In this Issue:
- Governor's Message
- Congratulations Illinois Northern Awardees
- ACP's Comprehensive COVID 19 Resources
- What is ACP's Vision for the US Health Care System?
- Resolutions Update
Anne Furey Schultz, MD, FACP , ACP Governor, Illinois Northern
All Changed, changed utterly: A terrible beauty is born. - WB Yeats, Easter Rising 1916
Dear ACP colleagues and friends,
I hope you and your families are safe and well.
Normally, the spring governor's letter would highlight the success of the annual meeting and celebrate our coming together in fellowship and learning. This year, however, we logged in for a virtual governance breakfast, chatted over GROUP ME, and swapped photos of DIY haircuts. My class became governors on the same day the U.S. coronavirus death toll surpassed the 50,000 mark.
In these extraordinary times much has changed. But even here in lockdown ACP remains my professional home. I walk Mulligan and our quarantine puppy, Flanagan, while listening to Bob Centor's Annals on Call. I read ACP Advocate a little too obsessively. I am proud of ACP's swift and successful push for pay parity for telemedicine and for their support of small physician practices struggling to keep their doors open. I agree with ACP's passionately stated concern that painting the choice facing our nation as a binary one - re-opening or shutting down the economy – “creates unnecessary conflict and hampers decision-making.” On Meet the Press last Sunday morning, Chuck Todd asked his guests: “Where's the plan?” On Twitter Sunday night, Dr. Bill Fox, ACP Chair of the Board of Governors, replied “ Here it is”.
As a primary care doc in lockdown, myself, I realize I am lucky to be working. But as my group “reactivates” following social distancing I miss the daily banter with my colleagues. I miss coming out of an exam room and immediately sharing a painful story with my partner who used to sit next me. Above all I miss the “Sacred Space” of the exam room, unencumbered by masks, where because I have known a patient through cancer, a child's addiction, a lost job, a cheating spouse, aging parents – we connect and heal. Thirty million Americans will have lost their job and likely their health insurance according to the Economic Policy Institute. I wonder how many of them are my patients.
In my personal life I miss the bear-hug greeting I used to get from my 85-year-old father (who retired from the practice of medicine at age 82). I miss the duets we sang over dinners. How fitting that our last big night out together was an IM PROUD event at Timothy O’Toole's where he “dropped the mic” at a Story Slam.
I remain an optimist at heart – and that is how I interpret Yeats' “terrible beauty.” Dr. Khalilah Gates, pulmonary and critical care specialist, powerfully captured how the COVID crisis has created a public health crisis we no longer can ignore. Chicago COVID-19 Cases by Zip Code, a gut-punch of a Grand Rounds slide, laid bare the dire consequences of poverty, inequality, and race in a sometimes cruel health care system: essential workers, multi-generational homes, obesity, chronic under-treated illnesses, and no easy way to social distance.
We can do better for ourselves as physicians too. Physician burn out, practice transformation, and growing professional isolation were issues prior to the pandemic. Disaster research teaches us that we are in the “fight or flight” mode now. Most of us – even us doctor humans - will need help in the next six months as we pivot from recovering from adverse events to overall stress. When asked how we can tell how a colleague is faring if we are all wearing masks, Dr. Gaurava Agarwal, Director of Physician Well-being at Northwestern Medical Group, advised us to consider who among us is high risk: older docs with pre-existing conditions, docs who struggle with depression, docs who live alone, COVID-quarantined docs coming back to work, docs with empty waiting rooms, and female docs with school-aged children. We will need to look out for each other, now more than ever.
Dr. Joan Anzia, psychiatrist, asks us to reframe the warrior as hero culture that trained us: “Resilient doctors reach out for help when they need it. As we listen to the fears for the safety and well-being of our patients and their families, we should anticipate the same responses from our colleagues.” In the March 23, 2020, JAMA study of front-line workers in Wuhan China, a significant proportion of participants experienced anxiety, depression, and insomnia symptoms, and more than 70% reported psychological distress.
ACP has been hard at work on the unique challenges we face. I value ACP's core mission: to serve as the collective, unified voice of internal medicine and to foster supportive communities in our work as internists. I believe our profession will be remembered for coming together – not coming apart - through this terrible crisis, and we will be changed, beautifully, on the other side. We will successfully and compassionately innovate, collaborate, teach, and care for our patients and ourselves in a post pandemic world. Your continued engagement in the ACP internal medicine community is essential to advance this important work.
Anne Furey Schultz, MD, FACP
What do we live for, if it is not to make life less difficult for each other? George Eliot
I can be changed by what happens to me. But I refuse to be reduced by it. Maya Angelou
You can't be that kid standing at the top of the waterslide, overthinking it. You have to go down the chute. Tina Fey
Congratulations Illinois Northern Awardees
Vineet Arora, MD, MACP
Christine A Sinsky, MD, MACP
Franklin B. Saksena, MD, FACP
Lynne M. Kirk, MD, MACP
Thursday, April 23, 2020 was to be the day of the 2020 Convocation Ceremony. ACP Illinois was looking forward to celebrating our members achievements. We regret that we must wait a full year to recognize them, but we congratulate them on their awards.
ACP's Comprehensive COVID 19 Resources
ACP is committed to doing everything possible to help internists prevent and slow the spread of COVID-19 virus to ensure that our patients get the care they need.
The resources on our regularly updated webpage include:
- Educational resources, including ACP's “Novel Coronavirus: A Physician's Guide”
- Resources on Telehealth including ACP's New Curriculum, Telemedicine: A Practical Guide for Incorporation into your Practice, and ACP's Telehealth Coding and Billing Practice Management Tips
- The collection of Annals of Internal Medicine
- Advocacy and Regulatory letters and statements
- A link to ACP's Member Forum
COVID-19 information resources from other organizations
- The Centers for Disease Control and Prevention website
- Johns Hopkins University: Corona Virus Resource Center
What is ACP's Vision for the US Health Care System?
On January 21, 2020, ACP published a supplement, “Envisioning a Better Health Care System for All” in Annals of Internal Medicine. Comprised of four papers, this comprehensive, interconnected set of ACP policies challenges the U.S. to implement systematic health care reforms to provide our patients with better care. As COVID-19 demonstrates, ACP's recommendations are more important than ever.
It is clear we are living in unprecedented times with so much uncertainty about what lies ahead. After careful consideration of the feedback and comments received from the Board of Governors, many of who are on the front lines, the discussion of the spring resolutions has been postponed until the fall. The ability for many Governors to find the time or focus effectively on resolutions right now seems unlikely. Given there is a full slate of resolutions the College will not accept any new resolutions for the fall.