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June 2010
| Carrie A. Horwitch, MD,
MPH, FACP, Governor
 "It was the best of times, it was the worst of
times; it was the age of wisdom, it was the age of foolishness; it was the
epoch of belief, it was the epoch of incredulity..." - Charles Dickens: A Tale of Two Cities
Reading that quote by Dickens in the book A
Tale of Two Cities, I am struck by how appropriate those emotions are
today as we look at the hopefulness of the recent health care reform law and
the utter failure to make any reasonable headway in repealing the Medicare
SGRs.
Congress and the Senate recently failed to support
legislation to prevent the upcoming 21% cut in Medicare reimbursement. Two weeks ago the House and the Senate were
prepared to offer legislation providing at least stable Medicare updates
through 2014. While ACP is still
advocating for a permanent repeal of the SGRs, at least a 3-5 year framework
would avoid the monthly (and more recently weekly) voting to freeze the SGR
cuts. At the recent Leadership Day on
May 19th we met with all of our state's representatives and senators
(or their legislative assistants), and both parties seemed to be in agreement
that a longer term solution for the Medicare SGR was needed.
It was very disappointing to learn just last week that once
again no long term solution was passed. It
was politics as usual in D.C., much to the devastation to our profession, and
more importantly to our patients.
What will come of this latest fiasco won't be known until Congress
comes back on June 1 after the holiday recess. Hopefully our leaders in Washington D.C. will focus on wisdom and doing
the right thing for our country on this issue. What can we do as ACP members, internists, hospitalists,
and subspecialists? We can voice our concern
to our congressperson and our senators. Please take the time to contact them directly and let them know how
these cuts will affect your ability to care for an increasingly aging population
in our state. If you need information on
what the latest issues and outcomes are, please go to: www.acponline.org for more information.
Some of my goals as Governor of the Washington state chapter
of ACP are to increase member awareness of key advocacy issues, expand our
chapter activities including activities for young physicians, associates,
students and physicians in their mid-career or later and continue ACPs
excellent educational endeavors.
The Washington
chapter executive council and I are here to represent you. We are open to your suggestions for
activities, any comments, and, of course, your participation. To better understand your needs, we have sent
members a very brief survey. If you have not already done so, please
complete this survey so we can be informed as to your needs as members and
associates of ACP.
If you have any questions or want to be more involved please
contact Jan Larsen at jal@wsma.org or myself at carrieho@comcast.net. Thank you.
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Leadership Day 2010
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On May 19, 2010, ACP member internists (including primary
care, hospitalists and subspecialists) went to Washington D.C. to meet with our
congressmen and women and our senators to continue to work on bipartisan
support for policies to ensure patients' access to health care and control
cost. This year we had nine participants
from Washington state (shown in photo below).
We were able to meet with all of our nine house representatives and our
two senators (or their legislative assistants).
Our priorities for this Leadership Day were to ensure
adequate appropriation of funding for key portions of the new health care law
(Patient Protection and Affordable Care Act). First, we are urging support for legislation
to end the cycle of Medicare physician payment cuts and move to a new system
that reflects the increases in practice costs and need to cover primary care
and preventive services. Second, we need
to ensure adequate primary care physicians and other specialties facing
shortages in the near future. To make
sure that implementation of the PPACA does not exclude primary care doctors who
also see patients in the hospital. Expand primary care training and community-based programs; establish new
loan forgiveness programs to each student debt repayment. Third, we want to
promote broad adoption of the Patient Centered Medical Home (PCMH). Washington state is fortunate to have several
PCMH pilot projects that have been successful in lowering cost, improving
quality of care and enhancing the work environment.
There are many other issues that ACP is involved with as
well and we welcome your input. One way
to better impact our political leaders is by becoming a Key Contact of the ACP.
If you are interested please go to the following link to
sign on: http://capwiz.com/acponline/mlm/signup/
Chapter Members meet with Congressman McDermott at Leadership Day 2010
Standing left to right: Bruce Smith, Dennis Rochier,
Sandeep Sachdeva, Congressman Jim McDermott, Carrie Horwitch, Christine
Palermo, Hugh Maloney, George Merriam
Seated: Sunita Mishra, Birdie Ehlen |
Member Accomplishments
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Key Contact Award
Congratulations to Bruce Smith,
MD, FACP who received the Key Contact award as one of the College's top ten
Key Contacts. The Key Contact Award program was implemented to recognize
individuals who have made exceptional efforts in response to legislative
requests. Dr. Smith has made exceptional
efforts in support of the chapter's state and federal advocacy programs
throughout the past year. He is also a member of the Washington state ACP
Executive council, the Medicare Advisory Liaison and our Advocacy specialist on
the council.
