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Connecticut Governor's Newsletter June 2017

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Rebecca A. Andrews, MD, FACP, ACP Governor

Rebecca A. Andrews, MD, FACP, ACP Governor

 


Wellness

In May, I found a link from the NEJM Catalyst article from 2016 on patient engagement. The article comments on how we measure patient engagement and what methods work. Surprise! It turns out internal surveys of patients are most effective and the most effective tool to engage patients is spending more time with them. Suggested methods of doing this include asynchronous communication such as email, portals, texting; using staff team members to do outreach phone calls and follow up; and utilization of physician extenders. The article is interesting without doubt as how can we hope to start preventing disease or improve at treating it if our patients are not engaged in the process? But my mind wanders down another track as well. We are so very busy already. Should we be sacrificing “free time” (that should serve as a chance to recharge and perform self-care) to communication methods that know no boundaries of time or space? I think this decision is an individual one. For some it decreases in office pressures during patient care and for others it infringes on the little that remains of a doctor's privacy. I am not sure we have the answer yet, but here is a good start.

In the meantime, take even ten minutes to walk at lunch, choose a night to leave the dishes and get extra rest, try to use an occasional “no-show” appointment or unexpected meeting cancelation to do something for yourself instead of what we all do…catching up on work.

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Membership: What is the Worth of Your Medical Profession?

Henry Anyimadou, MD, FACP, CWSP, AAHIVS
Rosemarie Fisher, MD, MACP, FACG, FAASLD, FAGA

The true cost of your profession is unmeasurable. Many have tried to put a figure to this based on medical school cost and your lifetime potential earnings but the true cost of your profession as an internist, is in the number of hours of your life that you have invested into becoming a doctor. Without counting the hours invested into your bachelor's degree, some have calculated this on the average as 27,000 hours; assuming an 80 hour a week of studying and training for 48 weeks per year in medical school, and 80 hours a week of studying and work, for 50 weeks a year during residencies.

Twenty seven thousand hours just to get you out of residency, not even considering fellowship time if you completed one. Your post residency self-learning hours and daily reading about your patient's condition cannot even be quantified.

This is such a great investment; you can't afford to let it go stale. For most of us it is difficult to envisage any profession better than medicine but unfortunately this fulfilling vocation is constantly being plagued with shrinking compensation, pressure to see more, document more in less time and offer more to our respected patients without the necessary support from law makers and insurance companies.

In these trying times, the American College of Physicians (ACP) stands with you. There is no better time than now to immunize your profession with ACP membership! And here is why;

  1. There is an outcry of concern for lack of meaningful continuing medical education and Maintenance of Certification (MOC), ever increasing burden of documentation and paperwork, changing paradigm of insurance coverage for your patients etc. ACP is constantly working around the clock to advocate for your interest and represent you in addressing these imminent and future challenges we face now and into the future.
  2. Through your membership, you will have more opportunities to get involved and to make a difference for generations to come. You will help preserve our noble profession if not make it better. You can make your voice heard!!
  3. ACP provides you with several educational conferences and materials to help you maintain a healthy and well balanced vocation.

ACP needs you now more than ever to stand with us in protecting your profession. Your membership and participation is key in securing the future of the profession you have grown to cherish and respect.

Our patients are counting on you to stand with your colleagues to protect their wellbeing. Priceless! Priceless! Priceless, is the worth of your medical profession. Every effort at protecting a worthy profession is worthwhile so join ACP today and spread the word to your colleagues and friends

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Resident Fellow Members

Marilyn Katz, MD, FACP

Spring for most means cleaning, but for the Resident and Fellow's Council it means planning!

We are happy to announce an upcoming event focused on wellness: Resiliency & Grit: Handling Microaggressions from Patients with Dr. Marcella Nunez Smith and colleagues on Tuesday June 27th in Middletown, CT. The goal of this workshop is to help maintain personal wellness when patients make comments or use body language to your race, gender, ethnicity, age or religion. To RSVP, please email me at mkatz@uchc.edu.

During our chapter meeting at the Aquaturf in October we will hold our annual Resident Abstract Competition. Last year we hosted 22 research abstract presentations and 199 clinical vignettes! Put your clinical thinking caps on and start writing up potential submissions for this year's competition. We will distribute the official rules later this summer, a quick reminder: First authorship should be from a resident or fellow. We welcome collaborative efforts and encourage multi-authored posters; attendings and medical students will not be permitted as first authors or presenters for this competition.

In addition to the Resident Abstract Competition at the chapter meeting, we will also host the state-wide finals of the Doctor's Dilemma (Medical Challenge, Jeopardy-style). In preparation for this event, we will be hosting the preliminary rounds in early September – location and time TBA. If your institution is interested in hosting this event, please let us know! Between the preliminary rounds and the finals, we need over 360 medical challenge questions. If you have any interest in writing questions (particularly chiefs and fellows with a faculty mentor), we would love to hear from you. We are looking for questions in sets of five that fit into a “fun” category. For instance: “Of Mycin Men” and “In The News” were categories from last years' event.

