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Governor's Newsletter January 2012

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January 2012 Garold O. Minns, MD, FACP, Governor



Dr. Minns

The end of 2011 and the beginning of 2012 bring on transitions in our Kansas Chapter of the American College of Physicians. After the Internal Medicine 2012 meeting in April in New Orleans, Sue Pingleton will assume leadership of our Chapter. As I conclude my term as Governor of the Chapter, I will provide you with an update of activities over the last six months.

I was notified November 18, 2011 that the Kansas Chapter was awarded the 2011 Chapter Excellence Award for the 2010-11 year (ending in June of 2011). This award recognizes Chapters which have achieved significant activities over the year such as associate mentoring, membership recruitment, Chapter meeting excellence, participation in leadership day and many other programs. This award recognizes the activities and commitment of our membership. Thanks and congratulations are in order for all of you who helped in this achievement.

The Chapter continues its involvement in the collaborative effort to promote the development of Patient Centered Medical Homes (PCMH). The collaboration was awarded a $500,000 grant in early 2011 to develop a number of PCMH pilot clinics. Two Internal Medicine clinics were selected to receive grants in this pilot program. The Internal Medicine Group, PA in Lawrence, Kansas and the KU School of Medicine-Wichita Internal Medicine Clinic were recipients of this initial grant cycle. Both clinics continue to develop activities which promote the PCMH concept. The next annual meeting of the PCMH consortium will occur September 14-15, 2012 at the KU Edwards Campus in Overland Park, Kansas. Look for additional details as plans for the meeting are finalized.

The Board of Governors fall meeting was held in San Antonio in September 2011. As usual it was a productive and informative meeting. A number of presentations were given about clinics that have developed ACO like delivery systems. The challenges and potential rewards of such models were interesting and will be instructive as all of us consider developing or joining similar organizations.

Robert Doherty, Senior Vice President, ACP Governmental Affairs & Public Policy, presented his usual comprehensive and insightful analysis of Capitol Hill activities. Obviously, many issues are in limbo as Congress engages in gridlock and we enter the 10 month period before major elections. In addition, the ACA health care bill is also in limbo as it awaits review by the Supreme Court. It is certainly a time of uncertainty and a murky future for medical providers.

Mr. Doherty emphasized that negotiations about the final ACA legislation did not include discussions about the SGR Fix. ACP continues to insist that the SGR fiasco be fixed as soon as possible but the SGR Fix and the ACA were separate issues during the health care reform deliberations. Congress continues to struggle with the SGR problem. While everyone seems to agree that the SGR is a failed concept, no one has agreed on how to pay for the cost of eliminating it.

The Board of Governors reviewed a number of resolutions, some of which were forwarded on to the Board of Regents (BOR) which approved the resolutions listed at the end of this newsletter. If any chapter member has suggestions for a resolution, please contact James Gardner, Chair of the Health and Policy Committee or myself. However, resolutions will not likely be approved by the BOR unless they address one of the current priorities of ACP which are: 1) Priority A, To be the premier synthesizer and distributor of education and information, 2) Priority B, To be the professional home for all internists (specialists, subspecialists and hospitalists) thru focused and customized membership development, 3) Priority C, To define and communicate the unique value of internal medicine, and 4) Priority D, To support changes in the U.S. health care system that improve patient care, improve health and promote cost conscious care.

The Kansas Chapter meeting occurred October 1-2, 2011 in Wichita. The meeting was considered a success by the attendees and the meeting assessment was positive. Associates participation was excellent. The awards for oral presentations went to Karim Masri from Wichita for his first place presentation titled "Chronic Cannabis Intoxication with Hyperemesis, Epigastric Crises, and Conditioned Relief Bathing Behavior"; second place went to Iass El Lakkis from Wichita for his presentation on "Salmonella Pyomyositis". Third place went to Jessica Newman from Kansas City for her presentation on "An Exceedingly Unusual Disease Following an Uncommon Procedure: CJD S/P OLT". Linh Nguyen from Wichita was awarded for the best presentation on an infectious disease subject titled "Blastomycoses Dermatitidis in Kansas: A Case Series" and received a $500 check from the Infectious Disease Division of the School of Medicine in Kansas City. We thank the Infectious Disease Division and Dr. Dan Hinthorn for their support of our associates.

The meeting included enlightening presentations concerning bedside sonography for internists, Vitamin D deficiency, patient counseling for behavior change strategies, clinic policies for use of opioids for chronic pain unrelated to malignancies, medical coding to optimize coding accuracy, and many other topics. Dr. Fred Ralston, Immediate Past President of ACP was the guest lecturer for the Delp lectureship. He presented "Looking Back and Forward: U.S. Health Care Delivery and Insurance Coverage". It was a very instructive presentation. We greatly appreciated Dr. Ralston's presence at our Chapter event.

I also want to acknowledge the invaluable support and allegiance by the Delp endowment to our Chapter. They support the costs of the Delp dinner, the Delp Lecturer, and awards for the Associates' presentations. Dr. Alan Fleming leads the Delp endowment and has been stalwart in our Chapter.

