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Utah Chapter Governor'sNewsletter

Summer 2000

FROM YOUR GOVERNOR

"Some things never change..."

We are all aware of how rapidly our environment seems to change. The stock market rises and then it plummets; medicare no longer pays for pulse oximetry, but agrees to pay for PSA screening for men over age 50; hospitalists assume the role of primary physician for inpatients; nurse practitioners assume roles in primary care; and the government responds to a major report on medical errors. These are but a few of the changes that seem to buffet us daily.

The constancy of the ACP-ASIM stands strongly in the face of change. Not that the ACP-ASIM does not change and respond, it does. Witness the measured and firm response to the Institute of Medicine Report. But the ACP-ASIM remains unchanging in its commitments and core values. The ACP-ASIM continues to establish and promote the highest clinical standards and ethical ideals; to be the foremost comprehensive education resource for all internists, including those who practice in medical subspecialties; to advocate responsible positions on individual health and on public policy relating to health care; to serve the professional needs of our membership and advance internal medicine as a career, and to recognize individual excellence and distinguished contributions to internal medicine.

Examples of the ACP-ASIM constancy abound and are evident in this newsletter. The leadership of the Utah Chapter ACP-ASIM will change in an orderly fashion. The format of the Utah Chapter Scientific Meeting changes; but the core values and mission of the ACP-ASIM remain constant. This is important. As a society and as an organization we should always look to our core values in times of change and hold on to what is good. I believe the ACP-ASIM is one organization that has held on to important core values and will continue to do so.

ANNUAL SCIENTIFIC MEETING OF THE UTAH CHAPTER, ACP-ASIM

Are you up-to-date on the evaluation and management of patients with congestive heart failure; and the health issues of peri-menopausal/menopausal women? If not you will want to join us at the Utah Chapter Annual Scientific Session on Thursday, September 21, 2000, at the SL Marriott University Park Hotel.

The Program Committee, chaired by Steven Towner, MD, FACP, has created an innovative scientific program with short scientific presentations by Jeffrey Anderson, MD, FACP, and Dale Renlund, MD, on the evaluation and management of congestive heart failure. Drs. Anderson and Renlund will then join in an interactive panel discussion. A second session will feature William Odell, MD, MACP, and Mary Beard, MD, who will address the health issues of peri-menopausal/menopausal women.

The Utah Chapter is fortunate to have David J. Gullen, MD, FACP, Immediate Past Chair of the Board of Regents, ACP-ASIM, as our guest and official College Representative. Dr. Gullen will provide an update on college initiatives and activities and he will be available to participate in our Annual Business Meeting. The afternoon will again feature highly interactive clinical skills breakout sessions. Participants will hone their skills for cardiac, endocrine, orthopedic, and dermatologic examinations and procedures.

Mark your calendar now, and plan to join us. Thursday, September 21, 2000 SL Marriott University Park Hotel For questions, please contact Beth Bush at 801-408-1875 or ldbbush@ihc.com.

UTAH CHAPTER CHOOSES
MARTIN GREGORY, MD, FACP

Martin Gregory, MD, FACP, is the Governor-Elect for the Utah Chapter of the ACP-ASIM. Martin has practiced and taught internal medicine at the University of Utah Health Sciences Center for the past 18 years. He also has served the Utah Chapter of the ACP-ASIM steadfastly for the past 15 years. He brings a strong commitment to serve Utah internists and their patients to his new role as Governor-Elect. Martin will assume the responsibilities of Governor in March of 2001.

ASSOCIATES

The Associate members of the Utah Chapter, ACP-ASIM, held their Annual Meeting on May 12th, at The Point Restaurant & Reception Center. Brent Petty MD, Associate Professor of Medicine, Johns Hopkins School of Medicine, was the guest speaker. Dr. Petty addressed the "Legacy of Sir William Osler." More than 15 Associates entered the Annual Clinical Vignette Competition. Three abstracts were chosen for oral presentation at the meeting. Congratulations to Dr. Michelle Zebrack, recipient of the Annual Associates Clinical Vignette Competition prize; and to all who participated for their hard work. Dr. Aya Kamaya, Dr. Timothy Lahey and Dr. Michelle Zebrack, made oral clinical vignette presentations.

