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Governor's Newsletter - Spring 2002

(The Spring 2002 Governor's newsletter is also available as an Adobe Acrobat PDF file.)

From the Governor's Desk…

This year's Rhode Island Spring Meeting of the American College of Physicians-American Society of Internal Medicine will be held at the Radisson Airport Hotel in Warwick, RI on Thursday, May 2 and Friday, 3, 2002. As usual, we will have the abstracts submitted by medical residents from Brown University and Boston University-affiliated hospitals presented at the hotel from 6:00 to 9:00 PM with refreshments and hors d'oeuvres. This will take place in the University Ballroom. Also attending this event will be our College Representative, Dr. Rowen Zetterman., MACP, Vice-Chairman of Medicine, Nebraska Medical Center and Professor of Medicine, University of Nebraska. Dr. Zetterman was Chair of the ACP-ASIM Board of Regents from 2000-2001. That evening, we will also present a Governor's Award for service to the Chapter to one of our members.

On Friday morning, following registration, I will make brief welcoming remarks to be followed by Dr. Zetterman's presenting information from the College. A brief business meeting will be followed by a mini symposium on bioterrorism and chemical warfare by Dr. Andrew Artenstein, FACP, Associate Professor of Medicine, Brown Medical School; Dr. Leonard Mermel, FACP, Assistant Professor of Medicine, Brown Medical School and Dr. Patricia Nolan, Assistant Professor of Community Health, Brown Medical School and Director of the Rhode Island Department of Health.

Following a refreshment break, the abstracts selected for oral presentations will be presented by the medical resident authors and moderated by Dr. Robert Crausman, FACP, Assistant Professor of Medicine, Brown Medical School. The Irving Beck Award will be presented between 11:15 and 11:30 AM.

Our "Gastrointestinal Meet the Professor" session this year will be facilitated by Dr. Zetterman, our College representative who will discuss puzzling liver disease cases, Dr. Bernard Zimmermann, III, Adjunct Associate Professor of Medicine, Brown Medical School and Associate Professor of Medicine Boston University will discuss rheumatology cases and Dr. Joseph Sweeney, Associate Professor of Pathology, Brown Medical School who will discuss the hypercoagulability dilemma. Following this, the Associates presentations for the afternoon will be made, moderated by Dr. Alan Weitberg, Chairman of Medicine, Roger Williams Medical Center, Professor of Medicine, Boston University Medical School.

After a refreshment break, the afternoon mini symposium promises to be a provocative one. "MRI and CT Total Body Screening - Hope or Hype?" is the title. Faculty are Dr. Tom Wachtel, FACP, Professor of Community Health & Medicine, Brown Medical School; Dr. Gary Strauss, Professor of Medicine and Public Health, Boston University School of Medicine, and Dr. John Pezzullo, Associate Professor of Diagnostic Imaging (Clinical), Brown Medical School. Before closing, transfer of the Governorship from me to Dr. Yul Ejnes will occur.

This will be my last column as Governor of the ACP-ASIM. I would like to emphasize how pleasurable my years as governor have been. I feel that the merger of the ACP-ASIM that took place during my tenure was an especially harmonious one. Compared with the turmoil experienced by other chapters, ours was an exemplary coming together. Mutual benefits for our group are obvious to all members, I believe. I feel that our organization is now more complete stronger.

I am, of course, especially pleased that Yul Ejnes who, as the transitional governor and now the Governor-elect, has done so much for the ACP-ASIM and will continue to strengthen our organization and enhance its missions beyond all expectations.

Fred J. Schiffman, MD, FACP
Governor, Rhode Island Chapter ACP-ASIM

P.S.: Don't forget to check our website at www.acponline.org/chapters/ri periodically for chapter news.

Student Member Wins ACP-ASIM Award

Alexander Feller (M.D. '03) is winner of the 2002 National Student Clinical Vignette Competition sponsored by the American College of Physicians-American Society of Internal Medicine. He will receive an all-expense paid trip to the national meeting in Philadelphia in April to make an oral presentation of his research, "Meckel's Diverticulum: A Geriatric Disease Masquerading as Common GI Disorders". Co-authors are Samir Shah, M.D., Clinical Assistant Professor of Medicine, Division of Gastroenterology and Jonathon Movson, Clinical Assistant Professor of Radiology.