This year, the Delp Committee recognized two third year residents (one from each Internal Medicine residency in Kansas) for demonstrating the physician characteristics and ideals modeled by Dr. Delp. The awardees were Jeremiah Kempke from Wichita and Laura Frye from Kansas City. Congratulations to both of them.

Dr. Nancy Nowlin of Lawrence, Kansas was awarded the Laureate Award by the Kansas Chapter at the conclusion of the Delp dinner. Congratulations to Dr. Nowlin.

Dr. Pingleton is currently working on the program for the 2012 Chapter meeting. The dates for the meeting are October 5-6, 2012. If you have suggestions for the program, please contact her. The meeting will be held in Kansas City. The location for the meeting has yet been determined. I hope you can attend.

Also, I hope you can attend Internal Medicine 2012 in New Orleans April 19-21. As always, it will be one of the best Internal Medicine meetings for the year providing excellent updates, networking opportunities, associate and student posters, and time to meet colleagues. New Orleans is always a great city and meeting place. I hope to see you there.

This will be my last newsletter as your Governor. It has been my pleasure and privilege to serve you over the last four years. Please support Dr. Pingleton as she assumes the Governor's position this April.


Resolutions - Final Results of BOG Business Meeting, Fall 2011

2-F11. Requesting Chapter Input When Considering the Development of ACP National Quality Initiatives

RESOLVED, that the Board of Regents requests chapter input where appropriate and feasible when considering the development of ACP National quality initiatives; and be it further
RESOLVED, that the Board of Regents assures there is direct communication with chapters once ACP National quality initiatives are developed so that chapters can educate members and support the implementation of such programs.
The Board of Governors recommends that the Board of Regents adopt this resolution as amended.


3-F11. Developing Programs to Retrain Previously Active Physicians to Resume the Practice of Internal Medicine

RESOLVED, that the Board of Regents encourages the development of programs to retrain a previously active physician who demonstrates a sincere commitment to resuming the skilled and competent practice of internal medicine; and be it further
RESOLVED, that the Board of Regents advocates for sources of funding to support the training of previously active physicians who wish to resume the practice of internal medicine.
The Board of Governors recommends that the Board of Regents adopt this resolution as amended.


4-F11. Providing Educational Programs and Specific Guidelines for Outpatient Pain Management, and Supporting a National Standard of Rational Use

RESOLVED, that the Board of Regents provides education and guidelines for outpatient pain management; and be it further
RESOLVED, that the Board of Regents supports a national standard of rational use of opioid narcotics. The decision to prescribe narcotics should be evidence-based and remain that of the practitioner after complete assessment of the patient.
The Board of Governors recommends that the Board of Regents adopt this resolution as amended.


6-F11. Encouraging Continual Assessment and Further Research into Improving the Usability, Functionality, and Workflow Efficiencies of Incorporating EHRs into Medical Practice

RESOLVED, that the Board of Regents encourages continual assessment and further research into improving the usability, functionality and workflow efficiencies of incorporating electronic health records (EHR) into medical practice to include patient, physician, trainee, and other healthcare professional satisfaction; and be it further
RESOLVED, that the Board of Regents encourages continual assessment and research to include estimates of the direct cost of implementing and updating EHR technology, including conversion of ICD codes both current and future, and the indirect costs (or savings) from the resulting changes in practice (e.g., staffing, facility, productivity); and be it further
RESOLVED, that the Board of Regents communicates on behalf of ACP members on the impact of EHR implementation on productivity to vendors, government regulators, payors and physician employers.
The Board of Governors recommends that the Board of Regents adopt this resolution as amended.


7-F11. Advocating for the Reinstatement of EPA Oversight of Natural Gas Drilling

RESOLVED, that the Board of Regents advocates for the reinstatement of EPA oversight of natural gas drilling throughout the United States.
The Board of Governors recommends that the Board of Regents adopt this resolution as amended.


The following resolutions were not recommended to the Board of Regents:

12-F10. Encouraging the U.S. Senate to Ratify the United Nations Convention on the Rights of the Child
5-F11. Studying Whether the Clinical Use of Products Promoted at Internal Medicine 2012-2013 Will Further Appropriate and Effective Care that Maximizes Value
8-F11. Consulting the Ethics Committee and Informing Members in Advance about ACP's Proposed Relationships with Other Organizations


Withdrawn by sponsor:

1-F11. Developing an Affiliate Membership Category for All Allied Health Care Professionals Involved in the Patient-Centered Medical Home
(July 2011 BOR action fulfilled this resolution's intent)


Photo Gallery

Nancy Nowlin
Laureate awardee - Drs. Nancy Nowlin and Garold Minns

Karim Masri
Drs. Karim Masri and Donna Sweet

Drs Frye and Kempe
Delp awardees; Left - Drs. Laura Frye and far right Jeremiah Kempke. Center - Dr. Garold Minns

Oral Presentation winners
Left - Oral presentation winners, Drs. Karim Masri, Iass El Lakkis, and Jessica Newman, Back row - Dr. Garold Minns