Congratulations also to Annett Bosworth, MD, who presented at the ACP-ASIM Annual Scientific Session held in Philadelphia, April, 2000. Her poster "Anemia Secondary to Massive Pinworm Infection" was well received. Annette stated that she had a great experience at the Annual Session. She reported after the meeting that if she can attend one meeting each year it will be the ACP-ASIM Annual Session.

The Associates Committee with Steven Horton, MD, as Chair, aims to organize and promote activities for Utah Associates of the ACP-ASIM. We appreciate the efforts of Scott Stevens, MD, and Kurt Besch, MD. Kurt will enter the practice of general internal medicine in Tampa, Florida. We welcome John Joeppe, MD, Dane Sobek, MD, Gunnor Strobel, MD, and Suresh Khandekar, MD, current Chief Medical Residents in the University of Utah affiliated internal
medicine residency program; and Shawn Speirs, MD, Chief Medical Resident at the LDS Hospital.

HEALTH and PUBLIC POLICY

Ken Buchi, MD, FACP, Chair, Utah Chapter

Contact Your Legislators Through the Legislative Action Center

To make participation in grassroots advocacy easier for its members, ACP-ASIM established a Legislative Action Center (LAC), which may be accessed from ACP-ASIM Online. The LAC allows you as an ACP-ASIM member to view the most current ACP-ASIM Legislative Alerts, find out who your federal legislators are, and send e-mails or faxes to your members of Congress. It also provides you with the status of key legislative issues of concern to ACP-ASIM, Congress' schedule, and tips on communicating with your legislators. ACP-ASIM encourages you to try the LAC by sending an e-mail to your members of Congress in response to the current Legislative Alert posted on the LAC.

You can access the Legislative Action Center through the "Where We Stand" section of ACP-ASIM Online, or by going straight to the LAC. To send a message to Congress, you are prompted for your zipcode and are zip-matched to your federal legislators. You will then be asked for your name and address (so that congressional offices can identify you as a constituent.) ACP-ASIM encourages you to send a message based on the sample message posted for you, with your own personal anecdotes added.

If you have any questions about the LAC or ACP-ASIM's Key Contact program, please contact Jenn Jenkins, Associate for Grassroots Advocacy, at jjenkins@acponline.org, or 800-338-2746, ext. 4536.

News Briefs for the Internist

  • The Medicare physician fee schedules year 2000 conversion factor is $36.6137 (a 5.4% boost).
  • Medicare now pays for annual screening digital rectal exams and PSA assays for men over age 50. Use code 60102 for DRE and 60103 for PSA.
  • Medicare no longer pays for pulse oximetry.

Institute of Medicine (IOM) Report: To Err is Human and the Response of the ACP-ASIM

Two large studies, one conducted in Colorado and Utah, and the other in New York found that adverse events occurred in 2.9 and 3.7 percent of hospitalizations. In the Colorado and Utah Hospitals, 8.8 percent of adverse events led to death; and over half resulted from medical errors. This data suggest that at least 44,000 Americans die annually as the result of health care system errors. In response to this data, a series of recommendations were made to improve the safety of our hospitals over the next ten years. Prominent recommendations include:

  1. Establish a nationwide mandatory reporting system(s) that collects information about adverse events that result in death or serious harm.
  2. Set national goals for patient safety and track progress in meeting these goals. The ACP-ASIM supports the recommendations of the IOM, provided that the goal is to enlist physicians, nurses, hospitals, and other providers in a concerted drive to prevent major errors. For additional information on this important topic, please see www.acponline.org.

AWARDS

The Awards Committee under the chairmanship of Darrell Hensleigh, MD, seeks to identify recipients for three major chapter awards. .

Laureate Award Award recipients are Fellows or Masters of the ACP-ASIM who have demonstrated, by their example and conduct, an abiding commitment to excellence in medical care, education, or research, and in service to their community, their chapter and the ACP-ASIM.

