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Governor's Newsletter, Winter 2000/2001

C. Gregory Elliott, MD, FACP
Governor, Utah Chapter

From Your Governor

Four years have passed rapidly, and it is time for my off-service note. I believe the ACP-ASIM remains the foremost professional organization for internists. Through my service as Governor, I have developed a greater appreciation for the national leadership of this organization. The leadership is strong, and they are supported by an organization rooted in the democratic process. The organization's mission and core values are right and worthy of support of the membership. Indeed this is an organization that looks actively to its membership for direction.

Locally, the chapter has thrived. The annual scientific meeting has attracted practicing internists, associate members and medical students in spite of much competition for the time of these busy professionals. The program has been energized by the participation of expert faculty, practicing internists (who bring a wealth of experience and the all important need to know), associates who participate in a scientific poster competition and medical students, eager to learn more about the practice of internal medicine. Membership has grown and the associates have remained very active. The annual associates meeting has complemented the annual scientific meeting by placing the focus on associates and associate issues. The chapter has chosen Laureate awardees from the community, as well as from academic settings. Each recipient has brought honor to the award, just as the award has honored them. In addition, the chapter has developed two new awards - the DuWayne Schmidt Distinguished Chapter Service Award, and the Utah Chapter ACP-ASIM Volunteerism and Community Service Award

Organizationally the chapter has moved to the next level. The merger of ACP-ASIM is complete and the chapter is incorporated as a 501 c3 organization. The committees are organized such that each member serves for three years, and as chairperson and a member of the Governor's Council during the third year. This structure should aid leadership development.

None of this could have been accomplished without the support of a number of committed individuals. I wish to thank publicly all of you for your support. I know that my successor will be the beneficiary of the continued commitment of our members. I especially want to thank my administrative assistant, Beth Bush, for her tireless work on behalf of our chapter.

Thanks and congratulations to our outgoing committee chairs for their outstanding service. They are:

Jeff Anderson, MD, FACP- Nominations
Steven Towner, MD, FACP- Scientific Program
Beth Hanlon, MD- Membership
Ken Buchi, MD, FACP- Health and Public Policy
Darrell Hensleigh, MD, FACP- Awards
Steve Horton, MD, FACP- Associates.

Annual Scientific Meeting

The Annual Scientific Meeting was held September 21, 2000, at the University Park Hotel. More than 100 members, associate members and medical students attended. The program focused upon the management of congestive heart failure and medical issues related to menopause. Jeff Anderson, MD, FACP, presented a critical appraisal of the scientific evidence for each aspect of treatment. He emphasized the role of ACE inhibitors and beta blockers. Dale Renlund, MD, FACP, followed with a practical overview and then joined Dr. Anderson to answer questions. After a break, Mary Beard, MD, provided a gynecologist's perspective on issues of health related to the menopause and Bill O'Dell, MD, MACP, provided a thorough evidence based review of managing disease related to the menopause. Drs. Beard and O'Dell joined to respond to questions and comments from the audience.

The associates poster competition included three posters in the fellow category and four posters in the resident category. James Zebrak, MD, garnered the prize in the fellow category for his work titled "Elevated CRP Predicts Mortality or Myocardial Infarction in Unstable or Stable Angina, But Not After Acute Myocardial Infarction," and Tim Lahey, MD, received top honors in the resident category for his poster "Fevers in a Transplant Recipient: Infection, Cancer or Both?" Congratulations to all participants for this exciting part of the program.

A luncheon business meeting focused upon the good health of our chapter and the programs and projects of the ACP-ASIM. Dave Gullen, MD, MACP, presented the keynote address in which he emphasized the College's continued advocacy for patients and their physicians.

The afternoon featured small workshops where physicians and students honed their skills with lower extremity examinations, thyroid examinations and rheumatologic examinations. These sessions featured patient partners who provided feedback related to the examination and physical findings. Another small group session gave participants practical instruction on the treatment of warts.

The Program Committee, led by Barry Stults, MD, has already planned the next scientific meeting. So mark your calendars now and plan to join us Friday, September, 21, 2001, at the University Park Hotel.