Thanks, Fred!

Yul D. Ejnes, MD, FACP

One of the prerogatives of the incoming Chapter Governor is to pay tribute to his predecessor. I will not pass up that opportunity, especially given the ease with which I can write that accolade. Fred Schiffman has been an excellent leader for the Rhode Island Chapter of ACP-ASIM. At a time when many chapter governors struggled with the merger, Fred took full advantage of the opportunity and presided over a period of unprecedented growth in the effectiveness of the Rhode Island Chapter by combining the talent and energy of the two predecessor organizations and expanding the chapter into a full-service professional organization.

Eight very successful scientific meetings, two Chapter Management Awards, one Chapter Excellence Award, and an Evergreen Award are just a few of Fred's accomplishments during his term. The Rhode Island Chapter has achieved prominence in the national organization that exceeds its proportions as well as a local reputation for helping its members.

Personally, it has been a pleasure to work with Fred for the past four years. I have known him for…, let's just say a while (thank me later, Fred) and I enjoyed our time together. As a Transitional Governor appointed at the time of the merger in 1998, I benefited from Fred's uncompromised support of my activities at the chapter and national level. Fred welcomed me as a partner (I would frequently have to correct him when he referred to me as his co-Governor, since he was really the Governor) and together we were able to make a difference. Our collaboration will not end with the transition in May, since the state is too small for a past Governor to hide (especially when I still have a few months left in my RIMS term).

Therefore, on behalf of the members of the Rhode Island Chapter, I thank Fred Schiffman, MD, FACP, for his service to the chapter and look forward to many more years of his active participation in ACP-ASIM.

Physician-Industry Relations Paper Published

The March 5, 2002 print edition of Annals of Internal Medicine included a two-part paper on physician-industry relations. The paper, prepared by the College's Ethics and Human Rights Committee and approved by the Board of Regents, is available at www.annals.org.

For more information, please contact Lois Snyder, JD, director of the ACP-ASIM Center for Ethics and Professionalism, at 800-523-1546, ext. 2835.

Leadership Day 2002

Yul D. Ejnes, MD, FACP

Tuesday, May 21 and Wednesday, May 22 are the dates of the tenth annual Leadership Day, held in Washington, DC. This year, as it has done for the past few years, the Rhode Island Chapter will send a delegation to meet with Senators Reed and Chafee and Representatives Kennedy and Langevin.

Issues on the agenda for the congressional visits include the 5.4% reduction in the Medicare Fee Schedule Update, the Patients' Bill of Rights, bioterrorism preparedness, regulatory relief, and patient safety.

For further information on Leadership Day, please contact me at Yul_Ejnes@brown.edu.

Lend a Hand to Tobacco Prevention

Tobacco use, primarily smoking, causes heart disease, lung disease and many cancers. More than 400,000 deaths in the United States every year are a direct result of tobacco use. According to the American Lung Association, 100 billion dollars a year are spent in health care costs and lost productivity due to tobacco use. Tobacco use and addiction is the leading preventable cause of death and disease in the United States.

The amount of CME time devoted to educating physicians and medical students about the health effects of tobacco use and the treatment of tobacco addiction is extremely small in proportion to the health importance of tobacco use and addiction. As a result, the College encourages members to join local anti-smoking campaigns and discourage the use of tobacco, particularly by young people.

One program that has been successful in getting the message out to children is Tar Wars, coordinated locally by the Rhode Island Medical Society. Tar Wars is geared to elementary school students, who learn about the dangers of smoking and chewing tobacco from physician volunteers who visit fifth grade classes throughout Rhode Island. Students are encouraged to create posters illustrating some of the points that they learned from the talks and these posters become eligible for a statewide competition held each spring. The winner participates in a national competition. For information on Tar Wars, contact the Rhode Island Medical Society at 331-3207.

