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Governor's Newsletter, Winter - 1999

ACP-ASIM National Merger

While the National ACP and ASIM have merged, the individual mergers at the state level are still progressing. The State of Wisconsin through the help of Tim Radelet of Foley and Lardner (to dot the "i's" and cross the "t's"), have completed the formal merger of the ACP Wisconsin Chapter and ASIM. Our merger is now before the Board of Regents for final approval.

Another notable concerning the merger is that our organization has not had "tax-exempt" status or "charitable organization" status in the past. With the new merger, we have been able to obtain "charitable organization" status and are currently working with National to obtain "tax exempt" status. I will keep you updated on these issues.

National News

ACP-ASIM Plan for Health Care Insurance

At a recent news conference, ACP-ASIM released a plan to make health insurance coverage attainable to approximately 10.5 million poor and moderate income Americans. The plan calls for Congress to devote funds equal to 12.6% of the budget surplus to fund the following initiatives: expansion of Medicaid to all individuals within 100% of poverty; tax credits to be applied to the purchase of health insurance for uninsured individuals with incomes from 101-150% of poverty; increased funding for Medicaid outreach; and subsidies for COBRA coverage for the temporarily uninsured and unemployed. The initiatives were taken from a 1998 position paper, as approved by the Board of Regents, titled "Strategies for Incremental Expansion of Access to Care: Steps to Universal Coverage." At the news conference, the College reaffirmed its call for universal coverage.

ACP-ASIM's Proposed Plan of Action

ACP-ASIM specifically calls on Congress and the President to agree to the following plan of action:

  1. Dedicate an amount equal to 12.6% of the budget surplus over the next five years toward expanding access to health insurance coverage. By committing to this level of funding, Congress would be able to provide coverage to an estimated 10.5 million uninsured Americans.
  2. Target the dedicated funds to support the following initiatives to help low-to-moderate income Americans obtain coverage:
    • Enact a refundable tax credit for uninsured Americans whose incomes fall between 100-150% of the poverty level. A refundable tax credit provides a tax relief subside from the federal government to assist individuals in buying coverage. By administering the program with an advanced payment option, enrollees would be able to receive monthly payments to offset premium costs, rather than having to wait until their taxes are filed to obtain credits. The tax credit would target low-to-moderate income working Americans who now have the greatest difficulty in affording coverage.
    • Expand Medicaid coverage to provide coverage to all Americans with incomes up to 100% of poverty. Since many states do not currently cover people with incomes up to 100% of poverty, this expansion would target the poorest Americans who now lack coverage.
    • Expand funding for Medicaid enrollment outreach. Outreach programs are designed to make already-eligible individuals aware of their eligibility for coverage under Medicaid. Lack of knowledge concerning Medicaid coverage options is one of the principal reasons that millions of Americans who are eligible for Medicaid coverage remain uninsured. The ability of states to educate potential enrollees about their options has been hampered by inadequate funding for outreach programs. ACP-ASIM also advocates that states and the federal government institute administrative changes to make enrollment in Medicaid a simpler option for potential enrollees.
    • Provide federal subsidies for temporarily unemployed and uninsured persons to obtain coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA) program. COBRA requires that unemployed persons who had employer-sponsored insurance prior to their period of unemployment be given the option of making premium payments to continue their group insurance coverage for a maximum of 18 months after they leave their job. Many unemployed persons cannot afford such payments. A full subsidy, limited to 100% of the costs of COBRA premiums, would be provided to workers with monthly incomes at or below poverty, phasing out proportionately at 250% of poverty. Federal subsidies would be limited to a six-month period.

It is recognized that the above plan will raise many questions that need to be addressed. Any comments would be welcomed in the Governor's office - fax: (608) 265-9604 or phone: (608) 263-3457.

ACP-ASIM Annual Session - April 22- 25, 1999, New Orleans, LA

Join your colleagues for a mixture of education and fun at the first Annual Session since the merger of the American College of Physicians and the American Society of Internal Medicine. From CME credits to recertification preparation, hands-on clinical skills workshops to computer training sessions, the 1999 Annual Session is one that you don't want to miss.

With over 250 educational scientific program sessions from which to choose, both generalists and subspecialists are guaranteed to gain invaluable knowledge and insight from the sessions' nationally recognized faculty. Don't forget to register in advance for those sessions that require reservations. There is no additional fee to attend a reserved session, but requests are filled on a first-come, first-served basis.

In addition, to keeping abreast of the latest developments in internal medicine, attendees can network with colleagues or simply unwind at one of the social/alumni events, including special luncheons and receptions. Please check your programs for a complete listing of the dates and times of these events. Also, be sure to visit the Exhibit Hall and learn about the latest pharmaceutical products, medical equipment and professional services. We give a special invitation to those individuals who were elected to Fellowship. Please come, enjoy and be a part of the pomp and circumstance of the induction ceremony.

The ACP-ASIM Wisconsin Chapter will be hosting a reception for all Wisconsin attendees at the annual session on Friday, April 23, 1999 at the Sheraton New Orleans Hotel, 500 Canal Street in Grand Ballroom E, from 6:30 to 8:30 p.m. Please come.

Resolution to the ACP-ASIM

Dr. Mahendr Kochar presented a proposed resolution from the State of Wisconsin to be presented to the Board of Governor's for consideration. This resolution would recommend a feasibility study be done to look into the possibility to having our organization publish a magazine to get the internist message out. It would be available for the public to buy. A motion was made and passed to accept this resolution and pass it on to National.

