| July 2011 | Alejandro R. Gonzalez, MD, FACP, Governor |
- Greetings and Notes from Your Governor
- Capital Update by John Nikoloff
- ACP Honors Pennsylvania Chapter with a 2011 John Tooker Evergreen Award
- ACP Leadership Day 2011
- Five New Fellows From West Inducted at ACP 2011 Convocation
- Evan Pollack, MD, FACP, Selected as Key Contact Awardee
- Five Medical Residents from Pennsylvania Chapter Named ACP National Research and Clinical Vignette Paper Winners
- Drexel Team Competed in National Medical Jeopardy
- Save The Date
- Chapter Council of Young Physicians
- PA Chapter Hosts Fourth Chief Residents Forum
- Pri-Med Access in Philadelphia
- Support Our Chapter – Recruit A Colleague Today
- Blogs, Links, and Reports to Share
- Pennsylvania Chapter Calendar of Events
Greetings and Notes from Your Governor
In this time of complex and at times chaotic upheavals in healthcare, one of the important issues is the shortage of physicians.
At the award ceremonies of the graduating class at Pitt, I was pleased to hear the impassionate appeal by the Chief of Pathology to the new graduates to consider becoming primary care doctors. I never expected a pathologist to remind everyone the crisis that we are facing. We are told that we need a minimum of 12,000 additional primary care physicians, but this is not all because we are also short of specialists. Patients are having as much trouble finding a PCP as they have getting an appointment with a rheumatologist or an endocrinologist. It is estimated that by 2025 we will be short of 125,000 doctors. CRNPs and PAs may be able to provide good care for patients who do not have access to physicians, but there are not enough extenders. Besides, when major health decisions need to be made, the patients want a physician and not an extender.
The picture gets worse when you look at changes that are occurring in the practice of medicine. When I began, physicians were mostly male, solo practitioners and owned their practices. They worked at least 12 hours a day every day. Every day except on Wednesdays when they went to the club to play golf...Now, more and more physicians are taking salaried jobs at hospitals and half of the younger physicians are women. Their priorities are different with less concern with the traditional issues like insurance reimbursement and tort reform. The new generation wants more time with their families and a better quality of life. Many are taking part or less than full time jobs and the consequence will be a larger work force shortage than estimated. Frankly, I fully support the ideas of the newer graduates, we have obligations to our patients but we also have families and ourselves to be taken care of. As someone wrote recently, the degree is a doctorate in medicine and not an application for martyrdom.
We have a major crisis on our hands, and we have to work together if it is to be resolved. It will not matter that every American has insurance coverage if they cannot make an appointment to see a doctor. This country needs to increase the output of physicians to have more primary care doctors and specialists. More money is needed for medical education. We have to eliminate the SGR immediately. Compensation to physicians must be updated so that we continue attracting the best and brightest. In addition, we need tort reform.
Whether you own your practice or are employed part or fulltime, try to be active as an individual or as a member of organizations that work on your behalf protecting the profession and the interests of your patients.
If we don't succeed, your only chance to get good medical care in the future will be by having a doctor in the family... In my case, I'm lucky, I'm covered!
Alex Gonzalez, MD, FACP Governor, Western Region
Capital Update by John Nikoloff
Budget
PA-ACP continued to advocate for state funding of key programs, including Graduate Medical Education assistance and chronic care programs. While leadership of the House, Senate and Corbett administration negotiated the state budget, the College joined with the PAFP and PAAP to ask that funding for the Chronic Care Initiative not be cut, noting the benefits of the program in helping lower healthcare costs and save lives.
The House-passed spending bill increased GME funding by almost $10 million from the Governor’s budget, and kept Chronic Care funding near 2010 levels. State spending would actually increase, but the loss of federal stimulus funds reduces the total amount available. The Heath Department budget was spared a major budget cut, with only a 2.1% reduction. DPW state funding was increased.