Get involved in the campaign to limit tobacco. Help educate the public on the prevention of tobacco use and cessation of smoking. The following organizations maintain websites that will help get you started in the fight against tobacco:

Center for Disease Control (CDC) - The CDC hosts a "tip" page that contains specific information on smoking cessation.

Campaign for Tobacco Free Kids - An organization dedicated to protecting kids and adolescents from tobacco exposure. The website features tobacco initiatives on the state, federal and global levels.

American Lung Association - Articles, data and statistics educating on the use and effects of tobacco products.

The Truth.com - A site funded by the American Legacy Foundation, established in November 1998 after the Master Settlement Agreement (MSA) between 46 states, 5 US territories and the tobacco industry. Exposes the truth about tobacco and the companies that sell it.

Help Us Identify Chapter Awardees

Yul D. Ejnes, MD, FACP

Our chapter presents two Laureate Awards every year, the Irving A. Beck Award in the spring and the Milton W. Hamolsky Award in the fall. The Beck Award honors an internist in private practice with a distinguished career in the areas of clinical care, teaching, and service to the profession, while the Hamolsky Award is given to an internist in academic or full-time practice for similar accomplishments.

Recipients of Laureate Awards are recognized by ACP-ASIM and are invited to participate in the Convocation at Annual Session.

The Awards Subcommittee invites members to submit nominations for these awards as well as suggestions for current Fellows who would be good candidates for advancement to Mastership.

Congratulations to Newly Elected ACP-ASIM Fellows

The Board of Regents elected the following RI Chapter members to ACP-ASIM Fellowship in January:

Jeffrey D. Clement, MD - Providence
Kwame O. Dapaah-Afriyie, MD - Providence
Lance D. Dworkin, MD - Providence
Maria D. Mileno, MD - Providence
Kenneth B. Nanian, MD - Providence

We salute the new fellows and encourage members to consider advancement to fellowship.

All candidates for Fellowship who want to be considered at the November 2002 Credentials Subcommittee meeting must submit Fellowship proposals to ACP-ASIM's Member Records Section before June 1, 2002. Supporting letters from two current ACP-ASIM Masters or Fellows and current curricula vitae must accompany the proposals, which staff will then forward to the appropriate ACP-ASIM Governors.

For an advancement to Fellowship inquiry kit, contact the Customer Service Department at 800-523-1546, ext. 2600, or 215-351-2600 (9 a.m. to 5 p.m. EST), or download one in Adobe Acrobat format at http://www.acponline.org/college/membership/fellowpro.pdf. For more information, contact Mariana Hotea at 800-523-1546, ext. 2709.

Pathways for advancement to Fellowship - Fellowship Advancement Made Easy (FAME)

(written by Marc Shabot, MD, FACP, Former Texas Southern Governor)

Prerequisites

ABIM, RCPSC, or AOBIM certified*
Licensed practitioner
Formal training completed, Member at least 2 years, in practice or teaching for at least 2 years
Proposed/seconded by 2 Masters/Fellows
Commitment to lifelong learning and professional development
*May be waived in extraordinary circumstances

Then, Qualify by one of the four Pathways*

Pathway 1- Academician

Holds academic appointment as teacher, researcher, administrator, writes scientific papers, scholarly reviews, book chapters, etc.

Pathway 2- The Scholar/Teacher/Multiple Certification

Active in community as teacher in Continuing Education and Professional Development activities

Recertified or dual boarded, or MKSAP for score

Pathway 3- The Active ACP-ASIM Member

10 years membership in the ACP-ASIM

Active in ACP-ASIM meetings and Committees at local and national level

Pathway 4- The Senior Physician

May have been a longstanding Member or have joined ACP-ASIM later in life

Has demonstrated longstanding professional activity in the community, in teaching, in patient care or in service; acts as a role model for other physicians and health professionals

Note: Community service, especially the voluntary provision of medical care, and ACP-ASIM activities significantly enhance the likelihood of advancement, under all four pathways.

*Pathways are not mutually exclusive; "combinations" are permissible

As you can see, the current ACP-ASIM guidelines acknowledge a range of professional activities that indicate continuing scholarship and professional achievement. You no longer have to publish to qualify for advancement. For information, contact the RI Chapter leadership or Mariana Hotea, Credentials Administrator, at 800-523-1546, ext. 2709, or go to http://www.acponline.org/college/membership/classes.htm#fellow.

