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GOVERNOR'S NEWSLETTER February 2015

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Phillip F. Bressoud, MD, FACP, ACP Governor

From the Governor's Desk

Maintenance of Certification (MOC) remains the greatest single concern of our members as well as the ACP Board of Governors. Last year, the ACP Board of Governors passed a resolution directly the ACP leadership to address the ACP members' concerns regarding MOC with the ABIM. Although discussions with the ABIM began early last summer almost as soon as the ACP resolution passed, the discussions were tenuous and slow going initially. The ACP was instrumental in getting the ABIM to reassess the MOC program which resulted in significant changes which were announced this January including the revision of the actual exam to be more clinically relevant to practicing physicians and suspension of the patient voice and practice assessment programs while they are reanalyzed. The ACP continues to be engaged in a dialogue with the ABIM during this retooling process and is committed to making is members voices heard.

At the state level, I continue to work with Dr. Tracy Ragland of the Greater Louisville Medical Society multi-specialty advocacy group on legislative issues that affect our ability to practice and care for our patients. We are fortunate to have ACP member Dr. Ralph Alvarado (R) serving as a first term senator in our legislature. Ralph has already introduced SB 58 to keep the medical board from using MOC or maintenance of licensure (MOL) as part of Kentucky's licensing requirements. Without such legislation MOC or MOL will become the de facto standard for continuing medical education. To receive email updates regarding SB 58 or other healthcare related bills by registering for Bill Watch.

Our annual meeting in September was a great success with several new offerings include a Maintenance of Certification on Update in Internal Medicine, over 60 student and resident research posters, presentations by Dr. Daisey Smith for the ACP on High Valued Care and How to Incorporate High Valued Care into Training Curriculum for program directors, Medical Jeopardy Competition and our annual awards dinner. While this was our most ambitious annual meeting ever, we are already working on improving the meeting for 2015.

Finally, please take time to register for Internal Medicine 2015 if you have not already done so. The ACP continues to host internal medicine's premier meeting. We will be sponsoring our first ever team for the national Doctor's Dilemma completion and I hope you get a chance to see them in action during the competition. We will once again host a reception along with Tennessee and North Carolina for those attending. I look forward to seeing you in Boston.

Sincerely,

Dr. Bressoud signature

Phillip F. Bressoud, MD, FACP
Governor

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ABIM: "We Got It Wrong. We're Sorry"

I hope by now you have seen the email that was recently sent by Dr. Richard Baron, ABIM President, to all ABIM diplomats about Maintenance of Certification (MOC). Clearly the "We got it wrong" was an admission that the process was broken. The ABIM has already suspended the Patient Safety, Practice Assessment and Patient Voice requirements for two years. While there remain significant problems with the recertification examination, it is a major step in the right direction. Significant changes are being made to the recertification examinations to make the more relevant to everyday practice.

While versions of MOC exist around the world, the United States is the only country that requires their physicians to pass recertification examinations to maintain their board certification. Unfortunately, the pass rate on the examination declined over several years bottoming out at 67% in the spring of 2014 for first time recertification. Although, the pass rate for the fall 2014 group improved to 79%, it still means that 1 in 5 practicing physicians failed the exam. The ABIM has advocated that board certification is not required to practice and loosing board certification should not be an issue for practicing physicians. The ABIM's anachronistic view of importance of board certification and licensure exemplifies just how detached the ABIM is from the reality of the profession. The ABIM has no idea how their decisions and processes have turned the lives of physicians upside down and in some cases ruined their careers and livelihoods.

Last year the Board of Governors of the ACP passed resolutions calling for the ACP to engage the ABIM in frank discussions to reform the MOC process or seek an alternative method of board certification. ACP has long supported the principle of maintenance of certification and the importance it places on lifelong learning, physician accountability, and demonstration of ongoing competence. The ABIM recommended that the ABIM address problems with the MOC process in 4 areas:

  1. Content, i.e. making substantive changes in the MOC process, including the secure examination and the self-assessment of practice component
  2. Timing, i.e. making the changes on a very rapid timeline
  3. Website reporting, i.e. changing "meeting MOC requirements" to "participating in MOC"
  4. Tone of communication, i.e. accepting responsibility for the problems (and for fixing them) rather than defending the current MOC process.

It appears that the ABIM is finally listening and making significant and meaningful changes to the MOC program. Although the MOC recertification exam hasn't been eliminated, the ABIM has begun to make significant and meaningful changes to the program. There is still much to do at the national and state level regarding MOC. As your Governor I will continue to advocate on your behalf for MOC reform at both the state and national level.

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Kentucky Chapter's New Master

I am pleased to announce that former Chapter Governor, Dr. Joseph Weigel (Somerset, KY), is our chapter's newest Master of the College. Joe is a 1981 graduate of the University Of Louisville School of Medicine and trained at University of Alabama- Birmingham before returning to his hometown of Somerset, KY to practice general internal medicine for the next 30 years. While maintaining a busy practice, Dr. Weigel served as an assistant clinical professor at UofK and UofL as well as the Lincoln Memorial Debusk College of Osteopathic Medicine. In addition to his professional activities, Joe is an avid runner.

While many would consider slowing down or even retiring, Dr. Weigel has taken his passion for teaching and is now the training program director for a new Osteopathic Internal Medicine Residency Program at Lake Cumberland Regional Hospital.

Dr. Weigel joins the chapter's 5 other Masters: Dr. David Bybee (Louisville), Dr. Harry Carloss (Paducah), Dr. James Holsinger (Lexington), Dr. Albert "Cap" Hoskins and Dr. Richard Redinger (Louisville).

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ACP's High Value Care Coordination Toolkit

ACP's High Value Care Coordination Toolkit features resources to improve referrals and care coordination between primary care physicians and specialists, eliminate waste and duplicative care, and create more efficiency in care delivery.

The toolkit was developed collaboratively through ACP's Council of Subspecialty Societies (CSS) and patient advocacy groups. CSS acts as a forum for the exchange of ideas between ACP and subspecialty organizations on matters affecting medicine in general and subspecialty societies in particular.

The High Value Care Coordination Toolkit includes 5 components:

  • A checklist of information to include in a generic referral to a subspecialist practice.
  • A checklist of information to include in a subspecialist's response to a referral request.
  • Pertinent data sets reflecting specific information - in addition to that found on a generic referral request - to include in a referral for a number of specific common conditions to help ensure an effective and high-value engagement.
  • Model care coordination agreement templates between primary care and subspecialty practices, and between a primary care practice and hospital care team.
  • An outline of recommendations to physicians on preparing a patient for a referral in a patient- and family-centered manner.

These resources are part of ACP's High Value Care initiative, which is designed to help doctors and patients understand the benefits, harms, and costs of tests and treatment options for common clinical issues so they can pursue care together that improves health, avoids harms, and eliminates wasteful practices.

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Medical Trivia Team to Compete at National Meeting

At the Fall Chapter meeting, we held our first Doctor's Dilemma (Medical Jeopardy) competition. Three teams (One from UK and two from UofL) competed to earn the right to represent the Kentucky Chapter at the national doctor's dilemma competition. The winning team from UofL composed of Drs. Udit Chaddha, Justin Kingery, Amrik Ray and Rahul Sinha will represent our Chapter at the national meeting in Boston, MA in May. Please look for Doctor's Dilemma sessions during the annual meeting and cheer our team on.

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Register Now Open for Annual Session

Internal Medicine 2015

I would encourage you to consider attending and registering now for the best selection of pre-courses, CME and MOC courses, reserved sessions and hotel rooms. I look forward to meeting seeing you in Boston.

Internal Medicine 2015: Sessions

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