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Governor's Newsletter, Fall 2001

David W. Potts, MD, FACP
Governor, South Carolina Chapter

Governor's Message

Dear Friends,
WOW! This years South Carolina Scientific Meeting was surely the best of my tenure as your Governor. My great thanks to Shawn Stinson and his committee, Ben Clyburn and Scott Arnold for putting together an outstanding Associate Meeting. Thanks also to Mike Hawkins, Barry Blackston and their committee members, Nadine Holtz, Marie Blackston, Kim Daves, Dawn Clancy, for a wonderful Scientific Session.

At this year's Associate Meeting, we had 40 oral and poster presentations by Associate Members and students. What wonderful presentations and fascinating information. As I have said before, anyone who is worried about the future of Internal Medicine needs to attend one of these sessions and appreciate our colleagues in training. My thanks and congratulations to all of the presenters but especially to those who were the associate winners. The winners are as follows:

First place winners (These three winners will receive up to $500 to help off set the costs of their presentation at the annual session of the ACP-ASIM in Philadelphia.):

  • Dr. Pallavi Peter, Resident, Greenville Hospital System
  • Dr. Craig McCotter, Resident, Medical University of South Carolina
  • Mr. Paul Bhella, Medical Student, Medical University of South Carolina

The following first runner up winners received a cash prize for there efforts:

  • Dr. Melissa Hummel, Resident, University of South Carolina
  • Dr. Iris Chamblis, Resident, Greenville Hospital System
  • Dr. Stephen Tann, Fellow, Medical University of South Carolina
  • Ms. Suzanne Anderson, Student, University of South Carolina

All Associate and Student Members of the ACP-SIM are invited and encouraged to submit there abstract to the National ACP-ASIM for consideration of a presentation at the National Meeting. Those interested in this opportunity should contact their program directors or me for additional abstract information.

The theme for this years General Session was "What About Us?" In keeping with this theme we had a variety of topics to include: "Physical Fitness for Physicians" by J. Larry Durstine, "Doctor's Etiquette" by Sybil Davis, "The Joy of Teaching" by Richard Hopman, "Stress and Physician Burn-out" by Ann Osborne-Kilpatrick. I found each of these topics extremely interesting and have incorporated concepts into my daily life hopefully allowing me to take better care of myself.

The superb updates in medicine included: Diabetes, by Sandra Weber, MD; Menopause, by Sandra Adamson Fryhofer, MD, FACP; Dermatology by Kathryn Schwarzenberger, MD; Radiology, by Joseph Mullaney, MD; Antibiotic Resistance, by Kent Stock, MD; Hospitalists Movement, by Kenneth DeHart, MD. Each of these added tremendous information to my knowledge base and the assistance of the syllabus serves as an on-going medical resource.

My special thanks to Dr. Sandra Adamson Fryhofer, MACP, and Immediate Past President of the ACP-ASIM. Dr. Fryhofer served as our Regent/College Representative this year and was always outstanding. Her medical presentations and College Updates were timely, appropriate and well delivered. Most importantly, she was available to assist all members and to take questions back to the National Organization.

This year the Annual Session of the ACP-ASIM will be held in Philadelphia from April 11-14, 2002. The National Meeting is surely a superb educational event every year for all Internists. Please plan to join us for this meeting. While in attendance in Philadelphia, please come to the South Carolina Reception, which is held every year in conjunction with North Carolina traditionally on Friday evening.

At this year's Chapter Meeting we had the opportunity to honor Dr. Alan Johnson with the Chapter Laureate Award. Most Internists throughout the state know Dr. Johnson for his contributions to the ACP-ASIM where he has served in numerous committees and as the Governor. He is also known for his service to the Medical University of South Carolina where he currently serves as the Interim Chairman of Medicine, a role that he has previously fulfilled at least twice. Congratulations to Dr. Johnson and all the previous Laureate Award recipients:

1999 - Donald E. Saunders, Jr., MD, FACP
1998 - James McFarland, Jr., MD, FACP
1997 - Edward Mims Mobley, Jr., FACP
1996 - J. O'Neil Humphries, MD, FACP
1995 - O'Niel Barrett Jr., MD, FACP
1994 - Kelly T. McKee, MD, FACP
1993 - Charles S. Bryan, MD, FACP
1992 - William W. Pryor, Sr., MD, FACP
1991 - Roy A. Howell, Jr., MD, FACP

Elections were held for officers for the upcoming year at this year's Chapter Meeting. The following officers were affirmed:

Dr. Mike Hawkins, Scientific Program Chair
Dr. Barry Blackston, Credentials/Membership Committee Chair
Dr. Dawn Clancy, Health and Public Policy Chair
Dr. Jim McFarland, Nominating Committee Chair
Dr. Mary Beth Poston, Associate Board Member
Marcus Cox, Student Board Member.