Lastly, if you are interested in helping to plan/organize events like the ones listed above, please let me know! We are always on the lookout for enthusiastic and energetic organizers to get involved!

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Convocation with the New Fellows

Each year at the annual scientific meeting, the Governor has the pleasure of walking in convocation with those of our chapter who have recently (within the last three years) become fellows. This achievement highlights a commitment to medicine, lifelong learning, and your professional college. Take a peek at this year's photo and congratulate the new fellows from our state:

  • Olugbenga Arole, MD, FACP
  • Theodore R. Hartenstein, MD, FACP
  • Shiromini C. Herath, MD, FACP
  • Eunice Y. Kang, MD, FACP
  • Varidi Nauriyal MBBS FACP
  • David J. Lobo, MD, FACP
  • Asha Marhatta, MBBS FACP
  • Edward K. Mensah, MD, FACP
  • Jaimie P. Meyer, MD, FACP
  • Debmalya Mukherjee, MBBS FACP
  • Janaka M. Periyapperuma, MBBS FACP
  • Shivi Sharma, MBBCh FACP
  • Jadwiga M. Stepczynski, MD, FACP
  • Svetlana Tikhomirova, MD, FACP
  • Amy M. Tocco, MD, FACP
  • Meghan Train, DO FACP
  • Martha Severino, MD, FACP
  • Sujata Prasad, MD, FACP

Drs. Arole, Nauriyal, Mensah, Mukherjee, Periyapperuma, Prasad, Severino, and Tikhomirova pictured below with Dr. Nardino, and myself before the proverbial “changing of the guard”.

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Medical Students

Barry J. Wu, MD, FACP, Yale School of Medicine
Ellen O. Nester, MD, FACP, University of Connecticut School of Medicine
Ilene L. Rosenberg, MD, FCCP, FACP
Frank H. Netter, MD School of Medicine at Quinnipiac University
Joshua Bia

Our Connecticut Chapter medical students were well represented at the national meeting in San Diego in March 2017. Nelson Ugwu, a first year Yale medical student and Connecticut Chapter medical student representative, participated in several sessions. Drs. Stephen A. Atlas and Barry J. Wu facilitated an interactive teaching workshop attended by nearly 100 students entitled “Success on Step 1 and Step 2 Clinical Knowledge (CK) and Clinical Skills (CS) Examinations” to help students prepare for the United States Medical Licensing Exams (USMLE) Step 1 and Step 2 CK and CS.

The Quinnipiac Internal Medicine Interest Group has continued to hold multiple, “Find Out What Internal Medicine Is All About” events each semester. These events are interactive ways for students to hear from a variety of internists and sub-specialists, followed by opportunities to ask questions. Dr. Jason Ouellette, Chair of Medicine and Director of the Internal Medicine Residency Program at Saint Mary's Hospital, gives an annual presentation on how students can best navigate through the residency selection process. Dr. Jennifer Kostela, Internal Medicine Clerkship Director at St. Vincent's Medical Center, gave an excellent presentation regarding preparation for Internal Medicine rotations and what students should expect. We closed the year by having a student led discussion panel, featuring recent graduates from our school's inaugural class who matched into Internal Medicine.

In the upcoming year, we plan to continue these events and expand upon them, as well as hold an event that will bring together the Internal Medicine Interest Groups from all three of Connecticut's medical schools. Joshua Bia has been elected as this year's student President of the IMIG, with Lisa Chan elected as student Vice President.

We are thrilled that Connecticut students continue to pursue careers in internal medicine. This year 20 of 89 (22%) graduating students from Yale University, 22 of 91 (24%) from the University of Connecticut School of Medicine and 13 of 58 (22%) from the Frank H. Netter, MD School of Medicine at Quinnipiac University matched to internal medicine residencies. This was the nineteenth year the Connecticut ACP Internal Medicine Award was given to a graduating student entering a Connecticut internal medicine program at Yale University and the University of Connecticut and the inaugural year for the award given at the Frank H. Netter, MD School of Medicine at Quinnipiac University. The school, award winners and matching institutions are as follows:

Yale: Dr. Yukiko Kunitomo - Yale New Haven Hospital
University of Connecticut: Dr. Gabriella Wilson - Yale New Haven Hospital
Quinnipiac University: Dr. John Huston - Yale New Haven Hospital

We look forward to their contributions in medicine and to the American College of Physicians.