Associates Clinical Vignette Poster Winner at
Internal Medicine 2010
Congratulations to Leslie Jett,
MD. Leslie is one of ten winners of the 2010 ACP Associates Clinical
Vignette Poster Competition for "Cryptogenic Elevated Shunt Fraction in a
Patient with Hereditary Hemorrhagic Telangiectasia". Leslie is a resident
in the Madigan Army Medical Center Program.
Washington Associates
- National ACP Doctors' Dilemma Competition
At
the April 2010 National ACP Meeting, the associate medical jeopardy (aka
Doctors' Dilemma) team of Drs. Amber Taylor, Deepthi Mani, and Naveed Quadeerfrom Spokane, WA, were narrowly defeated by an Army team. The ultimate
winner of the three-day competition was the team representing Northern
Illinois. Thank you to all of the Washington ACP members who helped to
cheer on the Spokane team. They represented our state well. The
ongoing saga of associate medical jeopardy will continue again at the
Washington state November 4-6th ACP Scientific meeting this
year. Hope to see you there.
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Save the Date! Washington State ACP Scientific Meeting Nov. 4-6, 2010
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By
Co-Chairs, Sandeep Sachdeva MD FACP, and Michael Soung MD FACP
Be sure to join us for this year's chapter meeting. It promises to deliver
another great program with excellent presenters and topics. - Enhance
your clinical knowledge and skills
- Earn
CME credit
- Network
with colleagues
Highlights
Pre-course
programs on behavioral medicine and hospital medicine Associates'
activities including oral presentations, poster presentations, Medical
Jeopardy, and a Board Review Course Updates
in key areas of inpatient and outpatient medicine Special
Interest Groups and Workshops Health
Care Reform update No
pharmaceutical support
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Young Physicians' Corner
| By Viral Shah MBBS, FACP, viralpandit@gmail.com
As
many of us have found out the hard way, life after residency comes with new
challenges - contracts and negotiation, licensing, malpractice, office
management, personal financial planning, leadership development and so on. I'm
happy to report that Governor Horwitch and the chapter's Executive Council will
be considering the formation of a Washington Council of Young Physicians
(WCYP).
Young Physicians are
tomorrow's leaders. The WCYP hopes to help bring out that hidden leader
in you. The WCYP will focus on educating our young members to make informed
decisions. I welcome your ideas and suggestions. Watch for updates
in "Young Physicians' Corner" in future chapter newsletters.
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Associates' Update
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On May 18 and 19, ACP Associates Drs. Catherine Birdie Ehlen
(University of Washington) and Christine Palermo (Virginia Mason Medical
Center), joined our Washington State delegation in Washington D.C. to
increase the College's presence on Capitol Hill and discuss our
issues of concern with U.S. lawmakers. In addition to increasing
awareness of topics ranging from the Medical Home, to reform of the
sustainable growth rate, and increased Medicaid reimbursement for
primary care, the event was also a great opportunity to learn more about
the legislative process and the tremendous and positive impact that
motivated and engaged physicians can have on advocacy efforts. Thank
you to our Washington State members who supported our delegation's trip.
And also a huge thank you to the veteran members in our delegation
for their mentorship. We definitely hope to increase our Associate
representation at upcoming Leadership Day events.
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Student Update
| By Russell Berg - Osler Club Events Coordinator
It's hard to believe the
school year is, once again, almost over. The Osler Club has continued to
provide UW School of Medicine students with programs that help them expand and
hone professional skills and to better understand the diverse field that is Internal
Medicine.
Dr. Moe Hagman helped us
put on our first program of the year, the Oral Case Presentation Workshop. Dr.
Hagman began with a brief presentation on the Do's and Don'ts of OCPs, and gave
a mock presentation to demonstrate the level of detail and pace expected from
medical students and residents. Almost a dozen residents from the Internal
Medicine program at UW accompanied Dr. Hagman and led small break-out groups,
where students could run through presentations they had prepared for ICM, and receive
feedback. Thank you Dr. Hagman, and all your wonderful residents for your time
and wisdom!
Our second program of the
year, held in April, was an Internal Medicine Physician Panel. There,
physicians from many of the Internal Medicine specialties talked to students
about their careers and the advantages and disadvantages of each of their
fields. Special thanks to all the physicians that helped with this program,
including Drs. Jordan Prutkin, Moe
Hagman, Irl Hirsch, Craig Pepin, Andy Luks, Wesley Van Voorhis, Michael
Ryan, Karen Stout and Ann Marie Kimball.
An essential
component of ensuring the continued success of the Osler Club is to involve new
students in the leadership of the Osler Club. This year, we are happy to
welcome three new members to the Osler Club Planning Committee: medical
students Katie Wysham, Olga Kochan and Monty Hawkins. All three have played
crucial roles in planning and executing our programs this year, and we look
forward to their continued involvement and leadership.