They will join Dr. Mac Chapman serving as Treasurer and Finance Committee Chair; Dr. Shawn Stinson, serving as Associate Committee Chair; and Dr. Bill Bouleware, Governor-Elect. Elections were also held for members at large. We were extremely pleased to have a slate of five candidates this year to include: Dr. Teresa Gallagher, Dr. Robert Walker, Dr. Robert Thomas, Dr. Shakib Rehman, and Dr. John DuBose. Among these candidates, Drs. Gallager and DuBose were elected to serve on the council next year and will join Dr. Kim Davis and Dr. Desmond Smith as members at large. Any members with questions or concerns about the ACP-ASIM please feel free to contact a council member or me.

For the last six months of my tenure as your Governor, I would like to emphasize membership. Each of you has colleagues, General Internists or Sub-specialists, who are not members of the organization. They are missing opportunities to be involved in an organization that is now over 120,000 members strong. Please contact these individuals and invite them to join us in the educational, political, financial, and patient care aspects of this organization. If you will send me the names of our colleagues who are not members I will send them a letter from you and me together informing them of the benefits of membership.

Governor's Address Change

I have recently changed positions and am now the Chief of Infectious Disease at the Anderson Area Medical Center. You can reach me by email at (dpotts@anmed.com) or by telephone (864) 261-2357 or by fax (864) 260-3777 or snail mail at 800 North Fant Street Department of Infectious Disease Anderson, South Carolina 29621. As always, if I can be of any assistance to you please contact me.

Visit ACPOnline Today!

The ACP-ASIM home page, (http://www.acponline.org) is a great source of information for all. If you've not recently logged on, please do so and update yourself on information concerning patient care and the business aspects of our practices. Recent postings include:

Bio-terrorism
Immunization
Cobra
End-of-Life Care
Medicare
Patient Safety

From Dawn Clancy, MD, FACP

With the events of the last 6 weeks the focus of our Nation and our Government has certainly changed. Prior to September 11, 2001 the Health and Public Policy Committee, nationally and statewide, were battling for Medicare reform, a meaningful patient bill of rights, and the plight of the uninsured. Post 9/11 we physicians find ourselves as frontline defense in a new battle - Bioterrorism. We see its effects daily in our offices and on the news. We have even seen it shut down one House of Congress.

So, what does this mean for our HPPC priorities? I think Bob Doherty in the National Office said it best - We do not know. What we do know, however, is that for our patients these priorities will become increasingly important. Our patients will want us to spend more time with them than with the paperwork of Medicare. They will want to be assured that any and all treatment which we deem appropriate will be given, regardless of a 3rd party payer's opinion. Additionally, as our unemployment rate rises, so too will our uninsured rate, we must continue to address these issues in an aggressive but thoughtful manner for the sake of our patients.

At our Annual Meeting several of you expressed interest in becoming active with this committee. I appreciate your willingness to commit your time. I would also ask that every member strongly consider joining the national Key Contact program via the ACP website. For those of you who would like to be involved beyond that, please contact me at (clancyd@musc.edu) or by phone at 843-953-8986. Together, with very little face-to-face meeting time, we can effect changes for our patients.

Medication Samples and Safety

Medication samples are an everyday part of ambulatory medicine. They can insure that low-income patients get the medications they need, and they help patients get started on their medication as quickly as possible. However, samples bring with them risks that can lead to accidents. To use samples safely, consider the following tips:

  • Keep a sample distribution log of what medications patients were given, and how much.
  • Use stickers or otherwise mark or separate look-alike and sound-alike items.
  • Make sure the sample storage area is well lit and secure.
  • Provide explicit written directions on how to use the medication.
  • Involve patients in the safety check: ask them to repeat back to you how they should take the medicine.
  • Provide empty childproof bottles to store the samples in to patients living with children.

The Scientific Policy Department of the ACP-ASIM is working to improve patient safety through its new CME series, Patient Safety: The Other Side of the Quality Equation. If you are interested in having this program presented at our next Chapter meeting, please contact me by emailing (dpotts@anmed.com).

From John Black, MD

I am concerned about a change in the payment system for reading Echocardiograms. There may be restrictions placed on payment for general Internists for this procedure. Interested in more details? Call me at (803) 796-0106.

