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May 2012 Kenneth E. Olive, MD, FACP, ACP Governor


From the Governor

Dr. Olive

The first half of 2012 has been a busy time in the Tennessee Chapter ACP. This issue of the Governor’s Newsletter will highlight the March Reading Retreat, planning for the 2012 Tennessee Chapter Scientific Meeting in Chattanooga this fall, chapter involvement in Internal Medicine 2012, the Tennessee Council of Young Physicians, and more.

On an unrelated note, I am sharing the joy many of you have already experienced of transitioning to an electronic health record. My practice went live two weeks ago. It has been amazing to see how much this has impacted office processes and work flow. Unfortunately during this initial stage it has also impacted interactions with patients who have been remarkably tolerant. The challenge of ensuring that the notes generated are both accurate and meaningful will be a long work in progress. Understanding meaningful use and making sure we are achieving this has taken on new meaning. I also have a long way to go in learning to efficiently use task lists. However, I also see potential improve medication management and diagnostic information. Whether the benefits live up to the promise remains to be seen. Yet I am encouraged by what I hear from many of you.

I hope the satisfaction of your professional lives exceeds the frustrations. I know you are doing good work. Remember that our patients need us!

Ken Olive, MD FACP
Governor

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Reading Retreat

The 2012 Tennessee ACP Reading Retreat was held at Fall Creek Falls State Park on March 1-2. This year marked the 25th annual event. Our topic this year was “Against Fatality” and concerned the struggle against our inevitable mortality that all must try to come to terms with – including we physicians. The idea that help can be searched for and found in great literature is the very foundation of this ACP sponsored series. The works used this year included Everyman by Philip Roth, Wit by Margaret Edson, Vanity Fair essays on cancer by Christopher Hitchens, Indestructable (film) by Ben Byers and poetry by Shakespeare, Donne, Dickinson and Dylan Thomas. Each work provided a glimpse of an incredible mind’s attempt to engage a subject that is painful to all, but necessary, especially to those trying help others with this process – as clinicians must do every day.

Our leader, for the 15th year, was Dr. Greg O’Dea, UC Foundation Professor of English and Director of the Honors Program, at the University of Tennessee, Chattanooga. In each of the four sessions, there was a short introductory lecture followed by a spirited and wide-ranging discussion by the group, deftly led by Dr O’Dea. There were 26 physician participants, many of their spouses/partners and 4 pre-med students from UTC. Many attendees of multiple retreats now consider this meeting a highlight of their year.

Preparations for the 2013 retreat will begin soon. It will also be held at Fall Creek Falls and is scheduled for March 1-3. Please contact Dr. Mark Anderson if you would like to be placed on the contact list for the meeting.

Mark Anderson, MD, FACP

Dr. Odea

Dr. O’Dea leading discussion at reading retreat

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Internal Medicine 2012

im 2012 logo

Over 160 members of the Tennessee Chapter joined 6300 other internists in attending Internal Medicine 2012 in New Orleans April 19-21. Internal Medicine 2012 is the premier internal medicine education meeting of the year. With hundreds of presentations by leading experts in the field it offers unparalleled learning opportunities for internists. In addition it presents an excellent opportunity for networking with colleagues from around the country. Wayne Riley MD, MPH, MBA, MACP of Nashville gave the keynote address “Health Disparities and Inequities in the Era of Health Reform: Why Internal Medicine Must Lead the Way.” He pointed out that, “Medicine is an art based on science. We have to come to grips with the fact that sometimes there is bias in the exam room.” He issued this challenge: “As internists we must insure that our patients get all the care they need and no more than they deserved regardless of race or background.” Several other members of the Tennessee Chapter participated as faculty members: Randy Curnow, MD, FACP, Knoxville, Steven Embry, MD, Nashville, Ryan Mire, MD, FACP, Brentwood, and Fred Ralston, MD, MACP, Fayetteville.

Thursday evening, 9 chapter members participated in the convocation as new fellows:

Hamilton Emokpae, MBBS, FACP, Winchester
Emmanuel Iloh, MD, FACP, Oakland
Gerald Mancebo, MD, FACP, Powell
John Mann III, MD, FACP, Bristol
David Miller, MD, FACP, Kingsport
Stephen Nace, MD, FACP, Memphis
Ugochuku Onyes-Nwachuku, MD, FACP, Nashville
Pankaj Privastava, MD, FACP, Dyersburg
John Tapp II, MD, FACP, Chattanooga
Dr. Miller and his son David Miller, Jr., MD, FACP of North Carolina had the distinction of going through convocation as a father and son.

2012 New Fellows

TN Chapter new fellows at convocation

The Tennessee Chapter was represented in the Doctors Dilemma competition by a team comprised of residents from UT Nashville (Baptist Hospital program) and Vanderbilt University. In this spirited competition the team competed valiantly and defeated their competing teams in the first round before falling in the second round.

