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Governor's Newsletter, Summer 2001

H. James Williams, MD, FACP
Governor, Utah Chapter

A Message from Your New Governor

I am delighted to have the opportunity to represent the Utah Chapter of ACP-ASIM on the Board of Governors and to serve the ACP-ASIM members in Utah. Dr. Elliott has left big shoes to fill, but is also serving as a mentor. More importantly, he will serve as an example as I strive to emulate his effective leadership. I hope to be able to call on the members of the Chapter for assistance with the work of the College. I would hope that what we do will be relevant and useful. I would welcome your suggestions and ideas as well as your personal involvement in the further progression of the Chapter.

The merger of the ACP and ASIM is now accomplished and the two organizations now function as one. This stronger organization is working to provide advocacy and a voice for internal medicine and its subspecialties. The ACP-ASIM will not only foster collegiality, but will advocate for common interests and needs. I would like to make the voice of Utah a part of this force.

I have been the program director for the residency training program for the past four years and I served in the same capacity for nine years previously. I have a special interest in residents and hope to increase the involvement of the Associates in our chapter. I also hope to continue the work with medical students that was advanced by Dr. Elliott. I would also like to make the Annual Scientific Meeting a priority for all practicing internists. As a chapter, I would desire that we reach out to new members of our internal medicine community and include them in our efforts.

I look forward to meeting with each of you. I hope that many of you will be involved in our mutual interests and that we can continue the forward progress of the chapter that is bequeathed to us by Dr. Elliott and his predecessors.

Elliott Completes Term as Governor

C. Gregory Elliott, MD FACP, has served as the Governor of the Utah Chapter of ACP-ASIM for the past four years. His term came to an end on March 31, 2001. We are all indebted to Dr. Elliott for the wonderful leadership he has provided to our Chapter. He has been active with the Board of Governors and is well-respected by his peers. He has served on several subcommittees and recently chaired the national committee on chapter awards. His dignified presence and attitude as well as his collegial manner has served us well. During his term, the Utah Chapter received three Chapter Management Awards from the ACP-ASIM. The Chapter also received an Evergreen Award for innovation in chapter programs. The Evergreen Award was the result of a program for medical students that substantially increased the medical student membership in the Chapter. We all extend our appreciation to Dr. Elliott.

Dr. Martin Gregory, FACP, was elected Governor-Elect last year. Unfortunately for us, Dr. Gregory has had the opportunity to move to Bermuda to practice there. This is a wonderful opportunity for Dr. Gregory, but he was unable to assume the role of Governor.

In a special election in February, H. James Williams, MD FACP, was elected Governor-Elect and assumed the office of Governor on April 1, 2001.

Dr. Williams is a rheumatologist at the University of Utah School of Medicine where he is a Professor of Medicine and the Associate Chairman for the Department of Internal Medicine. He is also the program director for the internal medicine residency training program and co-director of the medicine/pediatrics residency training program. We wish him well as Governor and look forward to his leadership of our Chapter.

Highlights of the ACP-ASIM Annual Session in Atlanta- March 29-April 1, 2001

The ACP-ASIM Annual Session in Atlanta was another success. The multiple pre-courses were well attended as were the educational and scientific sessions. There were more that 5,400 registrants for the annual meeting. Associates were also participants in a poster competition where Dr. Gregory Elliott, then our Governor, was one of the judges.

Dr. Steven Horton from our chapter was elected a Fellow in the ACP-ASIM this year and we extend our
congratulations to him.

During the Annual Session, the Board of Governors and the Board of Regents held meetings. Two of the topics discussed are of special interest to the Chapter.

One of the areas of greatest concern had to do with recertification. The Regents held meetings with representatives of the American Board of Internal Medicine (ABIM) and the ABIM made a presentation at the Annual Session. The College indicated in a letter to internists in January that the ACP-ASIM and the ABIM are separate and distinct organizations. The College neither appoints members to the ABIM nor has any say about policies developed by the ABIM. The Board of Governors made it clear that they are not in support of the current plans of the ABIM for recertification and have asked the Board of Regents to continue to meet with the ABIM to have the process modified. The College has enunciated three broad goals as it meets with the ABIM on this issue: 1) the process should be clinically relevant, cost and time effective and not redundant; 2) the responsibility of the ABIM should be limited to evaluation; and 3) there should be requirements for continuing medical education to assure maintenance of competency although there should be flexibility in this requirement. There is ongoing discussion with the ABIM about this issue, but the College is aware of your concerns in this matter.

The other issue presented to the Board of Governors was Dr. Kenneth Shine's report from the Institute of Medicine, "Crossing the Quality Chasm." The Institute has been studying errors in medicine and health quality and safety for several years. In 1998, the committee of Quality of Health Care in America was formed and charged with developing a strategy to improve health care over the next decade. The report concludes that tens of thousands of Americans die each year from errors in their management and additional hundreds of thousands are affected. The report made several recommendations. The College will be studying the Institute report and the implications for internists.

ACP-ASIM Works to Reduce Medicare Hassles

ACP-ASIM is pleased to announce its endorsement of the "Medicare Education and Regulatory Fairness Act" (MERFA), S. 452/ H.R. 868, which directly addresses internists' concerns with Medicare red tape and hassles.

Medicare's complex regulations have created a heavy paperwork burden that significantly reduces the time doctors spend with patients, according to William Hall, MD, FACP, President-Elect of ACP-ASIM and a practicing geriatrician.

