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North Dakota Governor's Newsletter August 2019

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Fadel Nammour, MD, FACP, ACP Governor

Fadel Nammour, MD, FACP, ACP Governor


Registration for Annual Meeting

Registration is now open for our Annual Scientific Meeting being held October 4 at the DoubleTree by Hilton Hotel in West Fargo. We are joining the North Dakota Medical Association for a combined meeting.

We are excited for the annual poster competition for medical students and residents on October 3. The Doctor's Dilemma competition for residents will also be on October 3.

Please visit our Chapter web site for additional information.



Your Feedback is Requested on Fall 2019 BOG Resolutions

The North Dakota Chapter requests your feedback on the 15 resolutions that will be heard at the Fall 2019 Board of Governors Meeting. The resolutions have been posted on ACP Online for your review.

After considering the intent of each resolution and how it fits with the College's Mission and Goals, please provide your feedback on each resolution and indicate your support or opposition by completing the electronic response form by September 9. Your input will be used as part of testimony on behalf of the chapter.

Thank you for taking time out of your busy schedule to provide comments regarding these resolutions. By providing your feedback on the Board of Governors resolutions, you have helped to shape College policy that impacts the practice of internal medicine. Please visit the chapter's Web site after the Fall 2019 Board of Governors meeting for updates.



Resident Corner

Dr. Erik Heitkamp, PGY3, attended IM 2019 in Philadelphia as part of the resident Doctor's Dilemma team. He shares his opinion on the Opening Ceremony speaker at the meeting.


It was with immense enthusiasm that I attended the annual ACP Internal Medicine meeting this year in Philadelphia, PA. This was my first time attending the annual conference and the first time North Dakota has been represented in recent history during the Doctor's Dilemma competition. With all the various conference attractions including lectures, skills clinics and poster competitions, one aspect that I was told stands out each year is the opening ceremony. This event kicks off the ensuing conference and, in part, sets the tone for where medical care is heading or exciting changes in medicine. This year's attendees were very fortunate to hear from Vice Admiral Dr. Vivek H. Murthy, MD, the 19th Surgeon General of the United States from 2014-2017.

Dr. Murthy's conversation with ACP Executive Vice President and Chief Executive Officer Dr. Darilyn V. Moyer, MD was compelling and emotional to say the least. Dr. Murthy spent a large portion of the conversation discussing what he feels is the largest health concern facing our country in modern times, the idea of loneliness and its effects on the individual's health as well as from a societal stand point. Dr. Murthy reviewed how loneliness and isolation has led to poorer health outcomes, including obesity, sedentary lifestyles, decreased work satisfaction and, particularly for physicians, increasing rates of physician burn out. Additionally, Dr. Murthy reviewed how the implications of technology and social media have slowly led to more individualism and less personal interactions, creating an isolated, more self-focused society. Dr. Murthy even discussed how the fear of being sued or finding a work-life balance has distanced professional colleagues within medicine to spend less time relating to one another and more time apart, as an individual. During his time as Surgeon General, Dr. Murthy and his staff worked diligently to raise awareness regarding the growing concern of loneliness and how it has, in a large way, negatively affected our health and wellbeing.

From a resident stand point, the idea of loneliness, depression, anxiety, work-life balance and risk of physician burn out isn't a new concept. This idea is one that has been strongly reviewed and stressed throughout my medical training, implying the significant importance this topic has on healthcare, specifically the individual health of our patients and ourselves. In residency, it is easy to fall into a pattern of working long hours, charting late into the evening and having little time to make a human connection with patients, coworkers or even your family. Dr. Murthy's comments resonated with me and help to re-engage the idea of fighting the urge to go about your daily work without taking the time to converse with patients, families, friends and coworkers. Within our profession, Dr. Murthy stressed the strong need of togetherness and teamwork. Rather than focusing only on what you have to offer for a patient, identifying how we, as a team, work together to serve all our patients, insisting the mentality that if we know one another we can work best together to serve those who entrust their care to us.

The ACGME has recognized the importance of work-life balance and has instituted duty hours to limit the amount of time residents spend working, thus ensuring safe patient care and reducing the risk of resident burn out. While this is immensely helpful, it isn't the whole picture. In my opinion, individual residency programs need to address the idea of loneliness within their own respective residencies. Within my program, our largest deterrent of loneliness is our program director who has an “always open door” policy. He is never “too busy” to sit and talk with residents about their concerns or individual needs. Additionally, our program is attempting to encourage resident social hours within any given month to foster a sense of togetherness and take a step away from solely the role of “coworkers”, but rather friends. We are working to incorporate social media, like twitter, to encourage social gatherings outside of the hospital or clinic. With large changes coming to our didactic curriculum this next year, we will try to encourage residents to incorporate simple pictures of their families, adventures, or interests within case conferences, journal clubs or other presentations to remind one another of who we are outside of resident coworkers. These are simple, yet effective, modalities that help to bridge the gap between loneliness and togetherness. I appreciate the reminder Dr. Murthy bestowed upon those who attended the opening ceremony and will continue to place the idea of togetherness in the forefront of the care I provide. This topic reminds me of a very famous quote from Henry Ford who once stated, “coming together is a beginning, keeping together is progress; working together is success.”