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Colorado Governor's Newsletter October 2022

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Alwinn Steinmann, MD, FACP, ACP Governor

Alwinn Steinmann, MD, FACP, ACP Governor

 


Governor's Welcome

I hope you all had a nice summer and were able to enjoy some time with friends and family. Now the leaves are starting to change and the days are getting cooler and I am looking forward to some of the spectacular fall weather we get here in Colorado. Fall also brings us election time, and this is an election year for our Chapter! In light of this, I am foregoing the usual chapter newsletter format and content and will have our two Governor-elect candidates respond to questions that our membership and Governor's Council submitted. (Please note that a recent change in ACP's “campaigning” policy allows this type of communication.)

As you are likely aware from a previous communication from the national ACP, our two candidates are Dr. Gail Mizner and Dr. Jennifer Ziouras. Both have a long history of service and dedication to our Chapter.

Below, you will find four questions posed to the candidates followed by their responses. Please note that the order of the candidate responses will alternate between the two candidates such that each will be the first response for two questions.

I hope you find this helpful and that you will participate in our Chapter election later this fall!

Al Steinmann, MD, FACP

Governor, CO Chapter ACP

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QUESTIONS FOR GOVERNOR-ELECT CANDIDATES:

What do you think are the most important issues facing internal medicine right now?

Dr. Mizner:

In addition to the existential crisis of climate change faced by all humans, internal medicine faces critical issues of recruitment and retention of internists as our field grows ever more complex. We need to find ways for internists to practice that are sustainable for an entire lengthy career.

Dr. Ziouras:

There are many issues facing internal medicine at this time, all of which are ultimately leading to significant burnout, early retirement, and moving to part time work to help maintain a work/life balance. Many factors play a role into burnout: the bureaucracy of insurance companies, the variation that exists for each insurance company and plan type, lack of time with patients who are heavily armed with information and want to dictate their care, communication challenges with colleagues and a loss of respect for the knowledge and expertise that we bring to the care of our patients. The daily inundation of the above on a daily basis leads to burnout and all of its negative sequelae. While being a physician is exhausting physically, emotionally and mentally, it is extremely rewarding. We are trusted with the most private information from our patients. We are healers of mind and body. We need to forge a path forward where we can start to return to our roots and truly focus on those elements of medicine that led us to this calling. Through this work, we will have a stronger impact on the next generation of physicians.

What do you imagine your focus would be over the next five years?

Dr. Ziouras:

The focus must be on the three critical elements of medicine- our patients, our physicians and our care teams. We need to identify and then act on the long term vision for the Colorado ACP chapter and, through collaboration with the various leaders within our local chapter, continue the work that has already started by previous governors. In addition, we need to ensure that patients have their non-medical needs met outside of the exam room, thus allowing physicians to truly focus on the medical conundrums. We need to support physicians and their teams to help decrease burnout and ensure that our communities have physicians available to care for them. Lastly, policy has a huge impact on the work we do. It is through policy that we would be able to enact changes to help patients receive help for their social determinants of health and it is through policy that we would be able to change the health care system to be more focused on patients and their care teams and less on the insurance companies. Continuing the strong voice of the ACP at the local and national level will be imperative in delivering on the above.

Dr. Mizner:

As an internist working in a relatively isolated setting, my involvement with the ACP has helped me both to feel more a part of the broader internal medicine community and to keep my knowledge and skills up to date. As Governor, I would promote those benefits, encouraging more participation, especially among rural physicians. I would support our membership committee in recruiting new members and our scientific meeting planning committee in continuing our excellent educational sessions.

I also would like to help find creative ways of retaining physicians in internal medicine. We are losing too many internists, both generalists and specialists in the prime of their careers, to early retirement because of burnout caused by the hassles of practicing medicine. As medicine becomes more team-based and so many providers struggle with professional satisfaction, I see an opportunity for internists to expand our roles as the leaders of physician-led teams. In serving as mentors, teachers, consultants, and supervisors, we can introduce variety and interest into our own professional lives and provide much needed support to our colleagues, especially Advance Practice Professionals who are often asked to take care of complex patients without adequate back-up. However, the time and effort required to play the role of consultant and teacher needs to be recognized and reimbursed, especially outside of the academic setting. I have carved out the roles of internal medicine consultant and director of clinical education for myself in my own institution and am both reimbursed and valued for those roles. These positions have allowed me to help improve the care of our patients, decrease the stress of other providers, and decrease costs to patients who do not have to undergo inappropriate testing or see a subspecialist unnecessarily. Doing this type of work has also provided me with enormous satisfaction and growth in the latter part of my career, allowing me to truly practice at the top of my license. I would like to see ACP explore the idea of an expanded, reimbursed consultative and teaching role for general internists and specialists in settings where that is needed.