Past recipients of the Laureate Award are: (1985) John H. Holbrook, MD, FACP; (1986) Drew M. Petersen, MD, FACP; (1987) James Rex Miller, MD, FACP; (1988) Wallis Craddock, MD, FACP; (1989) C. DuWayne Schmidt, MD, FACP; (1990) John R. Ward, MD, FACP; (1992) Kenneth J. Nielson, MD, FACP; (1993) Merrill Daines, MD, FACP; (1994) M. Paul Southwick, MD, FACP; (1995) David W. Richards, MD, FACP; (1996) Carlyle F. Stout, MD, FACP; (1997) H. James Williams, MD, FACP; (1998) C. Basil Williams, MD, FACP; and (1999) Thomas H. Caine, MD, FACP.

Volunteer Medical Service Award Award recipients must be members of the Utah Chapter, ACP-ASIM, who have distinguished themselves as providers of voluntary medical services. Volunteer service as part of the training or teaching requirements does not qualify.

Past recipients are: (1998) James Rex Miller, MD, FACP; and (1999) Henry Rosado-Santos, MD.

C. DuWayne Schmidt Chapter Service Award This award recognizes a member of the Utah Chapter ACP-ASIM who has enhanced the chapter through a high level of service. The recipient typically does far more that is expected to assure excellence in chapter activities.

Past recipients are: (1998) Peter Kaboli, MD; and (1999) Scott Stevens, MD.

MEMBERSHIP

Membership in the Utah Chapter has grown. The Membership Committee (Beth Hanlon, MD, FACP, Chair; Hanadi Farukh, MD, FACP; Steph Silas MD) seeks to identify candidates for membership, fellowship and mastership. If you or someone your know should advance, please contact a member of the committee or complete the questionnaire on page 11.

Advancement from Membership to Fellowship

"How do I advance from Membership to Fellowship?" is a question frequently asked by you, the ACP-ASIM members. Below, is a summary of the requirements and pathways that a
candidate must fulfill and/or meet in order to become a Fellow of the College.

Requirements:

  • be certified by the American Board of Internal Medicine, the Royal College of Physicians and Surgeons of Canada or the American Osteopathic Board of Internal Medicine;
  • have been a member in good standing for two years in either ACP or ASIM and have held a position in practice or in academia for at least two years since completion of training;
  • have an active medical license in good standing (if in clinical practice);
  • have confined professional activity to internal medicine or a subspecialty of
    internal medicine;
  • be proposed and seconded with detailed letters of support from two current Masters or Fellows with reference to character, ethics and medical activities, and outlining professional contributions and accomplishments;
  • be endorsed by the appropriate ACP-ASIM Governor;
  • have shown continuing scholarship and professional accomplishments; and
  • document continuing professional activities, including teaching (both institutional and community-based); hospital committee work; public service and community activities; and participation in continuing medical education activities as both a student and teacher.

Pathways The College has established four Pathways that serve as guidelines to qualify for Fellowship. For each of the following pathways, the candidates must meet the basic requirements listed above.

Pathway 1: Members must have demonstrated skill in written medical communication.

Pathway 2: Members must have significant and continuing certification activities and/or teaching (both institutional and community-based), and/or community activities that indicate professional achievement and scholarship; they must have under gone recertification, or they must have participated in the Medical Knowledge Self-Assessment Program (MKSAP) with a passing score. In addition, subspecialty certification or certificates of special competence in adolescent medicine, critical care medicine, clinical cardiac electrophysiology, geriatrics, or sports medicine can qualify a candidate for this pathway, but are not adequate by themselves.

Pathway 3: Members must have been active members in ACP or ASIM for at least 10 years, with substantial participation in programs and activities, as well as demonstration of other professional accomplishments. Note: Outstanding candidates who have been active Members for fewer than 10 years may qualify by combining Pathways 1 and/or 2 with Pathway 3.

Pathway 4: Members must have distinguished professional activity in teaching, patient care or professional service over many years. Candidates must document each pathway; however, a candidate may be accepted without fulfilling one pathway if his/her work in other pathways is deemed outstanding by the Credentials Committee. For a complete copy of the "Requirements for Advancement from Membership to Fellowship" and/or an advancement to Fellowship proposal, contact your local College Governor or call ACP-ASIM Customer Service at (800) 523-1546, ext. 2600. The "Requirements for Advancement from Membership to Fellowship" can also be found on the College's Web site.