ACP-ASIM Health Magazine

WHEREAS, ACP-ASIM Foundation is to provide health-related education to the public; and,

WHEREAS, a health magazine published by the ACP-ASIM Foundation can serve as a vehicle for the internists to get their message out to the public; and,

WHEREAS, a nicely put-together monthly color magazine will be attractive to the advertisers of health and medical care-related products; and

WHEREAS, such a magazine could be completely self-supporting; therefore,

BE IT RESOLVED that the ACP-ASIM do a feasibility and marketing study on publishing an attractive, monthly color health magazine.

Any comments - please fax (608) 265-9604 or call (608) 263-3457 the Governor's office.

Local News

Regional Meeting of the ACP-ASIM -
Pfister Hotel, Milwaukee, WI, September 16-18, 1999

At our recent council meeting, Chuck Holmberg (Program Chair) presented the theme for the annual program "Therapeutics in the New Millennium." This program will explore the multitude of new drugs that have recently become available for three major diseases affecting our patients, rheumatoid arthritis, diabetes mellitus and asthma.

As Governor, I would like to solicit nominations for our annual chapter awards - the Distinguished Internist Award, the Young Internist 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 president-elect, president, or immediate past president are not eligible; and
  • This award intends to recognize clinicians.

Young Internist Award:

Primary Criterion: This award aims to recognize the outstanding contributions of a young internists in primary care and medical education supporting criteria.

Supporting Criteria:

  • Proposer to specify the basis for nomination;
  • The current president-elect, president, or immediate past president are not eligible; and
  • 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 socio-economic aspects of medical practice.

Supporting Criteria:

  • Proposer to specify the basis for nomination;
  • The current president-elect, president, or immediate past president are not eligible; and
  • This award intends to recognize clinicians rather than medical scientists.

Nominations will be accepted at the Governor's office by phone, fax or mail.

While no one took advantage of the free guest registration for the last ACP-ASIM Regional Meeting, this will be offered once again. Those members attending the meeting and wanting to bring a physician (non-member of the ACP-ASIM), can now do so with no registration charge for the physician non-member.

Summer Externship Program

Dr. Ken Gold has chaired a committee to examine the continuance of this program. An examination of the number of students going into internal medicine after experiencing the program, revealed no real increase. Therefore, the question was raised as to whether this program should be continued. The overall committee recommendation was to continue the program but decrease the total number of students to 12 (6 from MCW, 6 from UWHC). Also, the program will now be called "ACP-ASIM Scholarship for Summer Internal Medicine Mentorship."

Associates Program at the Regional Meeting

We were gratified that the Associates Program (Vignettes/Posters) was published in the Wisconsin Medical Journal Vol. 97 (9), October, 1998 and on our website. We hope to be able to continue to publish these scholarly presentations in both areas in the future.

Making Medical Decisions

We would like to make known to all internists in the State of Wisconsin, of a very scholarly work published by the ACP-ASIM entitled, Making Medical Decisions: An Approach to Clinical Decision Making for Practicing Physicians. This book was written by Dr. Richard Gross, MD, Ph.D. Dr. Gross is Professor of Medicine at the University of Wisconsin Medical School. He spent 16 years in the private practice of General Internal Medicine before returning to full-time academic practice, where his academic focus, in addition to decision analysis, includes medical computer programming and the teaching of evidence-based medicine.

It is clear that never before have the powerful techniques of decision analysis had more importance for patient and doctor. Advances in medicine have increased the diagnostic and treatment options, which in turn have increased the level of uncertainty for the practitioner.

This book translates the major principles of medical decision making into clinically relevant and easy-to-understand terms. Filled with examples drawn from patient care and familiar games of chance, Making Medical Decisions teaches the reader how to feel confident about giving the best advice in the face of the inherent uncertainties of real-world medicine.

Notoriously confusing concepts are presented using creative new approaches refined over years of teaching. Written in a conversational style, with technical sections isolated for optional reference, Making Medical Decisions is a medical decision book for the front-line practitioner. We recommend this book highly.

New Members/Fellows/Associates

Fellows*
Roderick Koehler, MD
Prasanta Lahiri, MD
Benson Massey, MD
John K. McGuire, MD
Julia McMurray, MD
Jane Neumann, MD
Thomas Palmer, MD
Robert Phillips, MD
Jeffery Postles, MD
Ann Rosenthal, MD
Meenaxi Shah, MD
David Shapiro, MD
Bennett Vogelman, MD
David Weissman, MD
Associates**
Cherian Abraham, MBBS
David Berndt, MD
Cristin Bruns, MD
Kristin Cassidy, MD
Eric Chou, MD
Sharon Cline, MD
Joleen Finken, MD
Eric Gowing, MD
Michael Keown, MD
Brian Mahoney, MD
Holly Murphy, MD
Patrick Nestor, MD
Elizabeth O'Brien, MD
Christopher Peterson, MD
Raymond Poor, MD
Nasia Safdar, MBBS
Rebecca Sentman, MD
Brett Teten, MD
Anshu Varma, MD
Julie Vering, MD
Kathleen Walsh, DO
Members **
Regis Fermandes, MD
Malik Merchant, MD
Vikram Nangia, MBBS
Nasima Soomar, MBBS
*Fellows elected January 1999
**Time period of (October - December, 1998)

NOTE: Dr. Champalal Gupta was elected to fellowship in July of 1998. His name was inadvertently left out on the Fall - 98 Newsletter. We are sorry for the error.

Governor's Notes

We are delighted that the State ACP-ASIM merger is completed and we look forward to new and exciting educational and leadership ventures for our joint society. Any comments or suggestions, please contact the Governor's office at (608) 263-3457 or e-mail - fmg@medicine.wisc.edu