Awards

Warm congratulations to the following awards recipients during our recent Chapter Annual Scientific Meeting:

Laureate Award - Jeffrey L. Anderson, MD, FACP

Jeffrey L. Anderson is a native of Utah, where he was born in Salt Lake City. He received his education at the University of Utah, Harvard Medical School, Massachusetts General Hospital, NIH, and Stanford University after which he was appointed an Assistant Professor at the University of Michigan. In 1980 he returned to Utah where he joined the faculty of the University of Utah School of Medicine and became the Director of the Coronary Care Unit at the LDS Hospital. He advanced to become a Professor in the University of Utah School of Medicine and was Chief of the Division of Cardiology at LDS Hospital from 1984-1998. He left Utah to become the Executive Director for Cardiovascular Clinical Research at Merck Research Laboratory in Pennsylvania. He returned to Utah last year as the Chief of the Division of Cardiology at the University of Utah School of Medicine.

His research interests have been in the field of cardiac arrhythmias and in the areas of anticoagulation and thrombolysis in coronary ischemic diseases. He has authored over 230 peer-reviewed articles as well as numerous invited publications and reviews. He has written approximately 60 book chapters or monographs and one book.

Jeff served as Governor for the Utah Chapter of the ACC from 1984 to 1988, and he was President of the Utah Affiliate of the AHA From 1986 to 1987. He is the immediate past Governor for the Utah Chapter of the ACP-ASIM, having served from 1993-1997.

Jeff is married to the former Kathleen Tadje, they have three children. He is a fine violinist. Golf and running are two of his hobbies. He also enjoys traveling with his family.

Volunteerism and Community Service Award - Kristen M. Ries, MD, FACP

Kristen M. Ries is a native of Philadelphia, Pennsylvania. Her undergraduate education was obtained at Pennsylvania State University, and Women's Medical College of Pennsylvania. She was an Instructor in Medicine during her fellowship and then was appointed as an Assistant Professor of Medicine at the Medical College of Pennsylvania for three years before she moved to fill a similar role at the University of South Dakota for four years. In 1981 she moved to Salt Lake City where she entered private practice and became a clinical faculty member of the University of Utah School of Medicine with adjunct appointments in Health Education and Foods and Nutrition at the University of Utah. In 1994 she was recruited to the full-time faculty of the Division of Infectious Diseases where she is a Professor in the clinical track. She is the Director of Clinical Programs for the division and is responsible for the teaching in the infectious Disease Clinic.

Kristen is a dedicated and compassionate physician. She was among the first to reach out to those with HIV infection and still directs the care for the majority of these patients in Utah. Acknowledgement of her humanistic and compassionate approach to patient care and to her untiring efforts to serve the community has come from numerous awards she has received.

Dr. Ries is an example to all of a physician who places great emphasis on the care and welfare of her patients and who is willing to dedicate herself to improving the community.

DuWayne Schmidt Distinguished Chapter Service Award- C. Gregory Elliott, MD, FACP

Greg Elliott is a native of the State of Maryland having been born in Towson. His undergraduate work was completed at Brown University in Rhode Island. He completed his M.D., internship, residency, and chief medical residency at the University of Maryland School of Medicine in Baltimore, Maryland. His pulmonary fellowship was completed at the University of Utah School of Medicine. He is board-certified in Internal Medicine and Pulmonary Diseases. In 1980 he was recruited back to Salt Lake City where he became an Assistant Professor of Medicine at the University of Utah School of Medicine and the Medical Director of Respiratory Care at LDS Hospital. He is currently a Professor of Medicine at the University of Utah School of Medicine and Chief of the Pulmonary Division at LDS Hospital.

His research and patient care focus is with pulmonary hypertension and pulmonary vascular diseases. He has authored over 70 peer-reviewed articles, as well as numerous invited publications and reviews. He has also written 20 book chapters.

Greg is currently serving as Governor, for the Utah Chapter of ACP-ASIM. His term will end March, 2001. Along with his Utah Chapter responsibilities, he has also served as Chair of the Board of Governors Chapters Subcommittee.

He is married to the former Anne Bratt, they have three children. He enjoys the game of golf, bicycling, and cross country skiing.

Membership

Membership in the Utah Chapter continues to grow. This past quarter we added 12 new members and 11 associate members.

