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Governor's Newsletter

Summer 1998

National ACP News


On April 2nd the Board of Governors voted to merge the ACP and ASIM. This vote followed the ASIM Assembly vote to merge with the ACP and a period of due diligence study by Ernst and Young. With this vote, the ACP­ASIM (new name for the organization) will start an exciting time of unprecedented growth, and exploration into new areas of education and political awareness. The national leadership of both organizations are anxious for this new era to begin. The major issues that remain are financial and legal, with special attention to the 501(C)(3) and 501(C)(6) status of the organizations. The actual merger will be completed sometime in the summer with most states completing the merger within the year. We are grateful to Dr. Mahendr Kochar for his efforts as Co­chair of the National ACP/ASIM Chapter and Components Merger Task Force.

While some of the ACP­ASIM State Chapters will have difficult decisions to make, on our local level, we do not foresee difficulty with the merger. Dr. Kenneth Gold has chaired the local Task Force for the merger of the ACP­ASIM Wisconsin Chapter. Dr. Susan Turney (WSIM) of Marshfield has been appointed as one of 20 transitional governors appointed by the ACP as part of the merger plan. Dr. Turney will serve a two year term to start in July of 1998. Dr. Kim Hetsko (WSIM) of Madison has been appointed as one of seven new Regents to serve a two year term on the Board of Regents of the ACP­ASIM. At the Regional meeting of the ACP­ASIM Wisconsin Chapter in September, we will present the new organization's bylaws for a vote of acceptance by our members.

E/M Documentation Guidelines

On Monday, April 27, a one­day "fly­in" meeting was held in Chicago on E/M Documentation Guidelines. The purpose of the meeting was for national specialty societies and state medical societies to discuss problems with the new E/M Documentation Guidelines developed by the AMA for HCFA. The ACP was represented at the meeting by Harold Sox, FACP, James Borland, Jr., FACP, Robert Copeland, MACP, Mary Herald, FACP, and Walter McDonald, FACP. ASIM representatives were Executive Vice President Alan R. Nelson, MD, Glenn Littenburg, M.D., and Director of Regulatory Affairs, John DuMoulin.

A hand delivered letter from Nancy­Ann Min DeParle, administrator of HCFA, expressed an understanding of the problems physicians have with the new guidelines and recommends an indefinite delay in implementing them. Additionally, she recommends that the new guidelines not become effective until they have been adequately field tested and physicians and carriers have been educated on their use. It seems that a 1999 target date is not unrealistic.

The letter also addresses the issue of fraud and abuse charges stemming from inadvertent error. Ms. DeParle has informed the carriers that the intent of their audits is to impose sanctions on physicians who deliberately falsify information or act in disregard of the guidelines and not on those who make inadvertent errors. This point has been contentious for all physicians in the ACP­ASIM. The true spirit of the sanctions by HCFA has never been truly understood and the ACP­ASIM is committed to having this defined clearly. We will keep you abreast of this ongoing problem and debate. If you wish to voice concerns or have questions regarding E/M documentation guidelines please contact me through e­mail at fmg@medicine.wisc.edu. I will answer your question or refer you to the appropriate person in the ACP­ASIM office who can answer the question.

National ACP Meeting Highlights ­ April, 1998

The brightest highlight of the meeting of course was the merger of the ACP and ASIM. All involved in this merger are excited by the future of this organization.

The Board of Governors (BOG) of ACP discussed at length the Tobacco Control Legislation. The BOG made a clear statement that it is essential for the ACP to support the strongest and most comprehensive legislation to safeguard public health. We believe the legislation should be written to avoid court challenges on all public health measures, especially advertising and marketing restrictions. With the many falsehoods that the tobacco industry has stood by for many years, we believe it is imperative to be forceful in this legislation.

There was a presentation concerning the "Hospitalist" (physicians who only care for patients in the hospital) movement currently gathering steam. During the ACP meeting, this Hospitalist group had a separate meeting that attracted many attendees. This issue sparked much debate at the meeting and will be an issue for all of us to follow closely.