College Policy Paper on Pharmacist Scope of Practice Published

The College outlined its concerns about granting pharmacists independent prescribing authority in a "Pharmacist Scope of Practice" policy paper published in Annals of Internal Medicine (January 1, 2002). The paper noted that patients could benefit from pharmacists assuming a greater role in patient care through collaboration with physicians.

According to the paper, ACP-ASIM supports physician-directed pharmacist/physician collaborative practice agreements limited to pharmacist involvement in patient education and hospital rounds. The paper noted that collaborative drug therapy (CDT) in a hospital setting is one of the best examples of how pharmacists work with physicians. CDT includes basic dispensing functions, drug information services, solving patient- and medication-related problems, and making decisions regarding drug prescribing, monitoring and drug regimen adjustments. ACP-ASIM opposes pharmacists obtaining independent prescribing privileges and initiating drug therapies.

Of local interest, last year legislation was enacted to allow collaborative pharmacy practice in Rhode Island. The provisions of that act, from which the Department of Health is writing regulations, address many of the concerns raised in the Annals paper.

The text of the paper is available online at http://www.annals.org/issues/v136n1/full/200201010-00014.html.

Medicare Teaching Physician Documentation

The Centers for Medicare and Medicaid Services (CMS) is working with ACP-ASIM and others to revise the Medicare requirements that prescribe how teaching physicians must document evaluation and management (E/M) services involving residents in order to receive Part B payment. The revised regulations are expected to include scenarios that illustrate how teaching physicians involve residents in furnishing E/M services to beneficiaries and provide examples of acceptable and unacceptable medical record notations. The CMS Physicians Regulatory Issues Team (PRIT), an interdepartmental agency task force charged with reducing regulatory burden, is leading the effort to streamline the teaching physician documentation requirements.

ACP-ASIM comments on the CMS draft revisions are available at http://www.acponline.org/hpp/ppac_medicare.htm.

College Members Urged to Participate in Recruitment Program

The ACP-ASIM membership department introduced a "Peer-to-Peer Recruitment Program" in fall 2001 designed to encourage existing members to talk to their colleagues and friends about membership in the College. Surveys have shown that recruiting members through direct mail can result in low organizational commitment, but members recruited through social networks are more likely to remain a member of the association.

Interested "recruiters" are provided with recruiting packets that include a membership brochure, benefits flyer, proposal (membership application), generic cover letter and return envelope, all contained in a small envelope that can easily be handed to a colleague when it's convenient.

ACP-ASIM headquarters will provide up to 20 packets per recruiter, along with names of board-certified nonmember customers of ACP-ASIM in their region. Recruiters can also request packets to recruit Associates. College staff are available to assist Chapter Membership Committees and staff in organizing the Peer-to-Peer program. Please contact either Anita Richberg (800-523-1546, ext. 2721) or Danielle Howie (800-523-1546, ext. 2605).

Online Smallpox Clinical Decision Tool Now Available

ACP-ASIM recently revealed its Smallpox Clinical Decision Tool on the Bioterrorism Resource Center web page. The computer-based tool (available in both PC and Palm formats) interactively steps the user through an algorithm from the Centers for Disease Control (Acute, Generalized Vesicular or Pustular Rash Protocol) to help in the diagnosis of Smallpox.

Loose Ends

Yul D. Ejnes, MD, FACP

HIPAA - The College's Practice Management Center has posted two manuals that will facilitate members' preparing for the implementation of HIPAA regulations. The Transactions Rule manual, a fifty-page document, deals with the set of regulations related to electronic transactions, such as billing, and the Privacy Rule manual is a 140 page comprehensive reference on the confidentiality requirements that HIPAA introduces. In the Privacy Rule manual are sample documents such as consent forms and authorizations. Later this year, the Security Rule will be addressed in another manual. These resources are worth several hundreds of dollars but are available free to members of ACP-ASIM. They are downloadable from ACP-ASIM Online at http://www.acponline.org/pmc/regulatory.htm.