Welcome to the following new Members:

Michael L. Barnum, MD
Greta L. Branford, MD
Andrew T. Coletti, MD
Laura Davenport, MD
Michal Kolda, MD
Michael J. Lahey, MD
Clara P. Meysenburg, MD
Jonathan R. Nebeker, MD
Bryan Nelson, MD
Michael Skokan, MD
Agnieszka M. Szpunar, MD
Kevin W. Tschetter, MD

Welcome to the following Associate members:

Julie Bauman, MD
Patricia M. Buersmeyer, MD
Christopher R. Drysdale, MD
Amelia G. Fitzpatrick, MD
Chan M. Gonzales, MD
Christopher J. Goulet, MD
Launce G. Gouw, MD
Brian W. Hughes, MD
Alan G. Kelton, MD
Curry L. Koening, MD

Pathways

The College has established four Pathways that serve as guidelines to qualify for Fellowship.

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

Pathway 2: Members must have significant and continuing certification 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.

Elections

The Utah Chapter will elect a new Governor, as well as ten council members. Martin Gregory, MD, FACP, vacated the position of Governor-Elect in order to take a position out of state. Utah ACP-ASIM is fortunate to have a strong leadership base upon which to draw. Larry V. Staker, MD, FACP and H. James Williams, MD, FACP are candidates for Governor. Their personal vision statements for the chapter appear below. Utah ACP-ASIM bylaws (newly adopted after the merger of ACP-ASIM) call for election of the Governor's Council, which consists of the chairpersons for six committees, a secretary, a treasurer, and two at large council members.

Statement of Larry V. Staker, MD, FACP

Internal Medicine faces a crisis of identify that threatens its very existence. There is a need for leadership to stem the tide of erosion we see around us: leadership beyond providing CME tools and programs; leadership, which reaches effectively into legislative bodies, boardrooms, and the lives of physicians and their patients. First, we need unification of town and gown. Only as we create a unified voice of internists will we see that we once again attract the very best into medicine. Second, we must enable practice-based learning for improvement with measurement of outcomes providing definitively the value of our service. Third, we need someone who hears our voice, advocates our position, mediates our cause and gives us hope. My experience in practice, on faculty, in administration, in practice-improvement and in health-plan leadership gives a broad perspective, which I am willing to dedicate to creating a new day for internal medicine.

Statement of H. James Williams, MD, FACP

I have great interest in patient care and in student/housestaff education. The Utah Chapter has been an increasing positive influence in the medical school and I would hope to continue this involvement and increase the interest of medical students in the practice of internal medicine and its subspecialties. Many patients are concerned with managed care, and we need to assure that patients feel not only well cared for medically but also well cared for as individuals by concerned and compassionate physi- cians. The Utah Chapter of the ASP-ASIM should provide for collegial interactions but also provide a mechanism for internists as a group to respond to various societal and governmental forces.

Current Members of the Utah Chapter Committee

Health and Public Policy

The ACP-ASIM continues to advocate for access to care. The explicit goal is to provide all Americans with adequate health insurance by a target date. The College contends that federal budget surpluses should be invested to expand health coverage to the uninsured, and provide portable benefits to all. The college has authored a key position paper- "No health care, it's enough to make you sick," that describes the adverse health consequences of inadequate health insurance and points out that the vast majority of uninsured Americans work.

The ACP-ASIM also advocates for consumer protection from formularies administered by pharmacy benefit managers. In particular, the College is concerned when restrictive formularies hinder access to beneficial medications.

The ACP-ASIM has criticized HCFA's interim rules on the use of restraints. The College is especially concerned that HCFA has overstepped its bounds with the requirement for a face to face physician assessment within one hour.

Board Of Governors Fall Meeting

ACP-ASIM Resolution Process

ACP-ASIM Members may initiate a resolution addressing any issue or topic by submitting it to their Governor and/or Chapter Council. A resolution becomes a resolution of the chapter once the Chapter Council approves it. Members interested in researching the College's position on an issue prior to submitting a resolution may access this information in the "Where We Stand" section of ACP-ASIM online at www.acponline.org/home/policy.htm. In accordance with the College's resolution process, resolutions should clearly distinguish the action requested within its resolved clause(s) as either a policy resolve or a directive requesting action or study on an issue.