The National Internist Campaign is celebrating its second year of educating the public about internists and internal medicine. At this year's Annual Session in San Diego, ACP members had the opportunity to visit the Doctors for Adults exhibit booth and view a video highlighting the campaign. The campaign as it continues to unfold appears tasteful and effective.

The following individuals were inducted to Fellowship in the ACP at the Annual Meeting in San Diego:

Khalid Alam, M.D., FACP Bryan N. Becker, M.D., FACP
Willliam L. Berger, M.D., FACP Rajesh Bhargava, M.D., FACP
Mark K. Chelmowski, M.D., FACP Hulon E. Crayton, M.D., FACP
Mark R. Hennick, M.D., FACP Cyril M. Hetsko, M.D., FACP
Douglas B. McManus, M.D., FACP Gregory A. Shove, M.D., FACP
Howard J. Swanson, M.D., FACP Steven D. Weiss, M.D., FACP
Charles E. Wirtz, M.D., FACP

Fellowship in the ACP­ASIM is an honor achieved by dedication and hard work. Congratulations to all these individuals.

Managed Care Resource Center

The ACP Managed Care Resource Center, as a member benefit, is ready to give you the latest information on managed care. Its staff provide personalized assistance in many ways:

* creating tools such as bibliographies to point you in the right direction when conducting independent searches. A resource guide is in development as well as resource packets on capitation, industry trends, and patient education;

* supplying current literature related to managed care, international health care trends, practice management and more;

To stay current, the Managed Care Resource Center monitors trends and legislation affecting internists in managed care. The Center also networks with other experts to share resources within the general medical information community.

Contact the Managed Care Resource Center at 1­800­523­1546 between 9 a.m. and 5 p.m. Eastern time with your questions.

Fellowship Advancement

Fellowship in the ACP­ASIM is an honor achieved by those recognized by their peers for personal integrity, superior competence in internal medicine, professional accomplishments and demonstrated scholarship. Since some members do not have appreciation of the pathways for advancement to Fellowship, these are listed below. It is important to remember that these pathways to advancement are not mutually exclusive.

Pathway 1 ­ The candidate must meet basic College requirements with an emphasis on demonstrated skill in written medical communication.

Pathway 2 ­ The candidate must meet basic College requirements with an emphasis on significant and continuing certification activities and/or teaching, both institutional and community­based, and/or community activities that indicate professional achievement and scholarship. Recertification; participation in MKSAP with a passing score; certificates of special competence in adolescent medicine, critical care medicine, clinical cardiac electrophysiology, geriatrics and sports medicine; or sub­specialty certification are usually required for this pathway but by themselves are not adequate.

Pathway 3 ­ The candidate must meet basic College requirements with an emphasis on active membership in the College for at least 10 years, with substantial participation in College programs and activities as well as demonstration of other professional accomplishments.

Pathway 4 ­ The candidate must meet basic College requirements with an emphasis on distinguished professional activity in teaching, patients care, or professional service over many years.

For further information, call the ACP­ASIM Wisconsin Chapter Office at (608) 263­3457.

The 1998 Summer Mentorship Program for Medical Students

The following Internists from Wisconsin are participating in the Summer/Mentorship Program this year:

Curtis Radford, M.D. Oshkosh, WI
Bonnie Wirfs, M.D. Kenosha, WI
John Paulson, M.D. Stevens Point, WI
John McGuire, M.D. Pound, WI
Lisa Benson, M.D. Marshfield, WI
Lorene Ramsay, M.D. Racine, WI
Charles Holmburg, M.D. Menomonee Falls, WI
John Frost, M.D. Rhinelander, WI
Samuel Poser, M.D. Columbus, WI
Edwin Ferguson, M.D. Madison, WI
Gregory Motl, M.D. Sun Prairie, WI
Pam Alsum, M.D. Cottage Grove, WI
Gregory Blommel, M.D. West Bend, WI
Timothy Correll, M.D. Mineral Point, WI
Donald Williams, M.D. Fort Atkinson, WI
Jon Arnason, M.D. Portage, WI
Peter Valen, M.D. La Crosse, WI
Doug DeLong, M.D. Ladysmith, WI
Joel Miller, M.D. Beaver Dam, WI

