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In this Issue:
- Governor's Message
- Annual Scientific and Chapter Meeting
- Awards
- Women in Medicine
- Health and Public Policy
- Member News
- Maine Chapter Goes to SeaDogs game
- Membership Updates for Fiscal Year 2023/2024 Retired/Semi-Retired/Emeritus Rules
- Save the Dates
Stephen R. Hayes, MD, MACP, ACP Governor
Governor's Message
Spring has sprung! I hope everyone is feeling a sense of invigoration as Maine warms. Winter is a great time of year here, but there is nothing like the arrival of spring and increasing sunshine and temperatures to help everyone's outlook! This year, we officially welcomed the season with our 4th annual Engel Primary Care Symposium, held in honor and remembrance of our former governor and colleague Richard Engel. The focus this year was on osteoporosis and was a great review of the topic with much for us to take home around diagnosis and management.
The ACP has been developing tools and policy around many of the challenges facing us in medicine and facing society as a whole. I appreciate the feedback that many of you provided regarding the crop of resolutions that will be presented and debated at the ACP meeting in San Diego. I am looking forward to the debate, and I am anxious to see how we as an organization respond to the threats posed by climate change, firearms, limits on reproductive health rights, limits on gender affirming care, and other assaults on health, the practice of medicine, and our role in society. I will let you know what I learn!
Our chapter will remain focused on providing excellent educational opportunities and we have tried to build wellness focused activities to our offerings. Look for more to come. I hope we can extend the reach of some of these to different parts of the state. I always welcome suggestions and for those of you planning to be in San Diego, please come to the chapter reception and share your thoughts!
Take care everyone and be well!
Steve
Annual Scientific and Chapter Meeting
The Maine Chapter of the ACP held its Annual Scientific and Chapter Meeting on September 23rd through the 25th, 2022. The theme was “Challenges Facing Internists: From Psychiatry to Distance Technologies.” With prior years being virtual conferences due to the pandemic we were thrilled to have an in person conference this year.
The sessions opened with an update of ACP Leadership Day activities by Dr. Hani Jarawan, highlighting chapter representatives visits to members of Congress. This was followed by a legislative update at the state and federal level by Dan Morin from the Maine Medical Association.
Dr Henry Skinner's presentation on executive dysfunction was enlightening.
The chapter offered CME credits in “opioid prescribing” (to help attendees meet Maine licensing requirements) by offering back to back presentations on Suboxone/Buprenorphine by Dr. Emily Zarookian and Dr. Kristen Silvia.
A presentation by Dr. Christine Hein on wellness and professional satisfaction rounded out the didactic sessions for the day.
The Poster Sessions/Reception followed Friday afternoon's educational sessions.
The breakfast for Residents, Medical Students, Faculty and GAC members was well attended.
Breakfast is always a good way to start the day – along with good conversation.
The Saturday sessions were kicked off with 4 spectacular case presentations by Residents of the Maine Medical Center. This is the first year Elizabeth Eisenhardt, MD FACP as the Vignette Coordinator – there were 4 superb presentations !
Congratulations Dr. Eisenhardt on a job well done!
Jessica Evans MD: “Panniculitis, Pancytopenia, and Pathology reports: A Puzzling Case”
Katherine Herrick, MD: “An Unusual Case of Rapidly Progressive Multiorgan System Failure”
Rachel Heuer, MD: “Fever, Pancytopenia, and Hepatosplenomegaly in an HIV-Positive Patient”
Kimberly Toomire, DO: “A Case of Systemic Illness in a Young HIV+ Woman”
From left to right Elizabeth Eisenhardt, MD FACP, Vignette Coordinator,
Rachael Heuer, MD, Kimberly Toomire, DO, Jessica Evans, MD, Katherine Herrick, MD
Those were hard acts to follow.
Dr. Chessa was next on the agenda and provided 4 case studies, each providing an ethical dilemma. Many of us, as physicians, husbands, wives, father, mother may or may have faced theses dilemmas the decisions to be made. This was a thought-provoking presentation!
Stephanie Nichols, PharmD provided a better understanding of treatment options and sequence of medications for treatment resistant depression.
Thanks to the informational presentation by Hilary Eslinger, we are more familiar with Harm Reduction strategies allowing for better treatment and outcomes.
The Leonard Keilson, MD Memorial Lecture, “Wabanaki: Our Land Our Healing”, blended with the agenda. An attendee wrote: “I personally think WPHW provides just invaluable service to the Native American population in central and eastern Maine and is working hard in an otherwise underserved community.”
Attendees enjoying the Saturday evening reception.