Finally, the Osler Club
would like to extend our gratitude to the Washington Chapter of the American
College of Physicians for their continued support. We believe that exposure to
Internal Medicine during the pre-clinical years of medical training opens students'
eyes to the many, and diverse, career paths Internal Medicine can offer.
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Welcome New Fellows
| Since February 2010
Donna L Beeson, DO FACP - Kennewick
Paul D Bunge, MD FACP - Olympia
Jeffery S Clarke, MD FACP - Wenatchee
George S Hammond, MD FACP - Everett
Robert C Hansen, MD FACP - Redmond
William Russell McMullen, MD FACP - Seattle
 New Fellows at
Convocation Internal Medicine 2010From left to right: Carrie Horwitch, Hugh Maloney, Nancy
Simon, Kathleen Davis, Sandeep Sachdeva, Viral Shah, George Steve Hammond,
Kenneth Onyali, Eduardo Margo |
Welcome New Members
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Since February 2010
Tauseef Afaq, MD - Seattle
Fizzah M Ali, MD - Kirkland
Dexter James G Asuncion, MD - Kelso
Bruce Bonsack, MD - Seattle
Christopher J Davis, MD - Burton
Alexander Kats, MD - Olympia
Charles Kotal, MD - Mount Vernon
Kim E Koyamatsu, MD - Bellingham
Rajasri D Palepu, MBBS - Lynnwood
Sarah E Rogers, MD - Seattle
Samantha Segal, MD - Colville
Nadia Toshani, MBBCh - Kennewick
Charlotte H Yeomans, MD - Spokane
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Call for Internist Award Nominations
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By Paul Smith MD
FACP, Chapter Award Chair, gimpas@vmmc.org; 206-920-5425
To recognize
the outstanding efforts of internists in our state, we need your nominations!
Click here to access a streamlined
electronic award nomination form.
Washington
state ACP chapter has three awards available for deserving internists in our
community.
Washington ACP
Internist of the Year
We seek to honor a community-based internist considered to
be a role model by his or her peers. Nominees should possess excellent clinical
skills, dedication to patients, enthusiasm for medical practice, leadership,
and the ability to maintain humanity and a healthy balance between professional
and personal interests that we can all strive to emulate. Internists who have
championed innovations in practice to promote healthy patient behaviors will be
given special consideration
ACP Community Service
Award
We seek to recognize an internist or group of internists who
have an exceptionally positive impact on their community through volunteer
activities
ACP Golden Apple
Award
We seek to honor volunteer teachers who have made a
substantial contribution to the education of medical or other health profession
students in his/her community. Balancing teaching with all the other demands of
our profession is an important contribution to the future of internal medicine.
Please take a few minutes to tell us who is deserving of recognition from their
colleagues. Awards will be presented at this year's Washington Chapter ACP Annual Meeting,
November 4-6 in Seattle, Washington.
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Calendar of Events
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September 17 & 18, 2010
What's
New in Medicine Meeting (Southeast WA)
Three Rivers
Convention Center
Kennewick, WA
Meeting Brochure
September 24 - 26, 2010
WSMA
Annual Meeting
Tacoma, WA
November 4-6, 2010
WC-ACP Annual Scientific Meeting
Bell Harbor International Conference Center
Seattle, WA
January 24, 2011
WSMA Legislative Summit
Olympia, WA
April 7 - 9, 2011
ACP Internal Medicine 2011
San Diego, CA
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Help Your Low-Income Patients Quit for Good
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New
Quit-Smoking Campaign Features Real People, Real Struggles to Quit
By Dr.
Maxine Hayes, Washington State Health Officer
During the past decade,
Washington has had tremendous success reducing tobacco use. Since the Tobacco Prevention and Control
Program began in 2000, our state has nearly 30 percent fewer adult smokers. That equals about 295,000 people leading
healthier lives.
Our toll-free Washington
State Tobacco Quit Line (1-800-QUIT-NOW; 1-800-2NO-FUME in Spanish) is one
reason we've been so successful at helping people quit. Calling the Quit Line is free and can double
the chances of quitting successfully.
Since the program began about 10 years ago, more than 125,000 people
have called for help.
The agency
recently created a multi-media "Dear Me" campaign to reach people from all
walks of life with messages designed to motivate them to quit smoking. The campaign features real smokers writing
letters to themselves about their addiction.
The "Dear Me" letters highlight the effect tobacco has had on the
writer's family, health, and livelihood.
The videos-which are honest and, at times, emotional-convey the real,
everyday struggle people go through when they try to quit tobacco.
