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Governor's Newsletter
Summer 2001

Frank M. Graziano, MD, PhD, FACP
Governor, Wisconsin Chapter

National News

Recertification: The Dialogue with the ABIM

Herbert S. Waxman, MD, FACP
Senior Vice President, Education, ACP-ASIM

Given the many concerns expressed by our members about the ABIM Recertification Process, we have asked Dr. Herbert Waxman, FACP, Senior Vice President, Education, ACP-ASIM, to give us a status report on the ACP-ASIM position. Here is his statement:

It's about a year since there began a serious dialogue between the College and the American Board of Internal Medicine (ABIM) about the many concerns the College has with the ABIM's plan to implement the proposed Continuous Professional Development (CPD) process for recertification. The core concerns of the College are as follows:

  1. The process of recertification should be clinically relevant, not excessively burdensome, and not redundant of things that are already being done in physicians' practice environments (e.g. patient and peer evaluation, practice performance measures and improvement plans.) College Members have expressed very strong feelings about this!
  2. There should be a clear delineation of the responsibility for high stakes evaluation (ABIM) and education, including self-assessment (ACP-ASIM and other professional societies.)
  3. There should be a clear articulation of the fact that maintenance of competence requires more than just evaluation periodically. It should also encompass relevant continuing education, taking into account learning preferences of the individual physician.

A Joint ABIM-College Committee on Recertification was set up, with three high-level Governance Members and a Staff Person representing each party. The College sought resolution of the above concerns; the ABIM sought endorsement by the College of the proposed CPD recertification process.

Thus far, the dialogue has resulted in agreement in principle by the ABIM of the need to resolve the College's concerns. However, the devil is in the details, and there haven't yet been proposed details that have been perceived to satisfy the needs of the College and its Members.

At the meeting of the Board of Regents at the Annual Session in Atlanta, five resolutions pertaining to recertification were communicated to the ABIM, addressing the need to respond to the College's concerns and including a deadline for meaningful progress to have taken place. The Board has instructed its Members of the Joint Committee to recommend in July whether the College should endorse CPD or refuse to endorse the process.

In response, the ABIM requested detailed information about what we want specifically. In a letter from Drs. Bernard Rosof and William Hall (our Board of Regents Chair and our President, respectively) to the ABIM leadership, we presented our requirements. In short, we are insisting that a physician's participation in a self-assessment program (such as MKSAP) or in patient or peer evaluations or in practice performance measures in his or her own hospital or health system be allowed to satisfy the corresponding requirements of the self-evaluation modules of the recertification process. Recertification should not impose on the physician requirements of what is already being done well in many physicians' practices.

ACP-ASIM has not taken a position opposing the formal examination of medical knowledge. The College believes that such an evaluation is appropriate for documentation of maintenance of certification and is something the ABIM is skilled and experienced in doing. Meanwhile, our Research Center has carried out a telephone survey of over 600 College Members, most with time-limited certificates. The results confirm what we have been hearing strongly expressed individual opinions: the concept of recertification is supported, but the support for CPD is much weaker. Of the self-evaluation components of CPD, the patient and peer evaluation module is viewed most negatively, the knowledge module least negatively. There is a clear sense that the costs of recertification and of the educational programs to prepare for recertification are much greater than the perceived benefit.

Supporting anecdotal reports, a high proportion of respondents are carrying out in their practice environments most of the functions embodied in CPD. For these physicians, the CPD modules would be redundant and therefore represent an excessive burden.We're now waiting to hear how the ABIM responds to the demands outlined in our letter. Based on that response, there will be a final decision made by the College on whether or not to support the ABIM's proposed CPD process. Of paramount importance to the College is that, one way or another, the strongly felt and legitimate concerns of our members be satisfactorily responded to. Stay tuned!

Supporting Your Chapter Through Chapter Dues

Chapter dues are the backbone of local activities and vital to the success of our Chapter. While we are provided some financial support from the National Office, the chapter dues collected provide the majority of financial support for local activities. Educational meetings, mentoring programs for medical students, local Associates' research competitions, advocacy with State Legislators, and participation by Chapter Leaders in Leadership Day on Capitol Hill are just some of the activities supported by your chapter dues. Unpaid volunteer leaders in our Chapter orchestrate many of these activities. However, the increase in activities at the local level has created the need for additional staff support to help manage the day-to-day operation of the Chapter. Your chapter dues help support the cost of local staff and provide funding for new and existing Chapter Initiatives. When you receive your dues notice, please remember to include the chapter dues in your payment. You will be contributing to the success of many grass roots activities happening right here at home.

Local News

Annual Scientific Meeting
September 6-8, 2001
Pfister Hotel, Milwaukee, WI

I would like to invite you to join me and your colleagues in Internal Medicine at what will be this year's most important medical meeting in your field: the 2001 Scientific Meeting of the Wisconsin Chapter of the American College of Physicians-American Society of Internal Medicine. The Wisconsin Chapter's Annual Scientific Meeting will be held this year on September 6-8, 2001 at the Pfister Hotel in Milwaukee.