Doctors Dilemma team

TN Chapter Doctor’s Dilemma team

Friday evening the Tennessee Chapter joined forces with Indiana, Kentucky, and North Carolina to host a reception for our members at the Red Fish Grill. Wilma Cooley the TN Chapter Executive Director coordinated the event. 190 people participated in this event which was a great time to meet and visit with chapter members.

Reception 1 Reception 2 Reception 3

Members of TN Chapter enjoying reception.

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One medical student and several resident members of the Tennessee Chapter presented posters at Internal Medicine 2012
Medical Student Research poster

Armen Henderson, Meharry Medical College.
Molecular Cardiac Surgery with Retrograde Delivery (Mcard) in the Treatment of Heart Failure.

Mr. Henderson’s poster was one of the national medical student award winners in the competition!

Resident Research Posters

Muhammad U. Khan, MBBS, UTHSC, Memphis. Acute Stressor States: Cation Dyshomeostasis, Prolonged Myocardial Repolarization with Cardiac Arrhythmias and Necrosis

Muhammad U. Khan, MBBS, UTHSC, Memphis. Idiopathic Intracranial Hypertension Associated with Hypocalcemia and Aldosteronism: A Case Series

Owaisur Rahman, MD, University of Tennessee, Knoxville.
Point of Care Testing: Efficient, but Accurate?

Resident Clinical Vignette Posters

Ahmad Lutfi Alazzeh, MD, Quillen College of Medicine, ETSU.
Not Quite an Acute ST-Segment Elevation MI.

Matthew Erickson Edwards, DO, University of Tennessee, Knoxville.
Acute Psychosis in a Patient with Cushing's Disease.

Hetvi K Joshi, MD, Quillen College of Medicine, ETSU
Shaky Heart can Present as Shaky Limb.

Adrianne C Netterville, MD, University of Tennessee Knoxville.
Infected Left Atrial Myxoma, a Rare Cause of Bacteremia with a Common Pathogen.

Pranav B Patel, MD, Quillen College of Medicine, ETSU.
The Wolf in Sheep's Clothing.

Devon Paul, MD, Vanderbilt University.
Idiopathic Pulmonary Fibrosis, Or Something More? What Families Teach Us About The Disease.

Tejas Vinodbhai Raiyani, MD, Quillen College of Medicine, ETSU.
Dysphagia – Roots Laid in Coronaries !!!

Gaurav S Shah, MD, Quillen College of Medicine, ETSU.
A Rare Case of Paradoxical Renal Embolus Through Patent Foramen Ovale

Gaurav S Shah,MD, Quillen College of Medicine, ETSU.
Secondary Hyperparathyroidism in Metastatic Prostate Cancer: a New Syndrome?

More Photos from Internal Medicine 2012 will be posted in a gallery on the chapter website in early June.

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LEAD Program

The Leadership Enhancement and Development (LEAD) Program targets internists early in their careers and offers a variety of activities designed to provide participants with the skills, resources, and experiences necessary to become effective leaders in any setting. Gena Kaye Kluwe, MD, FACP received her certificate for completing the LEAD program at Internal Medicine 2012. Dr. Kluwe noted, “I have found the skills I developed through the lead program have been useful to me in my daily activities as a hospitalist.” Dr. Kluwe serves as a member of the TN Chapter Governor’s Council.

More information about the LEAD Program can be found at its website.

Lead 1

Dr. Kluwe with Dr. Virginia Hood, ACP president

Lead 2

Dr. Kluwe receiving LEAD certificate from Larry Ward, MD, FACP, Chair Council of Young Physicians and David Fleming, MD, FACP, Chair Board of Governors

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ACP Hospitalists Here to Stay

That hospitalists are an integral component of the American College of Physicians was clear at Internal Medicine 2012. There was a vibrant track of sessions devoted to hospitalists’ educational needs and visible recognition that hospital medicine is a form of practice embraced by internists across the country.

This is true in Tennessee as well. The Tennessee chapter plans several hospitalist-specific activities at its annual meeting in October. This year’s hospitalist breakfast will be hosted by Steve Hegedus, MD, FACP, a hospitalist in Memphis, and all hospitalists across the state are invited to attend. This is always a great opportunity to discuss ways to advance hospital medicine in the state, in the chapter, and in the ACP. There will also be several sessions at the chapter meeting devoted to hospital medicine topics.

In the past, hospitalists and office-based internists met together in Nashville to discuss transitions of care for hospitalized patients. As hospital medicine gains acceptance across the state, the opportunity must be taken to increase the unity of internal medicine by increasing communication between office- based internists and internists practicing hospital medicine – an endeavor for which ACP is the uniquely qualified forum.