The Quinnipiac Internal Medicine Interest Group has continued to hold multiple, “Find Out What Internal Medicine Is All About” events each semester. These events are interactive ways for students to hear from a variety of internists and sub-specialists, followed by opportunities to ask questions. We have continued to invite Dr. Jason Ouellette, Chair of Medicine and Director of the Internal Medicine Residency Program at Saint Mary's Hospital, to give his now annual presentation on how students can best navigate through the residency selection process. Dr. Jennifer Kostela, Internal Medicine Clerkship Director at St. Vincent's Medical Center, gave an excellent presentation regarding preparation for Internal Medicine rotations and what students should expect. We closed the year by having a student led discussion panel, featuring recent graduates from our school's inaugural class who matched into Internal Medicine. In the upcoming year, we plan to continue these events and expand upon them, as well as hold an event that will bring together the Internal Medicine Interest Groups from all three of Connecticut's medical schools. Joshua Bia has been elected as this year's student President of the IMIG, with Lisa Chan elected as student Vice President.

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ACP Connecticut Chapter Annual Fall Scientific Meeting - October 2017

Naseema B. Merchant, MD FCCP, FACP, FHM
Diana Sewell, MD, FACP

The countdown to the fall meeting has started. We have less than less than five months to go till the annual meeting on October 27, 2017 at the Aqua Turf event facility in Plantsville, CT. The meeting continues to get bigger and even more exciting with lots of learning and networking opportunities for everyone. The chapter strives to meet the needs of all of its diverse members including medical students, residents and practicing physicians from academic and non-academic backgrounds. Our planning committee has worked hard to make sure we have something for everyone. There will new changes to the program offerings which we hope will be useful and helpful to all participants

The morning will start as usual with poster exhibits and competition by our internal medicine residents from various training programs across the state. Our popular annual “women in medicine” networking breakfast will again take place at the same time as poster judging. It should be noted that this event is organized for “women only” as an opportunity to discuss gender specific issues in medicine. Pre-registration for this event is required to plan seating and other details.

Poster judging will be followed by the main annual scientific program which will start at 10:00 am with three parallel sessions which include an ABIM module 2017-2018 update in Internal Medicine and two clinical skills workshops. The musculoskeletal workshop will feature examination of the shoulder and the cardiology workshop will focus on cardiac exam. Each of these two workshops will be offered twice in the morning to allow maximum participation. Pre-registration is required for the two workshops as seating is limited.

New this year for lunch will be two separate lunch programs one each for trainees and attending physicians. The attending physician lunch will feature a talk on update on sexually transmitted diseases. The residents and trainees will have an interactive panel discussion during lunch with physicians representing ACP, CT state legislator and Connecticut State Medical Society. The trainees will have an opportunity understand healthcare advocacy at various levels within the state.

Post lunch, the first session would include an exciting and fun talk covering physician wellness with introduction to system approaches and resiliency techniques amongst physicians using laughter. This is a super interactive session, one that would be enjoyed by everyone for sure. The midafternoon program will feature three parallel sessions. These include our popular razor case workshop, doctor's dilemma, and a talk on depression in primary care. The razor case workshop is an interactive workshop focusing on appropriate resource utilization for inpatient and outpatient care as part of promoting ABIM's “Choosing Wisely” Campaign. This case based interactive workshop involves all trainees (students and residents) and attending physicians, all working in two separate locations to reach the diagnosis using as little money on diagnostic tests as possible. The idea is to promote clinical thinking and offer a health competition between trainees and attending physicians to see which group can come up with the diagnosis with the least amount of money spent.

Our day will conclude with the awards ceremony for winning posters and for various individuals recognized by the chapter as well as the annual address by our chapter governor Dr. Rebecca Andrews.

This day is packed with multiple and simultaneous opportunities for learning (CME as well as MOC credits) and networking. You do not want to miss this day. Please mark your calendars and request your time off now. If you are interested in being a judge for resident posters that day, please contact our chapter administrator Nancy Sullivan. Keep an eye out for more information about how to register for the meeting and sign up for sessions and workshops. Hope to see you all there.

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Diversity Committee

Varidhi Nauriyal, MD, FACP

The Diversity committee of the ACP CT chapter spent the fall of 2016 organizing our annual Women in Medicine networking event which has now become a very popular and well attended event at the annual chapter meeting. This summer, the committee plans on following up the annual event with another program at a smaller scale so we can continue the tradition of networking throughout the year. In the past year, the Diversity committee in collaboration with the Early Career Physicians and Council of Residents and Fellows committee organized a “Visa FAQ” event which was a great success. The great reception it received has prompted this committee to promote the event potentially as a webinar to reach out to a wider group of ACP members - stay tuned for details! We are also pleased to partner with the Council of Residents and Fellows for an upcoming event on “Resiliency and Grit” on June 27, 2017 (watch for the email announcement).