The Fall Regional Meeting

The planning for the ACP­ASIM Wisconsin Chapter meeting is complete and the brochure announcing the meeting should be coming to you soon. The meeting will be held September 10­12 at the Marriott Hotel in Racine, Wisconsin. For reservations call the hotel directly at 414­886­6100 or General Reservations at 1­800­228­9290. Highlights of the meeting are shown below:

TWO awards will be presented at this meeting ­ the Distinguished Physician Award and the Addis Costello Award. A description of these awards follow:

Distinguished Internist Award:
Primary criterion: This award aims to recognize an internist for a career distinguished by diligent effort or remarkable achievements in medical practice.

Supporting Criteria:

* Proposer to specify the basis for nomination.
* The current president­elect, president, or immediate past president are not eligible.
* This award intends to recognize clinicians.

Addis Costello Internist of the Year Award:
Primary criterion: This award aims to recognize a younger, active internist for diligent effort or exemplary achievement in the socio­economic aspects of medical practice.

Supporting Criteria:

* Proposer to specify the basis for nomination.
* The current president­elect, president, or immediate past president are not eligible.
* This award intends to recognize clinicians rather than medical scientists.

Please contact Dr. Mahendr Kochar or write to the ACP­ASIM Wisconsin Chapter office with nominations.

The program for the fall meeting will focus on Alternative Medicine and the schedule is shown below:

Thursday, September 10, 1998

12:30 PM Registration opens
2:00 ­ 4:00 PM ACP Wisconsin Council Meeting
4:30 ­ 6:30 PM Resident's Poster Session
Chair: George C. Mejicano, M.D., ACP Member
6:30 ­ 7:30 PM Welcome Reception

Friday, September 11, 1998

7:30 AM ACP Town Meeting and Chapter Business Meeting
Chair: Frank M. Graziano, M.D., Ph.D., FACP
Presentation by College Representative
John Noble, M.D., FACP
8:45 ­ Noon Residents' Clinical Vignettes
12:15 PM Luncheon and Presentation of Laureate Award to
Joseph J. Mazza, M.D., FACP
1:25 PM Middleton Memorial Lecture
Joseph J. Mazza, M.D., FACP
2:35 PM Scientific Sessions on Alternative Medicine
  1. Drug Therapies ­ Gary Plank, Ph.D.
  2. Acupuncture Therapy in Alternative Medicine
    Xi Ping Zhou, M.D.
  3. Chiropractic Treatment ­ eff Fitzthum, M.D.
  4. Hyperlipidemia and Alternative Therapies
    Mahmood Ahmad Khan, M.D.
6:30 PM ACP Banquet and Awards

Saturday, September 12, 1998

7:30 ­ 8:25 AM Financial Planning Seminar (CIGNA Financial Advisor)
8:30 ­ 9:30 AM Russell Quirk Memorial Lecture
9:45 ­ 11:30 AM Legislative Update

Governor's Notes

ACP­ASIM Wisconsin Chapter dues will remain at $25 for the next year. Chapter dues have been at this level for some time. Once the merger with ASIM is complete, new programs will become active. This necessitates a dues increase to $35. Remember that this money is used for programs such as the Summer Mentorship for first year medical students.

I am pleased and excited to be governor of the new ACP­ASIM Wisconsin Chapter. I look forward to four years of growth and new levels of education for our members. I would like all of us to thank Mahendr Kochar, M.D., FACP for the tireless work, intellectual input, and sacrifice he made for our organization over his term as Governor. Dr. Kochar will still be active on the National level as Chair of the Board of Governors of the ACP­ASIM and Regent on the Board of Regents of the ACP­ASIM. Thank you Dr. Kochar

New officers who will serve a concurrent term with me are John Paulson, Vice­President; Sharon Haase, Secretary; and George Mejicano, Treasurer. We all look forward to serving you during this exciting time for the ACP­ASIM.


Frank M. Graziano, M.D., Ph.D., FACP
ACP­ASIM Governor of Wisconsin
University of Wisconsin Hospital and Clinics
600 Highland Avenue, H6/368
Madison, WI 53792­3244