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U.S. Navy Governor's Newsletter June 2021

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CDR Mark P Tschanz, DO, FACP, ACP Governor

CDR Mark P Tschanz, DO, FACP, ACP Governor

 


Governor's Welcome

Welcome to the summer 2021 Newsletter! It is graduation and PCS season – I hope the transitions are smooth for everyone moving somewhere else in the world! Congratulations to the newest board-eligible internists and subspecialists, and to all the graduation interns embarking on operational tours!

ACP has been busy over the last months keeping the COVID updates current, continuing many virtual CME opportunities, and slowly planning a return to future live events. The Tri-Service ACP Scientific Planning Committee has also been very busy preparing for our virtual September meeting. Although we cannot meet in person this year, we will still have days of military-specific lectures, subspecialty breakout rooms, research and clinical posters. In addition, I hope you can join for our faculty development pre-course, and invite everyone watch the Navy Doctor's Dilemma team win the 2nd Tri-Service Bowl.

Please reach out to me if you have any questions about the chapter or are interested in volunteer opportunities.

Very Respectfully,

Mark

CDR Mark P. Tschanz DO, MACM, FACP

Governor, Navy Chapter, American College of Physicians.

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Happening Soon!

2021 Tri-service ACP Scientific Meeting: Virtual (Zoom)

September 8-10, 2021

Pre-course (Faculty Development) on September 7, 2021

Registration details will be coming soon. Registration will be required (link will be on the Navy ACP website) to gain access to the multiple Zoom rooms. There will be NO registration fee!

Abstract Competition: Due 09 July 2021!

Abstract Competition Categories:

  • Basic (Bench) Research
  • Clinical Research
  • Quality Improvement/Process Improvement
  • Clinical Vignette
  • High Value Care

As in years past, all Resident abstracts for presentation in a competition will be selected at the program level. Each program will select their top abstract for each of the following categories, and submit them directly to the abstract coordinators via e-mail at army.airforce.acp.abstracts@gmail.com.

All Fellow and ECP abstracts, as well as noncompetition Resident abstracts, should be submitted directly from the authors to the ACP abstract portal.

Authors should select their desired category from the list above.

All Fellow and ECP abstracts, as well as Resident abstracts not selected for competition will be considered for a podium presentation in a subspecialty breakout session OR for the open (non-competition) poster session.

The final deadline for online submission will be Friday, 9 July 2021.

Chapter Awards Nominations: Due 01 August 2021!

The chapter is accepting award nominations, to be awarded at the virtual Tri-service meeting 8 – 10 September 2021. Please see the information below regarding the awards and nomination process. Past winners are listed on the chapter website.

Please email your nomination letters to the Chair of the Chapter awards board, LCDR Matthew Russell.

  1. Spark's Award: Awarded to the most outstanding Internist at a non-teaching MTF or Family Medicine training program.
  2. VADM Nathan Young Leader's Award: Awarded to the top performing junior Internist at any MTF (LTs and LCDRs only).
  3. Master Teacher Award: Awarded to a faculty member with at least 7 years of experience (at least 3 as IM training staff).
  4. Volunteerism Award: Awarded to any Internist for consistent and/or extraordinary volunteer activities outside the military setting.
  5. Captain Patricia V. Pepper Senior Leadership Award: Awarded annually to an outstanding female internist at the rank of Commander (O-5) or above who has proven herself to be an exceptional leader at her command and across Navy internal medicine; a mentor and educator for residents, medical students, and junior attending physicians; and, above all, a compassionate and dedicated advocate for her patients.
  6. Laureate Award: The Laureate Award is presented to long-standing and loyal supporters of the College who have rendered distinguished service to their chapters and community and have upheld the high ideals and professional standards for which the American College of Physicians is known.

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Interested in Fellowship (FACP)?

Attention new residency graduates! Apply now for the Guided Fellowship program! For 2021 graduates only, applications will be accepted until November 15, 2021, with the program starting in January 2022.

The ACP Guided Fellowship Program provides early career physicians with guidance toward meeting the requirements for ACP Fellowship over a three-year program time period. This program, available only to physicians at the end of residency training, provides a framework — along with guidance from established ACP leaders — for advancement to ACP Fellowship through the completion of professional development activities. For Navy graduates, you will be able to meet the program requirements through your normal duties as a new internist (hospital committee work, clinic leadership, board certification, scholarship, mentorship, etc.).

For those who are not new graduates, please check out the ACP webpage for more information about fellowship. Fellowship in the College is an honor. Being an FACP® is a distinction earned from colleagues who recognize your accomplishments and achievements over and above the practice of medicine. The most important considerations for ACP Fellowship are excellence and contributions made to both medicine and to the broader community in which the internist lives and practices.