The committee is always looking for more ideas to engage our diverse community of physicians, residents and medical students. If you would like to share a suggestion, please email us at varidhi.nauriyal@gmail.com or naseema.merchant@gmail.com.

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Advocacy: Leadership Day

As usual, leadership day in our country's capital is always an invigorating opportunity to see our lawmakers in action! In addition to having an opportunity to meet with your legislators and staff in Washington, DC, attendees hear in-depth briefings from White House officials, Capitol Hill staffers, and members of Congress among the top health care decision makers. Thank you to the 2017 participants who joined me to lobby for physician and patient healthcare: Keith Vom Eigen, Talal Kaiser, Jacob Quinton, Erin Gombos, and Benjamin Cherry.

This year's top priorities:

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Why should you join us for Leadership Day 2018?

Participants in leadership day:

  • Receive a comprehensive orientation on ACP's top legislative priorities.
  • Earn Continuing Medical Education (CME) credits.
  • Learn advocacy skills that can be utilized back home.
  • Meet other internists who care about advocacy, including colleagues from your own state.
  • Learn about policy issues that impact your profession and your ability to provide quality care.
  • Get to know ACP leaders.

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ACP GUIDE on Hep C Testing Created in Conjunction with the American Academy of HIV Medicine

ACP has partnered with the American Academy of HIV Medicine (AAHIVM) to develop a new “Guide to Hepatitis C Testing,” in advance of Hepatitis Testing Day on May 19.

Approximately 2.7 to 3.9 million people in the United States have chronic hepatitis C (HCV), many of whom are undiagnosed. Last week, the CDC released new preliminary data that the number of new HCV infections has nearly tripled over the past five years, reaching a 15-year high. Adults ranging in age between 20 and 29 years saw the greatest increase and highest overall number of cases, with the primary route of transmission being injection-drug use.

The new guide aims to help primary care clinicians screen patients for HCV. It includes a summary of the latest testing recommendations; diagnostic, billing, and laboratory codes for testing; resources for referrals to HCV-experienced clinicians; and information on patient interactions, education, conversations, and case examples.

A downloadable PDF of the guide is available online. Also, visit ACP Online to access ACP's patient resources on hepatitis C.

In summary:

HCV TESTING IS RECOMMENDED FOR:

  • Adults born from 1945 through 1965 (“baby boomers”) should be tested at least once in their lifetime and more frequently if they are at ongoing risk
  • Persons who inject drugs (currently or in the past)
  • Patients who have HIV infection
  • Patients with persistently abnormal alanine aminotransferase (ALT) levels
  • Patients treated with clotting factor concentrates produced before 1987
  • Patients who ever received long-term hemodialysis
  • Patients who were recipients of either blood transfusions or organ transplants before July 1992, or who were notified their donor later tested positive for HCV
  • Children born to HCV-positive women
  • Healthcare, emergency medical, and public safety workers after a recognized exposure to HCV-positive blood through needle sticks, sharps, or mucosal exposures

HCV TESTING MAY ALSO BENEFIT

  • Recipients of transplanted tissue (e.g., corneal, musculoskeletal, skin, ova, sperm)
  • Intranasal cocaine and other non-injecting illegal drug users
  • Persons with a history of tattooing or body piercing
  • Persons with a history of multiple sex partners or sexually transmitted infections (STI)
  • Long-term steady sex partners of HCV-positive persons
  • Persons who inject drugs
  • Persons who engage high-risk sex and with history of sexually transmitted infections

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New Fellows in the Last Six Months

Olugbenga Arole, MD, FACP
Theodore R. Hartenstein, MD, FACP
Shiromini C. Herath, MD, FACP
Eunice Y. Kang, MD, FACP
David J. Lobo, MD, FACP
Asha Marhatta, MBBS, FACP
Edward K. Mensah, MD, FACP
Janaka M. Periyapperuma, MBBS, FACP
Shivi Sharma, MBBCh, FACP
Jadwiga M. Stepczynski, MD, FACP
Svetlana Tikhomirova, MD, FACP
Meghan Train, DO, FACP

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New Members in the Last Six Months

Gada Abdelhafiz, MD
Samuel Antwi-Boasiako, MD
Elin Christensen, MD
Maureen Dana, MD
Aartee Deshpande, MBBS
Uchenna Ikediobi
James M. Lai, MD
Meredith Niess, MD
Maria E. Quinones, MD
Suchismita Reed, AHP, DO
Devra M. Sirot, MD
Shetal Stewart, MD
Rasikh Tuktamyshov, MD

That's it for your June newsletter, but be on the look-out for monthly updates until the next newsletter at the end of the year!

Some of the best lessons we ever learn are learned from past mistakes. The error of the past is the wisdom and success of the future.
-Dale Turner


Respectfully,
Rebecca Andrews, MD, FACP
ACP Governor, Connecticut Chapter

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