Finally, my recent appointment as chair of the newly formed, governor-appointed Prescription Drug Affordability Board reflects my interest in improving patients' access to the care they need. As governor of the ACP, I would hope to help further the ACP's work in this area as well as its work on the health implications of climate change and gun safety.

What ideas do you have regarding ways to encourage more residents and young physicians to participate in ACP, especially those who are specialty or hospitalist oriented?

Dr. Mizner:

Our Colorado Early Career Physicians (CECP) group is already working with younger internists to address their interests and encourage their participation in the ACP. Supporting that group in their work and perhaps helping them to expand it is important.

We may also be able to do even more to encourage residents to participate in the ACP by working with internal medicine residency programs in the state to promote attendance at our meetings at the Broadmoor and other educational sessions with even steeper discounts, educational credit, days off, etc. We could also brainstorm further with those programs and their residents about their needs and how ACP can help meet those needs.

Doing more to address hospitalist topics in our educational sessions may help in promoting the organization to young hospitalist physicians.

Dr. Ziouras:

My first step would be to meet with individuals and groups to understand their needs and the barriers to joining our organization. By understanding the root of the issues, we will be better able to formulate a comprehensive approach. As an example, our Early Career Physician group has been immersed in this work with new physicians and we can explore how to replicate it. In addition, other approaches would include a stronger presence in the hospitals to highlight the value of ACP as a physician organization, partnering young physicians with existing ACP members to learn more about the benefits, increasing the number of opportunities in the chapter, socials with ACP members and students, and explore funding opportunities to help support students and newer physicians where participation cost may be a barrier.

Thinking of the Colorado ACP Chapter specifically, what do you see as our major strengths and our biggest opportunities?

Dr. Ziouras:

The CO ACP Chapter has many strengths. We have had strong leadership for over a decade in our governors, our chapter meetings, and in our various committees. This leadership has led to repeated awards from the ACP in recognition of our outcomes. We also have a significant number of highly engaged individuals, people who consistently devote their time and energy into the chapter to help ensure its success. This time is given without compensation and often with limited recognition. In addition, our Colorado ACP chapter has a number of dedicated physicians who are excellent clinicians and consistently participate in our local chapter meeting. One area of opportunity includes increasing participation in our committees and local chapter meeting, ensuring that all aspects of physician career paths have a voice in the work. Another opportunity is to have a more active approach in identifying the needs of our providers and create systems to help deliver on those needs, whether it be “just in time” tools, training or others. A third opportunity is lowering the barriers to engagement and involvement for the next generation of physician leaders.

Dr. Mizner:

The Colorado ACP Chapter has many strengths including our annual February meeting at the Broadmoor and our dedicated members. We have the opportunity in the coming years to expand our membership, especially among younger internists and rural physicians and to expand our political role within the state to promote patient access to care, assist with issues of public health, and keep internists practicing happily and productively throughout their careers.

That wraps up the Q & A! Please participate when the request for voting goes out.

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2022 policy statements, from, the national ACP

Health Care for Non-Detained asylum Seekers

Some of you may recall that our Colorado Chapter was the primary sponsor for a 2021 ACP resolution about this issue. It was submitted with the help of two student members (Taylor Harp and Kailey Stiles ). Prompted by that resolution, the ACP has released a position statement on that topic. You may find it here.

Food Insecurity

In this position paper, the American College of Physicians (ACP) offers several policy recommendations to strengthen the federal food-insecurity response and empower physicians and other medical professionals to better address those social drivers of health occurring beyond the office doors.

Women's Health Policy

In the wake of the Supreme Court's Dobbs decision, the ACP modified its policy statement on women's health.

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