The basic requirements to apply for fellowship are board certification, licensure, clinical practice for 3 years out of residency, and being a dues paying member for the previous 3 years. In addition, additional requirements include other professional activities – teaching, community service, leadership, scholarship, etc. Please contact me if you have any questions about how to achieve fellowship after reviewing the link above.

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From the archives: ACP History – African American Trailblazers:

James Derham

Born into slavery in Philadelphia on May 2, 1762, James Derham became our nation's first African American physician. Enslaved by three physicians, Derham learned to practice medicine, bought his own freedom, and established his own medical practice in New Orleans, defying the racism and injustice of the times. Derham was first enslaved by John Kearsley Jr., a Philadelphia physician who was considered an expert on throat diseases. Derham learned to read and write as a child and was later trained by Kearsley to compound medicines and wait on patients. After Kearsley's death, Derham was enslaved by Dr. George West, a British physician, who had Derham assist him in performing basic medical tasks. At the end of the Revolutionary War, West left Philadelphia to return to England, and Derham was then enslaved by New Orleans physician Dr. Robert Dove. Dove encouraged Derham to practice medicine and trained him to be a medical assistant and apothecarist. Derham purchased his freedom by working as Dove's assistant for four years. Derham freed himself in 1783 at the age of twenty-one and started his medical practice in New Orleans.

In colonial times, most medical practitioners learned their skills as apprentices of established doctors, so Derham's medical training was like most medical practitioners. (Of the approximately 3500 doctors in the United States in 1800, only about ten percent had been professionally trained in a medical school.) New Orleans, a French territory at the time, was not as openly racist as American cities of the same period. As a result, Derham treated both Black and white patients. In just five years, He had become one of the most popular and distinguished doctors in New Orleans, and was particularly admired for his knowledge of English, French, and Spanish.

In 1788, Derham met with prominent physician Dr. Benjamin Rush, the man often called the “father of American psychiatry.” Rush had heard of Derham's reputation for successfully treating diphtheria patients in New Orleans. Apart from his medical interest, abolitionist Rush may have been interested in interviewing Derham, as a means of challenging racist stereotypes. At the time, Derham was eager to return to Philadelphia to be formally baptized in the Episcopal Church he attended as a child. With Rush's encouragement, Derham returned to Philadelphia, where he became renowned as an expert in throat disorders as well as the relationship between climate and disease. Rush was so impressed with Derham that he read his paper on the treatment of diphtheria before the College of Physicians of Philadelphia.

Derham returned to New Orleans in 1789. During the yellow fever epidemic of the late 18th Century that raged through New Orleans, he managed to save the lives of 80% of his patients who had contracted the disease. His career progressed without much interruption until 1801, when city commissioners in New Orleans decided to limit the activities of individuals practicing medicine without medical degrees. Derham was restricted to serving as an assistant to degreed physicians. Derham was disconcerted about the restriction, and in his May 20th, 1801 correspondence to Rush, indicated that he would like to return to Philadelphia if his opportunity for earning a living would improve.

Here the mystery of Dr. James Derham begins. His letter to Benjamin Rush, dated April 5, 1802, is the last historical trace of this medical pioneer. Some think that Dr. Derham did in fact return to Philadelphia to open a medical practice; others speculate that he may have died of yellow fever or perhaps moved to some other place to continue treating patients. In any event, his fate and eventual death are unknown. Despite this mystery, the story of Dr. James Derham is a remarkable testament to the human spirit. Throughout his life, Dr. James Derham defied both cultural expectations and systemic racism to become a doctor in an age when such events were nearly unattainable.

Nathan Francis Mossell

A generation or two later, Nathan Francis Mossell continued the quest for equal rights by becoming the first African American to graduate from the University of Pennsylvania's Medical School.

Mossell was born in Hamilton, Ontario, Canada on July 27, 1856, to free Black parents. Married in Baltimore, Mossell's parents moved to Canada in 1853, their three children in tow, seeking a less discriminatory environment and greater educational opportunities for themselves and their children.

During the Civil War, the Mossell family, now including six children, resettled in upstate New York. In 1879, Nathan graduated from Lincoln University, a historical Black college outside of Philadelphia and then entered the Medical School of the University of Pennsylvania. He graduated in 1882, becoming the first African American to graduate from Penn's Medical School.