Dr. Hall represented the College and announced support for this important legislation at a March 7 press conference with the American Medical Association and the American College of Cardiology, as well as MERFA's Senate and House sponsors.

MERFA directly addresses the Medicare procedures and rules that are the source of much frustration with the program. Under Medicare regulations, physicians must comply with numerous federal rules and local contractor policies to complete claim forms, provide advance beneficiary notices, certify medical necessity, file enrollment forms and comply with code documentation guidelines. Yet, there is no single source that physicians can access to learn Medicare's rules and policies.

Introduced in the Senate by Senators Frank Murkowski (R-AK) and John Kerry (D-MA) and in the House by Representatives Shelley Berkley (D-1-NV) and Pat Toomey (R-15-PA), MERFA would allow physicians and their staff to spend more time treating patients, and less time handling needless paperwork. It would enact the following reforms:

  • Medicare rules and policies and answers to "frequently asked questions" would be made more accessible, and physicians would be given advance notice about changes in rules.
  • Medicare would be required to pay its claims, without demanding more paperwork, unless there is evidence that the bill is incorrect.
  • Medicare would be required to actually examine the records, rather than using a statistical sample, to determine that some claims were billed incorrectly.
  • Medicare's ability to investigate fraudulent claims would be preserved, while also educating physicians on how to prevent inadvertent billing mistakes that result in overpayments.

Enactment of MERFA is one of the College's highest priorities. The College strongly encourages you to ask your Senators and Representative to cosponsor this important bill if they have not already. Illustrate for your legislators your experiences with the burden of complying with regulations, and how much time it takes you and your staff to deal with complex, confusing, duplicative and unfair Medicare requirements.

E-mail, fax or compose a letter to your legislators through the ACP-ASIM Legislative Action Center at
http://www.acponline.org/lac (draft letter provided, please personalize), or call your Senators and Representative toll-free through the ACP-ASIM Grassroots Hotline at 1-888-218-7770. (The Hotline will prompt you for your 8-digit member number, which you can find on the mailing label of ACP-ASIM publications, such as Annals of Internal Medicine.) Report your contacts to Jenn Jenkins in the ACP-ASIM Washington Office at 800-338-2746, ext. 4536, or by blind copying e-mails to jjenkins@acponline.org. Thank you for your help.

Associates Banquet

The Associates Banquet was held on June 5, 2001, at the Marriott University Park Hotel. The meeting was sponsored by the Utah Chapter of ACP-ASIM and was directed by the Associates Committee of the chapter chaired by Dr. Corwin Edwards, with Dr. Scott Stevens and Dr. Steven Horton as committee members. It was a successful and enjoyable dinner.

A Clinical Vignette Competition was a part of the evening. Fifteen clinical vignettes had been entered into the competition. The selection committee, which was the same as the Associates Committee, selected five of the vignettes for presentation at the dinner. Presentations were 12 minutes in length and had impressive audio-visual support with echocardiograms, x-rays, pathological slides, angiograms, etc. The five presenters were:

JessArmor - (PGY 2)

Cheryl Bazzle - (PGY-3)

Nathan Williams - (PGY-1 transitional)

Timothy Lahey - (PGY-3)

Matt Cyphers - (PGY-2)

Each presentation was well done and well received.

The judges of the competition were Dr. Grant Cannon, Dr. Lisa Kuwahara, and Dr. James Williams. They selected three winners.

First place went to Dr. Tim Lahey for his presentation Devastating Systemic Emboli From MassiveLeft Atrial Calification Due to Chronic Renal Failure.

Second place was awarded to Dr. Nathan Williams for his presentation of One Bad Liver, which was a fatal case of herpes simplex virus hepatitis.

Third place was given to Dr. Matt Cyphers for his presentation A 45 Year Old Samoan Man With Type 2 Diabetes, Vomiting, Meningitis, Abdominal and Testicular Pain, which was a case of disseminated tuberculosis.

Our congratulations to the winners, but also to all participants.

Resources for Renewal

We have all heard stories of "burned-out" internists who left their practices, or of young residents who chose a field other than internal medicine because they heard of the long hours, bureaucratic hassles, and declining incomes associated with our field. College Governors have listened to their members' concerns about physician burn-out and the need for renewal, and spent the last several months developing a list of resources that could be used by anyone dealing with these issues. The Board of Governors reviewed a variety of speakers, websites, organizations, books, articles, and College publications, choosing resources they would personally recommend to their colleagues. This material has been collated and posted on ACP-ASIM Online, in the Careers section at http://www.acponline.org/careers/. If someone you know is looking for a better balance or a path to renewal, there may be something on this list you can recommend.

There is a response form linked to the list. If you refer to one of the pieces, and would, in turn, recommend it to someone else, let headquarters know. If you are aware of a wonderful resource that's not listed, you can suggest it be added. All feedback will be reviewed by a working group of ACP-ASIM Governors, who will be revising the list on an ongoing basis.

Visit the Careers section, check out the renewal project, and let us know what you think!

Advance to Fellowship

Would you like to receive information regarding advancement to Fellowship in the College? Please send your mailing address to Sandy Huston at Sandra.Huston@hsc.utah.edu, or call 801-581-4333, and you will receive an information/application packet.

Future Meetings - Mark Your Calendars Now

2001 Utah Chapter Scientific Meeting
September 28, 2001
Wyndham Hotel, Salt Lake City

Type 2 Diabetes Mellitus: Update on Practical Management

ACP-ASIM Annual Session
April 11-14, 2002