John W. Fowler Jr., MD, FACP
Medical Director
Baptist Memorial Medical Group – Memphis Hospitalists

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Governor-Elect

Dr. Lane

Richard Lane, MD, FACP, was elected Governor-elect in the chapter election held in the fall of 2011. Dr. Lane has extensive experience in various leadership roles in medicine including having served as president of the Tennessee Society of Internal Medicine and as chairman of the board of trustees of the Tennessee Medical Asociation. Dr. Lane has also served as chair of the internal medicine department of Williamson County mediclal center. Dr. Lane began his formal year as Governor-elect at the close of internal medicine 2012. This highly structured one year process involves the Governor-elect working closely with the Governor, with other Governors-elect and with ACP staff members to be prepared to assume the responsibilities at the conclusion of Internal medicine 2013. Dr. Lane attended the Board of Governors meeting in New Orleans along with Dr. Olive to begin this process. They have begun the process of reviewing a list of items on a monthly basis throughout the year.

As part of his plan for moving the chapter forward in the next four years, Dr. Lane will conduct a strategic planning retreat for Governor’s Council in the spring of 2012.

Dr. Lane and Wilma Cooley

Dr. Richard Lane and Wilma Cooley working during a planning session

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Treasurer

The Tennessee Chapter expresses gratitude to Tracey Doering, MD, FACP for her years of service to the Tennessee Chapter in the role of treasurer. Dr. Doering is succeeded by Ryan Mire, MD, FACP in this important position. Dr. Mire will work with the Governor, Governor-elect, and Executive Director to manage the chapter finances. In this capacity Dr. Mire will chair the finance Committee. This committee met (Drs. Mire, Olive, Lane & Doering) in January at TMA headquarters to review the chapter accounts.

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Council of Student Members

Earl Stewart, Jr., Meharry Medical College

Recently being elected to serve on the ACP’s Council of Student Members has truly reinvigorated my call to serve the College at-large and our Tennessee Chapter in a new way. I am so pleased and equally honored to have been elected to one of three positions recently vacated on the thirteen-member council of the College that represents medical student interests of the 25,000 medical student members of the ACP. I will be serving as a Southern Region Representative, representing students attending those medical schools across the entire southern region of the United States, which includes Tennessee, Kentucky, and the 11 other states comprising the region. My term officially begins May 1, 2012 and will last for one year. I look forward to representing our Tennessee Chapter well in aiding to fulfill the mission of the CSM to promote excellence and professionalism in medical students and thereby promoting internal medicine as a career.

At Internal Medicine 2012, the Council met and renewed our focus on serving the College and helping to advance the College’s goals of advocating for the highest quality of healthcare delivery to our patients and increasing medical student membership and knowledge of the resources afforded to medical student through that membership. I will particularly be helping to stimulate interest in the field of internal medicine as a career by working closely with Internal Medicine Interests Groups at medical schools throughout our region as well as serving on a temporary sub-committee to help improve IMpact, the monthly medical student e-newsletter of the College. Thanks so much to all of you, the members of our Tennessee Chapter, for your encouragement and indelible support as we all continue the very crucial work of catapulting internal medicine and primary care into the future of our chosen profession.

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Leadership Day

Leadership Day on Capitol Hill will be held June 6-7, 2012. This annual event provides education on current health related federal policies and provides a venue for lobbying our Congressional representatives. Jason Hayes, MD, FACP, Nashville, Catherine Womack, MD, FACP, Memphis, Ammar Almehmi, MD, Germantown, Fred Ralston, MD, MACP, Fayetteville, Earl Stewart, Jr. Medical Student, Nashville, Azee Azah, Medical Student, Nashville, Richard Lane, MD, FACP, Franklin, and Ken Olive, MD, FACP, Johnson City, will represent the Tennessee Chapter in Washington. The agenda for this year is somewhat uncertain given the status of the Affordable Care Act with the Supreme Court. While it is unlikely that at Supreme Court decision will be announced prior to the event, if it was it would likely significantly affect the policy agenda for Leadership Day.

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2012 Tennessee Chapter Scientific Meeting