Scientific Program and Special Events-
Join us for timely and topical discussions of the medical, economic, and political issues that internal medicine faces today-and in the future. At this year's meeting, you'll hear noted colleagues share the latest on:

  • This year's theme: "Evidence-Based Medicine in Women's Health"
  • Resident Poster Session and Clinical Vignettes
  • New Pharmacology for Internists
  • Legislative Update on Medical Issues

I particularly want to invite you to join us at our Annual Town Meeting and Business Meeting. You'll learn more about the activities of our Chapter and have a better opportunity to contribute in areas of particular concern to you. We are pleased to have Bernard M. Rosof, MD, FACP at our meeting to talk with us about College related issues. Don't miss this chance to make your voice heard by College Leadership.

Between Scientific Sessions, be sure to stop by the College display for an update on new programs and services for Members. Information will be available about new subspecialty MKSAPs, postgraduate courses, books and the upcoming Annual Session.

Last, and certainly not least, I encourage you to bring your family. There is always free time to enjoy numerous recreational activities and sightseeing that will make your attendance at our meeting enjoyable for all.

Don't delay! Mark your calendar now and send in your registration today. I am sure you'll agree this meeting with colleagues in our Chapter is an exciting, informative passport to the future in Internal Medicine.

The program this year is as follows:

Thursday, September 6, 2001
7:00 a.m. Golf Tournament ($55)
Silver Spring Country Club
12:30 p.m. Registration Opens
2:00-4:00 Wisconsin Chapter Council Meeting
4:30-6:30 Residents Poster Session
Mark A. Gennis, MD, FACP, Chair
6:30-7:00 Break - Visit the College Display and Exhibits
7:00-8:00 Welcome Reception
Friday, September 7, 2001
6:30 a.m. 5K Walk/Run
7:00 Registration Opens
7:30 ACP-ASIM Wisconsin Chapter Town Meeting and Business Meeting
Frank M. Graziano, PhD, MD, FACP Governor

College Update
Bernard M. Rosof, MD, FACP, College Representative

Scientific Sessions on Evidence-Based Medicine and Women's Health Issues
8:30 a.m. Evidence-Based Medicine: Application to Guidelines for Disease Prevention
Harold C. Sox, MD, MACP
9:30 Estrogen and Alzheimer Disease: A Success Story Without a Happy Ending
Molly Carnes, MD
10:15 Break - Visit College Display and Exhibits
10:45 Preventive Care as it Relates to Hypertension and Heart Disease in Women
Jane Morley Kotchen, MD
11:30 Middleton Memorial Lecture: The History of ACP-ASIM in Wisconsin- "Internal Medicine in Evolution"
Kenneth Gold, MD, FACP
12:15 p.m Luncheon and Presentation of Laureate Award to Kenneth Gold, MD, FACP
1:25 Residents' Clinical Vignettes
6:30 Chapter Banquet and Awards
Saturday, September 8, 2001
8:00 a.m. Continental Breakfast
8:30 - 9:30 Russell Quirk Memorial Lecture: "Wisconsin Women's Health Foundation"
Sue Ann Thompson
9:30 -10:15 Women with HIV - From Milwaukee to Central Africa
Karen Ivantic-Doucette, RNNP
10:15-11:45 Legislative Update

Information about registration for the meeting is available through Svinicki Association at (414) 276-8788.

Awards

It is my distinct pleasure to announce the winners of the 2001 ACP-ASIM Wisconsin Chapter Awards. These awards will be presented at the 2001 Wisconsin Scientific Meeting to be held at the Banquet Dinner on Friday evening, September 7th, 2001. Congratulations to the following individuals:

  • Laureate Award - Kenneth I. Gold, MD, FACP
  • Distinguished Internist of Year Award -Thomas Jackson, MD, FACP
  • Young Internist of the Year Award - Andrew Anderson, MD
  • Addis Costello Internist of the Year Award - Molly Carnes, MD

Recertification Course

A preparation course for Recertification in Internal Medicine is being offered in Chicago, IL from October 12-14, 2001. The course registration information phone number is 1-800-523-1546, ext. 2600. For information online see http://www.acponline.org. The course is being directed by Mahendr S. Kochar, MD, FACP and Kesavan Kutty, MD, FACP.

Governor's Note

I hope all will attend the Wisconsin Chapter Scientific Meeting to be held at the Pfister Hotel in Milwaukee, WI, from September 6-8, 2001. This meeting will be an opportunity to learn and discuss disease processes affecting our patients. We look forward to seeing you in September.

Any comments or questions regarding this newsletter or other issues, please contact the Chapter Office at:

600 Highland Avenue, H6/368
Madison, WI, 53792
Phone: (608) 263-3457
Email: fmg@medicine.wisc.edu