-1844