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ACP offers a number of resources to help members make sense of the MOC requirements and earn points.
Understanding MOC Requirements
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The most comprehensive meeting in Internal Medicine.
April 11-13, 2019
Internal Medicine Meeting 2019
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Ensure payment and avoid policy violations. Plus, new resources to help you navigate the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Access helpful forms developed by a variety of sources for patient charts, logs, information sheets, office signs, and use by practice administration.
ACP advocates on behalf on internists and their patients on a number of timely issues. Learn about where ACP stands on the following areas:
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Pam Hiebert, MD, FACP, ACP Governor
I attended the second Billings Clinic internal Medicine Residency graduation June 1, 2018.
Six excellent physicians successfully completed the internal medicine training program.
Christopher Dietrich, DO Faculty Hospitalist at Billings Clinic
Danielle deMontigny Avila, MD Infectious Diseases University of Alabama
Kylie Ebner, DO, Faculty Hospitalist at Billings Clinic
Christopher Kerrigan, MD, Addiction Medicine Vanderbilt University
Kevin Mitchell MBBS, Nephrology and Critical Care Brown University
Matthew Niemeyer DO, Faculty Hospitalist at Billings Clinic
The Billings Clinic IM residency continues to thrive with top notch faculty and residents.
I also had the honor of presenting the MT ACP Leadership Award to Kylie Ebner DO, graduating IM Resident. Dr. Ebner served as president of the Billings Clinic IM Residency Association. She serves as resident representative on the GME Teaching Committee and Program Evaluation Committee. She has also been very active in the MT Chapter of ACP with poster presentations and lectures at the Scientific Sessions. She recently attended ACP Leadership Day in Washington DC. She visited legislators to advocate for priorities of ACP. These include importance of GME funding, lower prescription drug costs, and measures to reduce firearm injury and death. Dr Ebner will be a great addition to the Billings IM Residency faculty starting this July. (picture)
Dr. Kylie Ebner, one of our graduating Billings Clinic Internal Medicine Residency residents, and I attended the ACP Leadership Day in Washington DC 5/22-23. The first day was spent learning about the legislative process and the ACP priority policy issues. We heard from our ACP lobby experts as well as those involved directly with the legislative process. On the second day, we met with the offices of Senators Daines and Tester and with Representative Gianforte himself. During our meetings we discussed some of the ACP priority issues including GME funding, prescription drug costs, and reducing firearm injury and death. Of course, during free time we explored venues along the Washington Mall.
Through this opportunity we gained insight into how physicians can affect healthcare policy and learned much about the process. We believe that our message was well received by our legislators and appreciate very much their willingness to meet with us and listen to our perspective. We also strongly appreciate the Montana ACP Chapter for this opportunity to advocate on their behalf.
Kylie Ebner DO ACP member
Steve Gerstner MD FACP
September 6-8, 2018
Double Tree Hotel, Billings
Don't forget to register for the Montana Chapter Scientific Meeting “Geriatric Women's Health”!
Visit the chapter website to view the meeting brochure and to register.
Hotel reservations can be made by calling (406-252-7400) or by using the following link: http://doubletree.hilton.com/en/dt/groups/personalized/B/BILDTDT-ACP-20180905/index.jhtml
September 8, 12:00 pm, Double Tree Hotel
Following the chapter meeting on Saturday, there will be a panel presentation on the following topics:
Negotiating a Contract – Katherine Dietrich, DO FACP
Contract Negotiations – Legal Pitfalls and Definitions – Rob Renjel, MBBS
Viewpoint from the C Suite – James Loeffelholz, MD, FACP
Well Being: Take Charge of Your Career, Clarify Your Goals, Achieving Gender Equity and Compensation and Advacement – Pam Hiebert, MD, FACP
Lunch provided with the $10.00 registration fee.
The WWAMI Internal Medicine interest group hosted the Osler club, June 11. We were honored to have Don Demetriades PHD, MSU philosophy professor. We had a lively discussion on the evolution of Hippocratic Oath. We read the ancient document and modern renditions of the oath. Consider reviewing the following:
NOVA - Official Website | The Hippocratic Oath Today
Modern Physician's Oath (The Lasagna Oath)
Declaration of Geneva - Wikipedia
Hippocratic Oath - Wikipedia
ACP's 2016-17 Annual Report from the EVP and CEO and Town Hall Webinar
ACP's Plan to Offer a Comprehensive Response to CMS's Proposed Physician Payment Rules
Thank you for sending your leaders to the Well-being Champions training at Internal Medicine. There were 73 Chapter Leaders trained as champions! They represented 46 domestic and 4 international chapters. As you know, the goal of the Well-being Champion program is to foster local communities of well-being by supporting chapter members, practices and organizations in addressing burnout and the conditions that create it. This training was an important first step; more great steps are coming.
We received survey evaluations from 78% of trainees. Overall, they were overall extremely pleased with the training and expressed gratitude that ACP is addressing this issue and that they were chosen (by you) to participate. Several key take-a ways were:
ACP is working on a number of next steps, including:
Sharon Hecker MD FACC, Montana ACP Wellness Champion
Physician burnout is a hot topic these days and it is easy to see why. What is “burnout”? Christina Maslach1 defines it: “Burnout is a psychological syndrome emerging as a prolonged response to chronic interpersonal stressors on the job. The three key dimensions of this response are an overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and lack of accomplishment.”
Six main factors seem to drive burnout: high workloads, workflow inefficiencies, increased time spent in documentation, loss of meaning in work, social isolation at work, and a cultural shift from health values to corporate values2.
Over 50% of physicians are considered at risk for burnout and this number is rising yearly3. While the personal costs of burnout are high (depression, divorce, substance abuse) health professional burnout can pose a significant threat to the clinical, financial and reputational success of an institution. For example, the national mean cost of a single physician turnover is $500,000. In other words, if an organization loses 4 doctors, the estimated cost of replacement is $2M.
In psychological research, the opposite of burnout is “engagement”. Engagement is considered a positive state and consists of high energy (vigor), dedication, and a sense of efficacy (absorption). There has been a concerted effort to collect data4 about what contributes to burnout and how we can change burnout to engagement, not just in individuals but in entire organizations.
The AMA “Steps Forward” program recommends the following nine steps2:
Something we can do ourselves, without the help of administration, is to support a “Community of Wellbeing”5.
Recognize well-being as a professional competency
Recognize burnout as a national epidemic and not a personal failure
Support peers' healthy behavior and help-seeking behavior
It is important that healthcare providers do not take on the entire burden of fixing this problem. Although there is much we can do around selfcare and advocacy, it is estimated that 80% of the factors contributing to burnout are organizational factors and outside of the direct control of healthcare providers3.
Figure 2: Key drivers of burnout and engagement in physicians6
A more engaged, satisfied workforce will provide better, safer, more compassionate care to patients, which will, in turn, reduce the total costs of care.
In fact, The Triple Aim of better care for individuals, better health for populations and at lower costs has been updated to the Quadruple Aim, with the fourth aim of clinician well-being7.
Most medical professional societies have taken up the cause of Professional Wellbeing and offer a number of resources which I will continue to share in this column. I will also spend some space focusing on solutions, some for the individual provider and some to help us advocate with our administrators and legislative representatives for change. If you have comments or suggestions, please feel free to stop me in the hall, email me at email@example.com or give me a call at 406-471-7429.