Tort Reform
The state House has passed both “apology” legislation and “Fair Share” legislation (joint and several liability reform) supported by PA-ACP. Other tort reform proposals may be considered in coming months, including a Constitutional amendment to allow caps on non-economic damage awards, supported by Governor Corbett.
In mid-June, the Senate Judiciary Committee finally moved a “joint and several” liability bill, SB 1131, that ignores the legislation already passed by both chambers in recent years. PA-ACP is working to amend SB 1131 to include the language already passed by the House.
Mcare Fund
The state Insurance Commissioner is finalizing a study of the state’s primary liability insurance carriers to determine their capacity to sell coverage to physicians and hospitals. If the Department finds the marketplace improved, physicians’ primary limits could increase to $750,000 in 2012, with a reduction in Mcare coverage to $250,000. The PA-ACP is working to secure a shorter-term phase-out of the Mcare Fund, without physicians having to bear the full burden of the Fund’s $1.3 billion unfunded liability.
Fair Provider Contracting
At the urging of PA-ACP, Rep. Nick Micarelli is introducing “fair contracting” legislation, which will incorporate the provisions of the Love settlement into state law. This legislation is important to physicians contracting with the Blues, when the provisions of the legal settlement end.
HIV Testing
Sen. Ted Erickson’s PA-ACP supported legislation, SB 260, requiring HIV testing as a routine part of general care following CDC recommendations passed the Senate by a unanimous vote. The bill eliminates the requirement to obtain written consent before testing, and permits testing where the subject is told they will be tested unless they refuse.
ACP Honors Pennsylvania Chapter with a 2011 John Tooker Evergreen Award
At the 2011 Internal Medicine Meeting, ACP presented a John Tooker Evergreen Award to honor the Pennsylvania Chapter for its initiative in recruiting former ACP members attending the Pri-Med Access with ACP educational programs.
Click on the link for details.
ACP Leadership Day 2011
Congressman Glenn “GT” Thompson, (L), met with PA-ACP leaders Drs. Susan Borys,
Evan Pollack and Larry Jones during Leadership Day, May 24-25 in Washington.
Sixteen PA-ACP members participated in ACP Leadership Day on Capitol Hill this year. ACP’s priority issues addressed Workforce, Payment, and Delivery System Reform, Fixing the Medicare Sustainable Growth Rate (SGR) and Transition to Better Payment Systems.
Our delegates visited 18 legislative offices. We are grateful for the face-to face dialogues we held with Congressmen Jason Altmire (4th district), Glenn Thompson (5th district), Jim Gerlach (6th district), Tom Marino (10th district), Joe Pitts (16th district), Tim Holden (17th district), and Todd Platts (19th district). In eleven other congressional and senatorial offices, we met with the chiefs of staff and/or the legislative aides for health.
We acknowledge our members who took time from their schedules to participate in Leadership Day 2011.
Aditya Sharma, MD
Alex Gonzalez, MD, FACP
Charles Cutler, MD, FACP
Dan Kimball, MD, FACP
Darilyn Moyer, MD, FACP
Evan Pollack, MD, FACP
Gela Mchedlishvili, MD, FACP
Giovanna Uzelac, MD
Henry Weiner, MD
John Derrickson
Kevin Berry
Larry Jones, MD, FACP
Mita Sharma
Rich Simons, MD, FACP
Sarah Messick, MD, FACP
Susan Borys, MD, FACP
Wojciech Czoch
Five New Fellows From West Inducted at ACP 2011 Convocation
Congratulations to all our colleagues who became Fellows this past year. Pictured above is the group from the Western Region following this year’s Convocation Ceremony in San Diego.
Additional congratulations are extended to our Western members named New Fellows as of March 2011.