Charter on Medical Professionalism - The February 5, 2002 Annals of Internal Medicine features an article titled Medical Professionalism in the New Millennium: a Physician Charter. It is not a quick read, not because of its length (it's only four pages long), but because of its weight. If you have moments when you wonder why you're doing what you're doing, this document will remind you. I encourage you to take the time to review it. If you don't have your paper copy, the online version is at http://www.annals.org/issues/v136n3/toc.html (this will take you to the table of contents for the February 5 issue).

Chapter Subcommittees - After you read the Charter, perhaps you will be inspired to get more involved in the Chapter. Our accomplishments are limited by human resources more than financial ones. Recently, Jim Hennessey's Education Subcommittee welcomed new members and had a successful meeting to plan the 2002 Fall Update in Internal Medicine. Our Executive Council enjoys active participation at every meeting. Munawar Azam continues to develop the IMG Subcommittee. The Associates and Medical Student Subcommittees, under the direction of Mark Fagan, welcome medical students and residents to participate. The Health and Public Policy Subcommittee, chaired by Paul McKenney, needs more members that are active. Two subcommittees that at this point are single-member committees, the Membership and Communications Subcommittees, could use a few good men and women. Pam Harrop chairs Membership, which will become more active this year in a joint recruiting effort with the Rhode Island Medical Society. The Communications Subcommittee is responsible for this newsletter and web site content. If you like to write, please join me - as a bonus, we never have meetings, since we can get our work done electronically.

Spring 2002 Member Response Form

Please Send Us Your E-mail Addresses and/or Fax Numbers

By e-mail:
riacpasim@worldnet.att.net

By fax:
(401) 444-4274

By paper mail:
Nancy Baker-Hobin
Ambulatory Services
Rhode Island Hospital (APC-150)
593 Eddy St.
Providence, RI 02903

Please let us know how the chapter can better serve you and your patients, or if you would like to play a more active role in the chapter. Also, if you have any suggestions for award recipients or for topics to be covered at the fall Update in Internal Medicine or the spring Regional meeting, please write them in the space below. Thank you.

Rhode Island Chapter of ACP-ASIM Executive Council

Fred J. Schiffman, MD, FACP - Governor (1998-2002) (401-793-4035)
Yul D. Ejnes, MD, FACP - Governor-elect; Chair, Communications Subcommittee and Newsletter Editor (401-275-1991)
Michele G. Cyr, MD, FACP - Immediate Past Governor (401-444-4765)
Mitchell A. Pressman, MD, FACP - Treasurer (401-435-5533)
John R. Audett III, MD, Member
Munawar Azam, MD, Member - Chair, IMG Subcommittee (401-456-3000)
James Burrill, MD, FACP
J. Russell Corcoran, MD, FACP
Robert S. Crausman, MD, FACP
Frederick S. Crisafulli, MD, FACP
Mark Fagan, MD, Member - Chair, Associates Subcommittee (401-444-5344)
Edward Feller, MD, Member
Neal Galinko, MD, FACP
Reginald Y. Gohh, MD, Member
R. Scott Hanson, MD, Member
Pamela Harrop, MD, Member - Chair, Membership Subcommittee (401-253-8900)
James V. Hennessey, MD, FACP - Chair, Education Subcommittee
Harold M. Horwitz, MD, Member
Janice M. Kizirian, MD, FACP
Dennis S. Krauss, MD, FACP
Paul F. McKenney, MD, Member - Chair, Health and Public Policy Subcommittee
Anthony Mega, MD, Member
Harold Sanders, MD, FACP
Mark Schwager, MD, Member
Diane Siedlicki, MD, Member
Karen Stevenson, MD, Member
Dominick Tammaro, MD, FACP
Alan Weitberg, MD, FACP

Administrative Assistant
Nancy Baker-Hobin
Ambulatory Services
Rhode Island Hospital (APC-150)
593 Eddy St., Providence, RI 02903
Tel. (401) 444-6289
FAX (401) 444-4274
NBaker-Hobin@lifespan.org

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