MEDICAL STUDENTS

Michael Battistone, MD, ChairThe Education and Career Development Department is pleased to announce the release of MKSAP for Students. In creating this product, the College has partnered with the Clerkship Directors in Internal Medicine to create a useful educational tool for 3rd and 4th year medical students. We have chosen to model it after the highly successful Medical Knowledge Self-Assessment Program (MKSAP) for internal medicine physicians. MKSAP for Students consists of a printed collection of nearly 400 patient-centered, self-assessment questions and their answers. The questions begin with a clinical vignette, and the vignettes are organized into 28 different categories that correspond to the Core Medicine Clerkship Curriculum Guide "Training Problems." The retail price for MKSAP for Students is $32.50, making the publication very competitive against other, lower quality books of this type. It can be purchased at medical school bookstores or by ordering through the ACP-ASIM Customer Service at 800 523-1546, ext. 2600.

UP-TO-DATE (HealthInsight)

Adult immunization: Estimates suggest that 40,000 Americans die from vaccine preventable pneumococcal or influenza infections, yet only one in two senior citizens have received pneumococcal vaccinations (and two of three senior citizens have received influenza vaccinations).

HOW THE "DOCTORS FOR ADULTS"
CAMPAIGN CAN WORK FOR YOU

ACP-ASIM's national public relations and ad campaign is reaching literally millions of Americans, telling them an internist is a "Doctor for Adults" Does your community know you are a "Doctor for Adults?" Here are five easy ways to put the campaign to work for you.

1. Introduce Yourself as an Internist Whether you're a generalist or a subspecialist, take a minute to tell your patients you are an internist and ask them if they know what that means. You might be surprised at their answers, but it's a quick and relaxed way to let patients know who you are a "Doctor for Adults." One easy way to clear up confusion is to distinguish yourself from general practitioners or family physicians, whose practices may include surgery, obstetrics and pediatrics, and whose training is not solely concentrated on adults. If you subspecialize, you'll want to explain that you chose additional training to specialize in one of the complex medical areas of interest that come under the internal medicine umbrella. When speaking publicly, publishing or responding to questions from the media, be sure to
identify yourself as an internist.

2. Hand Patients a Brochure Order your free sample copy of the College's "Doctors for Adults" patient brochures. One such brochure, Where We Fit in Today's Primary Care Picture, distinguishes internists from other primary care physicians and tells how we care for the whole patient. A new brochure, 100 Million Adult Americans Are Overweight and at Risk of Serious Disease, supports the College's 1998-99 national campaign to alert Americans to the risk of overweight/obesity and explains the role of internal medicine. There's space on the back to stamp your name and address in case your patients' friends or relatives want to see you.

3. Wear Your Badge and Patches For as little as $2 you can outfit yourself with a badge and 10 iron-on white-coat patches. They will instantly identify you with the national "Doctors for Adults" program, showing your patients at a glance who you are. And they might open the door to a quick chat with your patients about what an internist is and does. Many members are also outfitting their staffs with Campaign Polos or T-shirts to wear on office "casual days." Check out the growing line of "Doctors for Adults" merchandise and educational materials in the ACP-ASIM Observer, or in the 1999 College catalog, Resources for Internists.

4. Enlist Your Staff Does your office staff know the short answer to the question, "What is an internist?" Tell them about the "Doctors for Adults" campaign and take them through the Where We Fit brochure, so they can easily and accurately engage patients, explaining what distinguishes an internist from the other primary care physicians.

5. Use the Campaign Logo The "Doctors for Adults" logo is being registered in the name of the College for the exclusive use by members and associate members. The more you utilize it, the more closely you will be linked with our national public education campaign, which is telling literally millions of Americans, "We're Doctors for Adults." The logo is available at the following link. For additional information on the College's "Doctors for Adults" campaign, log on to www.doctorsforadults.com.

HOW TO REACH US

C. Gregory Elliott, MD, FACP
Chief, Pulmonary Division
LDS Hospital
Eighth Avenue and C Street
Salt Lake City, UT 84143
Phone: (801) 408-1875;
Fax: (801) 408-1671
E-mail: ldgellio@ihc.com

or


Beth Bush
(same information as above)
E-mail: ldbbush@ihc.com