To reach
more people from low-income backgrounds, the state's Medicaid program now
provides support to clients through the Quit Line. The benefit covers Quit Line services and the
cost of prescription medication, if appropriate.
Medicaid
reimburses physicians for smoking cessation referral visits, review of the Quit
Line's prescription medication recommendation, and prescription writing and
faxing. All patients have to do is call
the Quit Line at 1-800-QUIT-NOW to find out more.
Today,
many more people have quit smoking in Washington than there are current
smokers. As a health care provider,
you're in a unique position to help your patients quit tobacco - no matter
their income. By simply referring people
to the Quit Line, you can connect them with the support they need to quit.
The Tobacco Control Resource Center (www.tobaccoprc.org/TCRC/)
has online information. Just click on
"Tobacco Cessation and/or Quit Line Materials" to order Dear Me posters for your
office.
Additional
help for your patients who smoke is available at www.Quitline.com.
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Making the Case to Improve Immunization Rates Among Adults
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By Maxine Hayes, MD, MPH - Washington State Health Officer
It is
truly amazing how often adult immunizations are overlooked. Every year in the United States,
between 40,000 and 50,000 adults die from vaccine preventable diseases. As a
health care provider, it is important to make sure you know the latest adult
immunization schedule. Updates to the schedule happen every year.
The
world of immunizations is always in a state of change. Over the last couple
years, licensed vaccines to treat diseases such as shingles, human
papillomavirus (HPV), and meningitis have become available. Yet adult
immunization rates remain low. This is especially true for newly licensed
vaccines.
According
to the 2007 National Immunization Survey (NIS), approximately two percent of
all adults over 60 years of age reported having received the shingle's vaccine.
Ten percent of eligible adult women 18 to 26 years old had the HPV vaccine. Two
percent among adults18 to 64 years old received Tdap, a combined tetanus,
diphtheria and acellular pertussis vaccine. Approximately twelve percent of
adults 18-49 have received both doses of hepatitis A vaccine, and about twice
as many have gotten the three dose series of hepatitis B vaccine.
The most
success in adult immunizations is with pneumococcal and influenza vaccination.
As of 2008, the pneumococcal and influenza vaccination rates in Washington State for adults 65 and over are 70 and
71 percent respectively. These percentages reflect how far we've come and how
much we still need to do to reach the Healthy
People 2010 goal of 90 percent.
Why are adult immunization rates so poor?
A lack
of understanding and misinformation among healthcare providers and the public
can potentially create a negative impact on adult immunization rates. A survey
published in 2008 in the American Journal of Medicine on Barriers to Adult
Immunization showed: - Most consumers believe that a healthy person
does not need vaccines.
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Most consumers indicated that they were likely
to receive a vaccination if their healthcare provider recommended it.
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Healthcare professionals are not routinely
following recommended immunization practices for adults. Almost 50 percent of
surveyed healthcare providers did no rely on the CDC/ACIP guidelines.
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Missed opportunities-Healthcare professionals
are less likely to discuss immunization during sick visits. Mild acute
illnesses, even those presenting a slight temperature, are not a
contraindication for immunization.
The National
Vaccine Advisory Committee (NVAC) suggested several reasons:
Misperceptions about the risks of
vaccine-preventable diseases in adults.
Vaccine safety and efficacy.
Size of target population.
Lack of regulatory and/or legal requirements.
Reimbursement.
Lack of coordinated adult immunization
programs.
What you can do to increase adult immunization
rates in your practice!
Review the most current recommendations on
adult immunizations.
Discuss the immunization schedule with your
adult patients at every visit. A copy of the schedule is available here
Learn how standing orders can work in your
setting.
Follow- up with patients who need to be
vaccinated by utilizing a reminder- recall system.
To learn more about adult immunization issues,
I encourage you to read:
Trust for America's Health in conjunction with Infection Disease Society of America and the Robert Wood Johnson foundation- Adult Immunization: Shots to Save Live
The 2009 National Vaccine Advisory Committee approved Adult Immunization Recommendations
The 2009 Clinical Practice Guidelines by the Infectious Diseases Society of America
"Barriers to Adult Immunization." The American Journal of Medicine (2008) 121, S28-S35 |
The Washington Chapter
regularly sends messages about its programs and services of interest to
members. The Chapter has contracted with Constant Contact to
facilitate this service. ACP respects your privacy and will not sell or lease,
or share your email address with any organization except for the purpose of
communicating with members about Chapter business.
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| | Washington Chapter - ACP | 2033 6th Ave Ste 1100 | Seattle, WA 98121
Ph: 800.552.0612 Ext. 3026 | F: 206.441.5863
Jan Larsen, Executive Administrator | Email: jal@wsma.org
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