William P. Coyle, MD, FACP, McMurray
Melissa A. McNeil, MD, FACP, Pittsburgh
Susan S. Panah, DO, FACP, Bradford
Priya Prabhakar Saxena, MD, FACP, Pittsburgh
Vikramjit Singh, MBBS, FACP, Pittsburgh
If you were not able to attend this year’s national meeting in beautiful San Diego, we hope you will join us in New Orleans next April. There will be excellent educational sessions on a wide variety of topics. In addition, our Pennsylvania Chapter will host another outstanding reception with good food, fellowship and fun. We hope to see you in New Orleans!
Evan Pollack, MD, FACP, Selected as Key Contact Awardee
The American College of Physicians acknowledged the time and energy contributed by Dr. Evan Pollack in support of our federal and state grassroots advocacy programs. We thank him for being a strong and consistent voice for internal medicine. In appreciation of his recent efforts, Dr. Pollack was selected as an ACP Top-10 Key Contact recipient for 2010. ACP greatly appreciates his dedication to advocacy. Among his most notable contributions is serving as vice-chair of Pennsylvania’s very active Health & Public Policy Committee, and serving as a key player on Pennsylvania’s Leadership Day Delegation. In addition, during 2010, Dr. Pollack communicated with several members of Congress on health reform and asked that they work to find a permanent solution to Medicare’s broken payment structure.
Five Medical Residents from Pennsylvania Chapter Named ACP National Research and Clinical Vignette Paper Winners
Special congratulations to our Pennsylvania Chapter’s Research and Clinical Vignette Paper Winners for their outstanding podium presentations. They are as follows:
- Research: The use of statin is associated with reduced risk of breast cancer recurrence. Young Kwang Chae, MD MPH MBA, Albert Einstein Healthcare Network Program, Philadelphia, PA
- Research: House staff efficiency in ordering VTE prophylaxis Harsh N Patel, MD, Crozer-Chester Medical Center Program, Upland, PA
- Research: House staff efficiency in ordering VTE prophylaxis-phase 2 Keshav Parthasarathy, MD, Crozer-Chester Medical Center Program, Upland, PA
- Clinical Vignette: Bilateral spontaneous pneumothoraces in a healthy young adult Agustina D Saenz, MD, Albert Einstein Healthcare Network Program, Philadelphia, PA
- Clinical Vignette: Bilateral simultaneous quadriceps tendon rupture- A diagnostic trap Shobha Vootukuri, MD, Lankenau Hospital Program, Wynnewood, PA
We also congratulate associates from the Western Region who were invited to present their work in San Diego.
Shreyas Saligram, MD, Univ of Pittsburgh Medical Center Medical Program
Abhishek Biswas, MBBS, University of Pittsburgh Medical Center (Mercy) Program
Damanpreet K. Grewal, MD, Allegheny General Hospital Program
Fatima Iqbal, MD, University of Pittsburgh Medical Center (McKeesport) Program
Anthi Katsouli, MD, UPMC Shadyside
Leonardo P. Machado, MD, Allegheny General Hospital Program
Pavankumar Patel, MBBS, Conemaugh Valley Memorial Hospital Program
Meera Sareen, MD, Western Penn Hosp/Temple U Program
Daniel John Spinuzzi, MD MBA, Allegheny General Hospital Program
Victor Y. Yazbeck, MD, University of Pittsburgh Medical Center Program
Abhishek Krishna, MD, University of Pittsburgh Medical Center (McKeesport)Program
Drexel Team Competed in National Medical Jeopardy
Congratulations to our 2010 Medical Jeopardy Team from Drexel University College of Medicine: Dr. Krishna Rao, (L) Dr. Gaurav Mathur (C) and Dr. Ashwani Gupta (R). They competed in San Diego against teams from across the nation.
Earlier this year, the Drexel team successfully won the regional competition held at Temple University School of Medicine, besting eight other residency programs, and then was victorious over teams representing Conemaugh (West) and Reading (East) residency programs.
The 2011 national championship title went to Rush University Medical College, Chicago, Ill. We congratulate the winning team and all the outstanding participants.