Awards
Governor Stephen Hayes presents Dr. Kimberly Toomire, the winner of the Resident Vignettes. The winner of the Resident Cases of the Year wins a scholarship to present their vignette at Internal Medicine 2023.
The Maine Chapter thanked Rebecca Hemphill, MD FACP, for her service and leadership as Governor of the Maine Chapter for the past 4 years.
It was a great pleasure to announce Thomas P. Gearan, MD FACP as the recipient of the 2022 Laureate Award of the Maine Chapter. Dr. Gearan has been a longstanding active member of the Chapter and served as Chapter Treasurer. Congratulations Dr. Gearan!
Women in Medicine
The Women in Medicine met Sunday morning to discuss future meetings, events, etc. They requested more time to meet next year.
Dr. Hayes kicked the day off with a College Update and a Town Meeting, both provided conversations and discussions.
Dr. Dacso outlined the Fundamentals of Translational Research from the “Bench” to the “Bedside” and “Bedside to Community Focus.” This provided an interesting view of “Bench to Bedside.”
Andrea Lai, a pharmacist, provided a history of medication costs and the impact on patients. She discussed challenges related to new medical innovations and disease specific medications. There was a review of the many factions of medication pricing, including rebates, pharmacy benefit managers and wholesalers and pharmacies.
Dr. Dacso also provide a presentation on Telehealth and Rural Medicine in MaIne. He reviewed telehealth during and after the Pandemic. It was expressed that “Telehealth” is a two-way exchange of information between a patient and the provider. Telehealth allows teleconferencing and if available video conferencing with patients and their caregivers. It lends itself to discussion of test results more easily with the patient in the comfort of their home. Behavioral health is also available via telehealth.
Dr. Dora Anne Mills finished the educational program with a Post Pandemic Look at Health Care System Reform – Where Does It Stand Where is it Going? This was an interesting presentation looking at what has taken place during the Pandemic and the impact on public health – where do we go next, what do we change. We all were offered a peek of the future healthcare post Covid.
Dr. Dora Anne Mills closed the educational sessions with an interesting presentation
Overall, the session was contemporary and up to date. It was very well received by attendees. Next year we plan to be in Bar Harbor again and look forward to seeing you there!
Doug
Health and Public Policy
Election and Advocacy Updates
Midterm Election and the American College of Physicians
Abortion was second only to the economy in the mind of voters this past midterm election. Exit polls showed that the Supreme Court decision to overturn Roe v. Wade had a major impact on voter turnout and candidate choice. The backlash propelled state constitutional amendments protecting the right to an abortion, and defeated others meant to capitalize on the new landscape by banning abortion. Expect reproductive rights to be a crucial issue in the 2024 election and beyond.
Read more at https://www.kff.org/other/dashboard/health-care-in-the-midterm-elections-apvotecast-polling/
More broadly, pro-choice enthusiasm helped Democrats defy a historical trend of huge midterm losses for an incumbent president. Though the House flipped to Republican control, Democrats minimized losses to allow the Republicans only a narrow majority. Meanwhile, with Senator Raphael Warnock's special election win, Democrats gained a seat in the Senate. It remains to be seen how former-Democratic Senator Kyrsten Sinema's departure from the party will impact Senate politics.
The major effect of split control of the two chambers of Congress is threat of fiscal brinksmanship—government shutdown, debt ceiling default, or both—if the parties can't agree on a federal budget. (See more below)
Other health care issues that historically dominate election year debates—prescription drugs, long term care costs, climate change—were much lower in exit polls. Nonetheless, one ACP priority to expand Medicaid as allowed under the Affordable Care Act passed in South Dakota. Oregon passed a law to “ensure that every resident of Oregon has access to cost-effective, clinically appropriate, and affordable health care as a fundamental right.” Arizona passed a measure capping interest rates on medical debt to 3%, down from 10%.
Lastly, in the new 118th Congress, Maine senator Susan Collins became the top Republican on the powerful Senate Appropriations Committee, which has jurisdiction over all federal appropriations.
Lame Duck Advocacy
Before losing control of the House, Democrats pushed forward an ambitious agenda in the lame duck session of Congress. Fearing more unfavorable decisions from a 6-3 conservative Supreme Court, Congress passed and President Biden signed the Respect for Marriage Act to protect same-sex and interracial marriages at the federal level. Unfortunately, a push to extend the child tax credit—which cut the child poverty rate in half in 2021—failed to overcome a Republican filibuster, as did the president's renewed push for an assault weapons ban.
Physician Payment Cuts
Also in the end-of-the-year spending bill, the ACP and allies partially mitigated a harmful 4.5% Medicare payment cuts to physicians, and extended incentive payment to support physician practices participating in alternative payment models. Watch for updates and a Call to Action soon!