Patient Compliance: The Missing Link to Medication Safety

All physicians know that care of the patient doesn't stop at the clinic door. In fact, most ambulatory patient-safety accidents happen outside the clinic, as a result of medication errors, including non-compliance. But you can know the risk factors associated with medication errors and non-compliance, and you can work to prevent them. Below are just a few of the factors associated with errors of non-compliance:

  • Advanced age
  • Multiple co-morbidities or medications
  • Depression
  • Perception of overmedication

For example, a study of elderly primary-care patients revealed 86% of the participants misunderstood physician instructions regarding medication schedules. And patients with depression are three times more likely to be noncompliant with medical recommendations. For patients with noncompliance risk factors, take a little extra time to explain how to use the medication, and why it's important. If side effects are a possibility, let the patient know what to expect and what to do if the side effects are more than transitory. Working together, patients and physicians can promote safety beyond the clinic door.

The Scientific Policy Department of the ACP-ASIM is working to improve patient safety through its new CME series, Patient Safety: The Other Side of the Quality Equation. If you are interested in having this program presented at our next Chapter meeting, please contact me by emailing (dpotts@anmed.com).

Experience Annual Session—Philadelphia Style

Join the College April 11-14, 2002 and be a part of Annual Session 2002 in Philadelphia. Experience over 275 sessions covering the spectrum of internal medicine and the subspecialties. Upholding tradition, ACP-ASIM promises to offer a rich educational experience with an emphasis placed on content that is clinically relevant and practice oriented. Be Sure Not to Miss...

Clinical Pearls - Remember those words of wisdom from your most respected clinical teachers? Those Pearls were based on an experience of depth and knowledge of medical literature of remarkable scope. Pearls are noteworthy for their clarity, timelessness, and clinical applicability.

Introduced at the 2001 Annual Session and an instant hit, Clinical Pearls rekindles the joy of bedside learning, using a highly engaging, case-based format. With the audience-response keypad-system, you'll have a chance to test the depth of your clinical acumen. You'll leave each session with a rich collection of Pearls, ready to be applied directly to the patients.

Multiple Small Feedings of the Mind - Rated by many as the best of Annual Session, Multiple Small Feedings of the Mind uses a creative format to address some of the most common, yet challenging or controversial, patient-management issues. In these highly focused, fast-paced sessions, faculty offers answers to some of the most frequently faced dilemmas in patient care.

The Learning Center - Experience the excitement of the Learning Center. Refine your techniques in a variety of office-based examination and procedural skills. Take advantage of small group or individual tutorials with experts in the field. The Learning Center is unique to Annual Session and offers a wide range of opportunities for closely supervised, hands-on practice. Become familiar with procedures and examinations you don't perform on a routine basis. Try out the latest software for clinical information management and patient care. The Learning Center is a dynamic collection of hands-on activities, which you can immediately apply to your clinical practice.

Update - Keep up to date on the year's most important published papers in the subspecialty areas. Learn significant findings and their impact on patient care. Nationally recognized faculty reviews the literature and presents the year's highlights.

Experience Annual Session...

ACP-ASIM Annual Session 2002, April 11 - 14, 2002, Philadelphia, PA

Registration and other meeting information is available online. Log-on to the College website at (http://www.acponline.org/cme/as/2002/index.html), or contact Customer Service at 800-523-1546, extension 2600. Early sign-up is encouraged for the best selection of workshops and seating at breakfast/lunch sessions.

End Of Life Care Patient Education Brochures And Doctors Tip Sheet Available

In September, the Center for Ethics and Professionalism inaugurated its Patient Education and Caring: End-of-Life (PEACE) Series by releasing three patient education brochures designed to guide patients through various stages of palliative and end-of-life care. The brochures offer clearly worded advice for patients and caregivers and are suitable for distribution in doctor's offices. The available brochures are:

  • "When You Have Pain at the End of Life"
  • "Living with a Serious Illness: Talking to your Doctor When the Future is Uncertain"
  • "Making Medical Decisions for a Loved One at the End of Life"

Also available is "Improving Your End of Life Care Practice," a tip sheet for doctors, with suggestions on how to identify patients who would benefit from the brochures and tips on how to "break the ice" in face-to-face discussions about sensitive end-of-life issues.

The patient brochures are available at no charge in packages of 50 each from the Center (call 800-523-1546, ext. 2839 or e-mail ssmith@acponline.org); they can also be accessed in PDF format at (http://www.acponline.org/ethics/patient_education.htm).