Test Your Knowledge – Play Doctor’s Dilemma™
The Western Region’s Medical Jeopardy Competition will be hosted at Allegheny General Hospital on November 5, 2011 in Pittsburgh. Will you need to practice? Here is an opportunity to test your knowledge.
Play Doctor's Dilemma™ Mobile This new online game is based on the popular ACP Doctor's Dilemma™ Competition from ACP's annual Internal Medicine meetings. The game is simple to play (earn points with correct answers, lose them with incorrect answers), but the questions will challenge your mettle.
Save The Date - All Associates Western Region
Who: All Western Region Associates
What: Western Region Poster & Medical Jeopardy Competition
When: Saturday, November 5, 2011
Where: Allegheny General Hospital, Pittsburgh
Time: 8:00 AM to Noon
We are happy to announce that The Allegheny General Hospital will be the site for the 2011 Western PA residents’ competition.
Please remember that residents must be a member of the ACP to enter or present in the abstract or Medical Jeopardy competition. Western residents who are ACP members will receive detailed information via e-mail.
Chapter Council of Young Physicians
by Susan Glennon, MD, FACP
Dr. Jess Otto (left), Dr. Rachel Ramirez (center), and Dr. Larry Ward (right) attending “Lost in Translation” dinner program sponsored by our PA Chapter Council of Young Physicians and the Philadelphia County Medical Society.
The SE CCYP had a great first half of 2011! To start, we enjoyed a happy-hour networking event at Franco’s Trattoria in Roxborough in February. On May 19, we teamed up with the Philadelphia County Medical Society for “Lost In Translation–Optimizing Transitions in Care.” We brought together three of our local leaders in outpatient, hospital and long-term care medicine Emmanuel King, MD, FHM; Jen Mariotti, DO, FACP, and Daniel Haimowitz, MD, FACP, CMD, who shared their expertise on this important topic. The event was both well attended and well received and we thank all who came out to join the dialogue. We are excited to have added three new members to our council including two hospitalists, Baber Ghauri, MD and Ed Ma, MD, as well as Rachel Ramirez, MD, FACP, all of whom are helping to plan our second annual family event at Smith Memorial Playground on June 24. For anyone who would like more information about the council’s activities, have thoughts or ideas for upcoming events or would like to learn more about becoming a member of our council, please contact one of our co-chairs, Renee Cassidy, MD, FACP (reneemcassidy@gmail.com) or me, Susan Glennon, MD, FACP (seglennon@yahoo.com).
PA Chapter Hosts Fourth Chief Residents Forum
The Pennsylvania Chapter hosted the fourth Chief Residents Forum at ACP Headquarters in Philadelphia on May 4. Chiefs from hospitals in the Southeast and Eastern regions as well as New Jersey attended to learn the answer to, “What I wish I knew before I took this job.”
According to the Chiefs who shared their most important “take home” points:
- Good communication between co-chiefs is the key;
- Use your resources;
- Keep morale up by using short, sweet and practical ideas;
- Do not be afraid to make changes; and
- Do not be afraid not to be liked.
A huge thank you to the five current chiefs, Brooke Worster, Temple, Kim Jegel, Einstein, Jodi Lenko Washinsky, PENN, Vamshi Kaveti, Crozer, and Dina Halegoua-DeMarzio, Jefferson, who served on the faculty.
Pri-Med Access in Philadelphia
Ellen M. Tedaldi, MD, FACP, presented the local keynote address titled "Finding HIV Primary Care: When to Consider the Diagnosis" to the 450 attendees at the Pri-Med Access with ACP educational program, held at the Philadelphia Convention Center June 9-10.
The PA Chapter participates in these twice-a-year CME programs because they offer internal medicine physicians greater access to leading educators through a series of local, two day programs.