Budget Battle
President Biden unveiled his budget blueprint earlier in March. Congressional proposals are currently being debated in Senate and House budget committees. Beltway insiders believe that in order to secure the Speakership, Kevin McCarthy conceded to conservatives that top-line budget would equal 2022 levels without cuts to defense spending, which would mean deep cuts across the remainder of the federal government totaling more than $200 billion. In his State of the Union, President Biden publicly negotiated off the table cuts to Social Security and Medicare benefits, but the health care consequences of these standoffs remain.
With emergency measures already in place after the debt ceiling was reached in January, and the US government set to default on its debt sometime between July and September, expect a rancorous fight this Summer.
Maine Election and Advocacy Updates
Governor Janet Mills sailed to re-election. Democrats maintained their control of the State Senate and expanded their majority in the State House of Representatives, including with the election of ACP member Jane Pringle to the Maine House. Addressing substance use disorder, increasing health care access including abortion care, and clean energy initiatives are among the governor's top priorities.
Maine Medical Association Legislative Committee Meetings
Based on member input, the MMA legislative committee prioritized its advocacy plan for the 131st session of the Maine State Legislature. Look for updates in MMA weekly emails and on their advocacy website. There you can also find information on the legislative committee meetings, which is open to all members, and MMA's position on bills being tracked Bill Tracker 130-Status %287%29.pdf by the Association.
Maine Medical Association Statement on Health System Reform
The work of the Ad Hoc Committee on Health System Reform continues, with several successful listening sessions at the end of last year. A current draft and an opportunity to share your comments are linked here.
We welcome and encourage your questions, comments, and involvement in the Health and Public Policy Committee. Please reach out to HaniJarawan@gmail.com Stay tuned for more updates and opportunities to lend your voice to our advocacy!
Maine Medical Association's 2023 Physicians Day at the Legislature
Drs. Lisa Almeder and Hani Jarawan speaking with a member at Physicians Day at the Legislature. There was ample opportunity to speak with legislators and sit in on committee meetings of the chamber.
Member News
The Maine Chapter Congratulates chapter members that have been awarded the status of
Fellow in the American College of Physicians
Reid Andress, MD FACP. Dr. Andress was a previous Internal Medicine Chief at Maine Medical Center
Matthew Buttarazzi, MD FACP – Dr. Buttarazzi completed his residency at MMC.
Arjang Djamali MD FACP. Dr. Djamali is Chairman of the Department of Medicine, MMC.
Reynerio Lanoy, MD FACP. Dr. Lanoy is a hospitalist at MaineGeneral Medical Center in Augusta.
Maine Chapter Goes to SeaDogs game
Dr. Eric Mukai and Dr. Stephen Hayes
Current and Past Governors of Maine enjoying the game. Rebecca Hemphill, Steve Hayes & John Erickson
The Chapter attended a Sea Dogs baseball game in August, unfortunately, they did not win. We had great seats and enjoyed a BBQ during the game.
Robert L. Trowbridge, Jr, MD, MACP
The Maine Chapter is very pleased to announce that, Dr. Robert Trowbridge has been bestowed the status of Master of the American College of Physicians. Master is the highest level of membership in the ACP. Dr. Trowbridge is a hospitalist at MMC and the Senior Deputy Editor, MKSAP. CONGRATULATIONS Dr. Trowbridge!
Membership Updates for Fiscal Year 2023/2024 Retired/Semi-Retired/Emeritus Rules
The new Dues Reduction for Retired/Semi-Retired: (50% discount) will be only eligible for members 72 years of age or greater, fully retired or semi-retired (<20 hours a week), 10 or more years of continuous paid membership, US members only. Due to changing demographics and market conditions, ACP enacts this change from 60 years old minimum age of eligibility to now 72. Any existing member (Age 61+) who currently has been paying this rate will be grandfathered in to continue to receive with the stipulation they must maintain continuous membership annually. Any nonrenewal event will forfeit this rate and members will be referred to standard invoicing standards.
Waiver for Emeritus: ($25 annual fee) –75 years of age or greater, and 30+ years of membership, fully retired or semi-retired (<20 hours a week).
If you have any questions, please contact membership@acponline.org
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Save the Dates
Apr. 28, 2023 Joint ME & NH reception at IM 2023, The Fairweather Bar
Aug 12, 2023 Sea Dogs baseball 6:00 pm game time
Sept 15–17, 2023 2023 Maine Chapter Annual Scientific & Chapter Meeting
Atlantic Oceanside Hotel & Conference Center Bar Harbor
Watch your inbox for more information