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President’s Convocation Address

Sara Walker, MD, MACP

April 3, 2003

Thank you.

Welcome, new Fellows! A hearty welcome to your friends and families! It is wonderful to see so many great internists gathered in one place! You have advanced in a prestigious collegial society that performs a multitude of tasks for doctors of internal medicine!

As this year draws to an end I want to reflect for a moment on the College’s history and the invaluable services it provides for its members, their patients and the world of medicine in general.

ACP has fulfilled its mission “to promote the advancement of the science and practice of medicine” since its inception in 1915. And in the early 1980’s, it opened a Washington branch to provide a voice to the professional and public health concerns of internists.

Meanwhile, internists founded the ASIM in 1956 “To study the scientific, economic, social and political aspects of medicine,” and “To complement and supplement the aims and activities of The American College of Physicians.”

As economics and regulatory forces encroached on the practice of medicine, the two organizations realized that internal medicine would be better served if they could work together and become one. The merger of the American College of Physicians and the American Society of Internal Medicine in 1998 made two valuable medical associations even more indispensable to the effective practice of medicine. With this new voice and new organization, I am proud to say that we have accomplished much on behalf of patients and physicians.

ACP has been a leading proponent of providing coverage to all Americans by the end of the decade. I am delighted that our seven-year plan to insure all Americans has been written into legislation that Senator Jeff Bingaman will introduce in the United States Senate shortly.

In the advocacy arena, the College has tackled two of the largest threats to medical practices and patients’ continued access to care.

Reforming our nation’s professional liability system is no longer a distant blip on the political radar. Whether it’s a trauma center closing or internists leaving a state because of liability premiums, patients suffer. The good news is that President Bush has made reform of the medical liability system one of his top priorities. With his leadership, the House of Representatives last month passed legislation to establish a $250,000 cap on non-economic damages, limits on attorneys’ contingency fees, and other common sense reforms. ACP strongly supported this bill. The Senate is considering a compromise measure that would establish a higher cap on non-economic damages. While exploding liability premiums are eating into revenues, an equally large problem continues to loom on the horizon. Medicare payments to physicians are completely unrelated to the cost of providing care and in many cases are falling below the cost of care.

The College joined with the AMA and other medical organizations to achieve an important victory convincing Congress to avert the 4.4 percent Medicare Fee Schedule cut that would have taken place March 1 and replace it with a positive update for '03.

Here is how you and your patients were instrumental in stopping the cut for 2003. Together, we sent more than 5,900 messages to Congress describing how Medicare patients were being hurt by the fee schedule mess. By representing the interests of patients and internists, we influenced Congress to restore payments to physicians at a time when almost all other non-defense government programs were being cut.

Such an accomplishment bears eloquent testimony to the need for a single strong internal medicine organization and the power of numbers it can bring to bear.

While this initial victory is encouraging, it is not a permanent solution. Congress stemmed the losses, but did not treat the presenting problem - the flawed formula that links payments to how the overall economy is doing. Without further legislation, Medicare is projecting another cut of more than 4 percent in 2004. The College will be calling on you again to urge elected lawmakers to scrap the flawed formula and replace it one that will provide inflation-based updates, and I know that you will respond!

I know that you will continue to respond in force and I urge you to stop by the College booth on the exhibit floor and sign up for the Congressional Key Contact program that alerts you to opportunities to influence your representatives on important College issues.

Although less visible than congressional activities, of no less importance is ACP’s work with federal agencies and private insurers behind the scenes to cut the red tape and un-funded regulatory mandates that drive up costs and detract from time with patients.

This year, Medicare Teaching Physician Documentation Requirements were simplified, the culmination of a 7-year push by ACP and other organizations. Additionally, more than 50 of the College’s recommendations for regulatory relief were accepted by a task force appointed by HHS Secretary Thompson, charting the course for a major reduction in Medicare red tape.

While we cannot avoid all the regulatory burdens, the College offers a wide array of products for members to lighten their load. Let’s look at the scope of the benefits the College has developed for you. The Practice Management Center helps internists deal with vital issues including practice ownership and operations, coding and payment, computer tools for physicians and government regulations. The PMC can be a godsend if you are setting up a practice for the first time.

For those of us who have been in practice for a while, we must comply with incredibly complicated HIPAA transaction and privacy regulations by April 14th. The PMC guides on each section of HIPAA are available on a free CD being distributed at the ACP booth in the exhibit hall. This CD also includes over 50 publications on everything from hiring staff to choosing a computer system for complying with laboratory regulations.

And ACP continues its tradition of excellence in producing highly regarded educational tools and information that help internists and subspecialists respond to, and stay current with, the challenges of today’s practice environment. The timely articles published in the Annals of Internal Medicine and our clinical practice guidelines come to mind, and the College also produces a wealth of other clinical information, all available for free via its Web site!

The Bioterrorism Resource Center is a timely clinical tool that has a wide array of up-to-the-minute information about the medical and psychological aspects of bio-chemical terrorism. It was established back in 1998 and is one of the most comprehensive resources available today for physicians.

By now I hope you’ve all heard about PIER, the Physician’s Information and Education Resource, the College’s newest online clinical decision support tool. Experience it for yourself at this meeting, and I guarantee you’ll be hooked. And the College continues to add to its already impressive array of books, with titles ranging from Drug Prescribing in Renal Failure to The Quotable Osler.

When you consider everything the College does for its members, the question internists should ask themselves is not whether they can afford to belong to the College, but how can they afford not to?

In closing, I congratulate the new Fellows and I charge all of you to return home and impress on your non-member colleagues and your students the value of membership in the American College of Physicians. Our profession is too precious, and our mission too important, not to fight for internal medicine’s continued vitality and success in providing care for our patients.

Thank you, and God bless.

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