Congratulations to Dr. Paul Feldan of Mt. Laurel, NJ and Dr. Lynette Goodstine of Philadelphia who were the lucky Pri-Med Access raffle winners.
Pittsburgh - October 28-29, 2011 will be the Pittsburgh fall session of the Pri-Med Access with ACP. Two days of solid CME presented by engaging faculty. Free to PA-ACP members. E-mail the chapter office if you want to learn more.
Support Our Chapter – Recruit A Colleague Today
The Western Region appreciates the participation of Alberto Unzueta, Jr, MD, Melissa A. McNeil, MD and Tapasdip M. Gajjar, MBBS.
Help strengthen the voice of internal medicine - recommend ACP Membership to your colleagues!
The need for a strong voice to speak on behalf of medicine and, in particular, internal medicine has never been greater than it is today. It is critically important that we unify to address the specific needs of our medical specialty. There are advocacy efforts to champion, practice management issues to simplify, and a time-honored profession to foster. There is strength in numbers. Together, we can change the direction of internal medicine.
Ask your colleagues to join ACP today. To thank you for your time and effort, we offer the following recruitment program. Between now and March 15, 2012:
- Recruit one colleague and receive a $100 credit toward your 2012-13 annual dues.
- Recruit two colleagues and receive an additional $100 credit toward your 2012-13 annual dues.
- Recruit three colleagues and enjoy free annual dues in 2012-13.
Plus for every Member recruited within the promotional period, you will receive an entry into a grand-prize drawing for a trip to Internal Medicine 2012 in New Orleans that includes registration, airfare (up to $500), and four days of hotel accommodations.
Blogs, Links, and Reports to Share
CAC Meeting - June 9, 2011 - Submitted by Dan Kimball, MD, FACP, Governor, PA Eastern Region
The MAC J12 Contractor Advisory Committee met at the PAMED Offices on 9 June 2011 with other local meetings in NJ, DE, MD and DC on 8 and 10 June. The minutes for these five meetings will be combined to produce the J12 Jurisdiction minutes.
The minutes of the Feb 2011 J12 CAC meetings were approved as circulated.
Patrick Hamilton provided updates for CMS to include information on the HITECH program. In PA 2300+ eligible professionals (EPs) have registered for the Medicare Program with 45,000 registering nationally. In PA 144 EPs have attested to at least Stage I meaningful use with 2100+ attesting nationally. Payments of $234,000 have been provided to PA EPs and 3.8 million dollars nationally to EPs. These data do not include hospital data.
CMS is promoting its plan for insurance coverage for those with pre-existing conditions. Many states including PA have established their own programs with federal money. Information is available for patients through the CMS website (https://www.pcip.gov/).
Information was also highlighted about the e-prescribing incentive program (http://www.cms.gov/ERxIncentive/) and the preventive services program (http://www.cms.gov/MLNProducts/35_PreventiveServices.asp). He also noted that there was only 204 more days until the HIPAA 5010 compliance date with information at http://www.cms.gov/Versions5010andD0/.
Dr. Muscalus reviewed the CERT data (Comprehensive Error Rate Testing) for J12. The major drivers for the Part B errors were E&M services and provider signatures for lab and ECG orders. He also noted a likely revision to the Conflict of Interest Policy for CAC members that would require better documentation by each member. Future meeting documents will be sent electronically instead of in hard copy. The next CAC meeting will be held on 13 Oct 2011.
The following draft Local Coverage Determinations (LCDs) were discussed:
- Magnetic Resonance Angiography (MRA).
- Serotypes A and B Botulinum Toxin Products
- Intraoperative Neurophysiologic Testing
- Non-covered Serices (Services that are not reasonable and necessary)
- Qualitative Drug Testing
- Transcranial Magnetic Stimulation (TMS) for the treatment of depression.
- Stereotactic Radiosurgery (SRS)
There was no significant discussion on any of these draft LCDs. They will remain open for comments on the highmark website until 7 July 2011 (https://www.highmarkmedicareservices.com/policy/draft-status.html).