Thanks to Daphne Norwood, MD, MPH, FACP and her committee who have been busy planning the 2012 TN ACP Scientific Meeting scheduled for October 19-20 at the Chattanoogan Hotel in Chattanooga, TN, The meeting theme is “Internal Medicine 2012: Opportunities and Challenges” with resident-focused activities scheduled for October 18. An informative and timely program is planned with several special events. Susan Hingle, MD, FACP, the Chair-Elect of the National ACP Board of Directors, will be giving a keynote address on the ACP High-Value, Cost-Conscious Care. The new cervical cancer screening guidelines and how to incorporate HPV screening effectively in your practice will be reviewed by noted Gyn-Onc physician, Larry Kilgore, MD. The CME program will include a wide range of topics including reducing COPD readmissions, CHF update, new evidence changing peri-operative care, methods of stroke prevention in atrial fibrillation, HIV care for the general internist, and care/counseling of patients with one kidney. Interactive learning sessions with musculoskeletal skills and narrative medicine workshops will also be featured in the meeting. Breakfasts for hospitalists and outpatient physicians to share ideas on “Technology that Works” will be moderated by Sonal Gupta, MD, FACP and Steven Hegedus, MD, FACP. Charlene Dewey, MD, MEd, FACP, a very well-received lecturer in past TN ACP scientific meetings, will be returning for a session on “Setting Boundaries with your Prescribing Practices”, which will be eligible for credit with the TN Board of Medical Examiners mandated prescribing practices CME. On October 20, conference attendees will have the opportunity to hear the views and question a panel of practices trying a Patient Centered Medical Home Panel and on how this will integrate with Accountable Care Organizations (ACOs). Fred Ralston, MD, MACP, (former President of National ACP (Fayetteville) , Catherine Womack, MD, FACP, (Memphis), Randy Curnow, MD, FACP, (Knoxville) and Thomas Lundquist, MD, (Blue Cross Blue Shield) will be the panel participants. Medical students, residents and practicing internists will have the opportunity to participate in a narrative medicine contest, which is a new feature this year. The social event for the meeting will be at the TN Aquarium on Friday evening and the top narrative medicine entries will be featured. Information about the meeting schedule, registration and contest entries will be available on the TN ACP Chapter website by early June. The program has been designated for 11.5 hours of CME with four additional hours available for those participating in two ABIM Maintenance of Certification Modules on Saturday afternoon. Please come and join your colleagues for this great opportunity for sharing knowledge and experience!

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Tennessee Council of Young Physicians

The TCYP continues to be active in the TN ACP Chapter activities. The 2011-2012 activities were initiated with ‘The Principles of Coding and Billing’ dinner talk organized at Nashville in January 2012. A Spring Fling was organized by Sonal Gupta, MD, FACP, on May 6th 2012 at the Gupta home and was well attended. Two other dinner talks are being organized in the West and Middle zones for later this year.

This year too, three TCYP members are on the Tennessee Chapter scientific program committee for 2012. The TCYP is also actively involved with the Associates evening program in the yearly Chapter meeting- with organizing the Jeopardy and the judging of Posters and Oral presentations. Three members have been currently elected to serve on the Tennessee Chapter Governor's Council for the next 4 years. Once again, emphasizing the energetic role of the young physicians in the TN ACP Chapter activities. We continue to Co-sponsor the Internal Medicine grand rounds at Chattanooga and regularly present a message from the Governor of the Chapter.

At the National level three members attended Internal Medicine 2012 in New Orleans. As mentioned elsewhere in the newsletter, Gena Kluwe, MD, FACP, received the LEAD certificate this year. Two members will be attending the Leadership Day to be held at Washington DC in June 2012.

Every year, two to three members of the TCYP complete their term in the council and the council elects two or three new members to the council (membership is defined as within 16 years of graduating medical school). We hope that more and more young physicians get interested in the ACP activities and try to join the TCYP as a stepping stone to the Chapter ACP activities and to a fulfilling professional life.

Please follow us on Facebook and Twitter.

Reena Kuriacose, MD, FACP
Chair, Tennessee Council of Young Physicians

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Membership Summary

May 23, 2012

Masters - 15 Fellows - 488 Members - 959 Associates - 260 Medical Student Members - 383 Total - 2105

Our chapter has resumed participation in the Recruit-a-Colleague Chapter Rewards Program! Like the national Recruit-a-Colleague Program, the RACC Program rewards successful individual recruiters with dues credits for each new full Member recruited and a chance to win a trip to the annual Internal Medicine meeting. In addition, the RACC Program also provides rewards to the recruiters’ chapters. The Recruit-a-Colleague Chapter Rewards Program runs annually from April 1 through March 15.

To participate, simply forward to your colleagues the membership application found at www.acponline.org/racc. To qualify for the program, your name must be listed on the recruiter line of this specially coded application. You can also receive credit for recruiting former Members and Fellows; if a former Member or Fellow calls Customer Service for reinstatement, be sure to ask that you are mentioned as a recruiter.

Thank you for your help in strengthening our chapter! If you would like to serve on our Chapter membership committee, please send a letter of intent to Governor Olive and myself at Wilma.Cooley@tnmed.org and VKolade@gmail.com.

Victor O. Kolade, MBBS, FACP
Chattanooga

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Contact Information

Richard G. Lane, MD, FACP,
Governor, Tennessee Chapter

Renee Arnott
Executive Director
Ph: 615-460-1657
E-mail: renee.arnott@tnmed.org