New resolutions and recommendations for follow-up are acted upon by the Board of Governors and presented to the Board of Regents. Once the Board of Regents accepts recommendations, resolutions are either adopted as policy or forwarded to College staff and/or committees for study and/or implementation.

Two Resolutions Passed at the Fall Board of Governors Meeting

Resolve, that the Board of Regents amend the ACP-ASIM bylaws to permit Associates after two years of Associate membership to have the same voting privileges as afforded Members, Fellows, and Master.

Resolve, that the Board of Regents continue to urge HCFA to reinstate Medicare coverage for portable oxygen saturation testing done in physician offices.

Recertification and the ACP-ASIM

The time limited certificates of board certification call for recertification. The ABIM (a separate organization from the ACP-ASIM) administers recertification. At the recent Board of Governors meeting, the Governors offered a number of concerns about the current recertification

process.

For Your Calendar

ACP-ASIM Annual Sessions:
2001- March 29-April 1, Atlanta, GA

2002- April 11-April 14, Philadelphia, PA

2003- April 3-April 6, San Diego, CA

Utah Chapter Scientific Session:
2001- Friday, September 21, University Park Hotel

In Memoriam

Donald E. Smith, MD, FACP, died at home on July 10, 2000 of cardiac failure. He was born January 5, 1920 in Honolulu, Oahu, Hawaii, the son of Mary Huskinson Smith and Elias Wesley Smith, Sr. He married Alice Barratt in the Salt Lake Temple on December 29, 1941.

Dr. Smith received an M.D. degree from Washington University, St. Louis, Missouri in December 1943. He then served an internship at Presbyterian Hospital, Chicago, Illinois. He later completed a Fellowship in Internal Medicine at the Mayo Foundation, Rochester, Minnesota. He received an M.S. in Internal Medicine form the University Minnesota in 1949. Dr. Smith also served as a Captain in the U.S. Army Medical Corps during World War II.

Dr. Smith was a member of the American Medical Association, Utah State and Salt Lake County Medical Associations. He was also a member of the American Society of Internal Medicine and a Fellow of the American College of Physicians. He served as the Utah Governor for that organization from 1972 through 1977.

News Brief for ACP-ASIM Members

Now available for you, the physicians' edition of Medicare & You 2001 (the Medicare handbook.) This is the national edition of the Medical handbook, and many physicians have asked that Medicare provide this publication to them; to better understand what benefit information their patients are receiving. The publication is revised each year to reflect changes in benefit coverage and payment.

To receive your free copy of this publication, call 1-800-MEDICARE (1-800-633-4227) and ask for your copy of the physician's edition of Medicare & You 2001.

Current Members of the Utah Chapter Committees

Scientific Program Committee
Barry Stults, MD - 2001
Lisa Kurahara, MD, FACP - 2002
Thomas Knecht, MD, FACP - 2003
(Associate)

Membership Committee
Steph Silas, MD - 2001
Hanadi Farrukh, MD - 2002
Dan Davis, MD - 2003

Nominations
C. DuWayne Schmidt, MD, FACP - 2001
Greg Schweitzer, MD, FACP - 2002
Greg Elliott, MD, FACP - 2003

Health and Public Policy
Kevin McCusker, MD, FACP - 2001
Roy Gandolphi, MD - 2002

Awards
Thomas Caine, MD, FACP - 2001
Kent McDonald, MD, FACP - 2002
Associate)

Governor's Council
Jeff Anderson, MD, FACP, at large
Michael Battistone, MD, Medical Students
Thomas Caine, MD, FACP, Awards
Corwin Edwards, MD, FACP, Associates
Lisa Kuwahara, MD, FACP, Treasurer
Kevin McCusker, MD, FACP, H & PP
C. DuWayne Schmidt, MD, FACP, Sec.
Steph Silas, MD, Membership
Greg Schwitzer, MD, FACP, at large
Barry Stults, MD, Program

Medical Students
Michael Battistone, MD - 2001
Jim Williams, MD, FACP - 2002
Chief Medical Residents (Associates):
John Koeppe, MD
Dane Sobek, MD
Shawn Speirs, MD

Associates
Corwin Edwards, MD - 2001
Mike Strong, MD - 2002
Chief Medical Residents:
Shawn Speirs, MD
Dane Sobek, MD
John Koeppe, MD

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