Dan Kimball, CAC Internal Medicine Representative
PCMH Collaborative Involvement
LVPP (Lehigh Valley Physician Practice Perspective By Jennifer Mariotti, DO, FACP
The Patient Centered Medical Home (PCMH) transformation in Primary Care has given many practices a road map to improvement. Lehigh Valley Health Network’s Internal Medicine Residency Practice (LVPP) embarked on the PCMH transformation during the past year with great success. The practice has been integrated as the only Internal Medicine practice within the Improving Performance in Practice (IPIP) / Pennsylvania Association for Family Practice (PAFP) Collaborative to work toward achieving PCMH certification. The experiences from this collaborative integration have allowed the practice to gain traction toward true redesign and transformation.
A national call has been made to Internal Medicine Residency programs to redesign ambulatory education. The goal is to develop highly-functioning experiences that will foster resident matriculation into outpatient General Internal Medicine. PCMH helped the practice achieve strong improvements.
The collaborative has provided multiple resources, connections, and guidance toward the goals of meaningful Electronic Medical Record (EMR) use, assistance in how to operationalize population management, how to integrate residents into quality improvement work, and how to determine the best data measurements in the setting of GME learners, all framed in an educational mission.
LVPP has been able to successfully accomplish many improvements through the help of the collaborative. The practice improved its diabetic foot exam compliance from 44% to 85% in the past eight months. The residents now receive regular updates on their individual performance measures. Many GME learners now facilitate projects and are actively engaged in the QI work that underscores the developing culture. The staff and administration now understand the concepts and tenets of a PCMH and the importance of a team approach to patient-centered care.
The PCMH Collaborative has enabled a framework to guide our Residency Practice to better performance. We look forward to the future and are excited about the changing environment for our learners. The redesign is upon us and the benefits have already begun. Only through continued change efforts will we achieve transformation. There is no doubt that collaboration will be the key to our success.
Let me know what you think.
Jennifer Mariotti, DO, FACP
Medical Director, LVPP
Associate Vice-Chair, 17th Street LVHN Campus
Jennifer.Mariotti@lvhn.org
Vineet Arora, MD, FACP Blog
Dr. Darilyn Moyer, Governor, Southeast Region shares a blog written by Vineet Arora, MD, FACP from the University of Chicago: Vampires and Urban Legends: Teaching Residents about Healthcare Costs.
A second blog attracting reader interest is written by Jaan Sidorov, MD, FACP. Dr. Sidorov, a general internist, is a former medical director for Geisinger Health Plan and a former member of our PA-ACP Council. His blog is called the Disease Management Care Blog.
Pennsylvania Chapter Calendar of Events
Check out the Calendar of Events
Page updated: 7/27/11
What's New
- Southeastern Region Governor's Newsletter - June 2013
- Western Region Governor's Newsletter - June 2013
- Pennsylvania Eastern Region 2013 Abstract Competition
- Pennsylvania Southeastern Region 2013 Abstract Competition Information
- Eastern Region Governor's Newsletter - June 2013
- Learn about PAS Governor-elect Gregory C. Kane, MD, FACP
- Member Feedback - Share Your Thoughts
- Member Accomplishments
- Internist Weekly
Contact Information
Eastern Region
Daniel B Kimball, Jr, MD, FACP, Governor
Southeastern Region
Darilyn V. Moyer, MD, FACP, Governor
Western Region
G. Alan Yeasted, MD, FACP
John Derrickson
Executive Director
Phone: 610-543-6880 or Toll-free: 800-846-7746
Fax: 610-543-6806
E-mail: jd@pa-acp.org
General chapter information/questions:
John Derrickson
jd@pa-acp.org
Chapter Office:
Jackie Franco
jf@pa-acp.org
VoterVoice:
votervoice@pa-acp.org
Chapter Events:
events@pa-acp.org