After graduation, Dr. Mossell was trained first by prominent surgeon Dr. D. Hayes Agnew in the outpatient surgical clinic of the University Hospital. Systemic racism made it difficult for Black students to secure internships in the United States, so, Mossell traveled to England to complete an internship at the Guy's, Queens College and St. Thomas hospitals in London. In 1888, after his return to Philadelphia, Mossell opened an office at 924 Lombard Street and surmounted significant racist opposition to become the first African American physician to obtain membership in the Philadelphia County Medical Society.

Not content with these accomplishments, Dr. Mossell founded The Frederick Douglass Memorial Hospital and Training School, which was only the second Black hospital in the United States at the time. The Hospital, a Black-owned and operated 15-bed facility at 1512 Lombard Street, offered healthcare services to the African American community in Philadelphia; it also trained Black nurses and provided internships for Black physicians. In 1909, the hospital purchased a new building with 75 beds at 1534 Lombard Street.

In addition to his medical achievements, Mossell also played a leading role in civil rights and political action. He was one of the first to pressure for the hiring of Black professors at his alma mater Lincoln University. In 1900, Dr. Mossell co-founded the Philadelphia Academy of Medicine and Allied Sciences, an association for African-Americans in medicine; was a founder and director of the Philadelphia branch of the National Association for the Advancement of Colored People in 1910; and was a member of the Niagara Movement organized by W.E.B. DuBois in 1905. He spent decades advocating for the integration of Girard College. Mossell also worked with state representative Arthur Faucett, to pass a bill banning exclusion of Black students from university housing at Penn.

Nathan Mossell, his wife Gertrude and their two daughters, Mary, and Florence Alma, lived at 1432 Lombard Street in Philadelphia. Gertrude Bustill Mossell worked as a professional writer and editor, publishing several books, and working for such Philadelphia papers as the Press, Times, and Inquirer. She also became active in civic causes, especially fund raising for Douglas Hospital and the establishment of the Southwest branch of the YWCA.

Both Nathan and Gertrude Mossell were part of remarkable extended families. Her great-grandfather had been a baker for George Washington's army and her sister became the mother of singer and actor Paul Robeson. Nathan's younger brother Aaron Albert Mossell was the first African American to graduate from Penn's Law School in 1888; Nathan's niece, Sadie Tanner Mossell Alexander earned her Ph.D. from Penn in 1921, she became the first Black woman to obtain a Ph.D. in the United States. She was also the first African American woman to graduate from Penn's Law School and the first to be admitted to the Pennsylvania Bar.

Mossell served as Frederick Douglass Memorial Hospital's chief-of-staff and medical director for 35 years, retiring in 1933. He continued to work in his private practice until shortly before his death at age 90, on October 27, 1946. Two years after his death, Frederick Douglass Memorial Hospital merged with Mercy Hospital, to create Mercy Douglass Hospital which continued to serve Philadelphia until its closure in 1973. At the time of his death, Nathan Francis Mossell is believed to have been our nation's oldest practicing Black physician.

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Podcasts to check out:

Looking for some new podcasts to add to your library, or new to podcasts? ACP has wonderful and fresh material to check out!

ACP is partnering with The DEI Shift, a podcast hosted by internists that focuses on diversity, equity and inclusion in medicine. ACP members can claim continuing medical education (CME) credits and maintenance of certification (MOC) points for each episode by logging into ACP's Online Learning Center.

Annals On Call: Annals of Internal Medicine podcast hosted by Dr. Robert Centor, exploring recent publications. Visit the website to learn about CME credit.

Curbsiders: Likely the best-known podcast, with hundreds of podcasts on multiple topics. CME is available as well – check out the webpage or subscribe!

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Clinical Corner:

What has been published recently that your residents know before you???

A couple of pertinent blood pressure updates for you this month!

Check out the synopsis of the new 2021 KDIGO Guidelines published in the Annals of Internal Medicine. It seems the pendulum has completed its' swing, and the new target systolic blood pressure for many patients with chronic kidney disease is less than 120 mmHg. Pay special attention to the section on proper blood pressure measurement (“standard” office blood pressure), as this is a key portion of the guideline. If you don't have your clinic staff on board with proper blood pressure management, now is the time! Maybe someone can present this as a QI project at Tri-Service ACP 2022!

Next article for review is from the Lancet, and it involves renal denervation. Thanks to CDR Travis Harrell for providing this article. The RADIANCE-HTN trial compared renal denervation to “standard therapy”. As is often the case with these articles, there is much to learn outside of the abstract. In this trial, they switched all “resistant” hypertension patients to a single fixed dose of a triple therapy (calcium channel blocker, an angiotensin receptor blocker, and a thiazide diuretic) before enrollment. This simple, single daily dose controlled the blood pressure in many of the formerly “resistant” hypertension patients. Simple dosing regimens may work for many of our patients.

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