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U.S. Navy Governor's Newsletter May 2019
In this Issue:
- Governor's Welcome
- Member Update
- Wellness Update
- New Fellows
- Around the Horn
- Opportunities for Engagement
- Updates from the College
- Clinical Corner
CDR Mark P Tschanz, DO, FACP, ACP Governor
Welcome to the spring 2019 Newsletter! I am humbled to serve as your new Navy Chapter governor, assuming the helm from CAPT Michael Keith after the IM 2019 meeting. Please join me in offering a huge BRAVO ZULU to CAPT Keith for his leadership and efforts for the Chapter over the past 4+ years. The Chapter is in great shape both financially and from a membership standpoint. The annual chapter scientific meetings over the past 4 years have been a wonderful “meeting of the minds” from around Navy IM, especially important as the community navigates the shoal waters of military medicine. Fair winds and following seas to CAPT Keith as he begins his next assignment as a fully employed retired rheumatologist!
As I look ahead at Navy Internal Medicine over the next 5-10 years, I see many ways the Navy Chapter of the ACP can continue to be a vocal advocate for the community, help shape and define the Knowledge-Skills-Attitudes (KSAs) of a Navy Internist, help support the forward deployed/small MTF internist, and continue to advance academic internal medicine. To reach these goals, I need your help! Please see the “opportunities for engagement” section below to see upcoming opportunities. Please do not hesitate to reach out to me if you have ideas of how the chapter can support you and meet your needs.
I am especially looking for volunteer members of the new Medical Practice and Quality Committee, with a focus on transition to practice, sharing best practices, and quality improvement at the small MTFs. If you have experience at a small MTF CONUS or OCONUS and have ideas about how to improve the experience for new staff and patients, please email me!
I look forward to serving with you over the next 4 years!
Mark P. Tschanz DO, MACM, FACP
Governor, Navy Chapter
Navy IM was well represented at the National Meeting in Philadelphia. Thanks to all who were able to meet up, and congratulations to all the associates who presented at the meeting!
LT Kyle Eaton (NMCP PGY1) presented poster “NMCP Penicillin Allergy De-labeling Project: Is it safe to proceed to direct oral challenge with Amoxicillin?” Coauthors LT Austin May PGY2 and CDR Bill Chin
LT Jess Zimmerman (NMCP PGY1 alum) presented poster “Implementation of a Pneumonia Order-Set in the Electronic Medical Record to Improve Standard of Care: A Quality Improvement Project” Coauthors LT Ross Patrick (staff internist Okinawa), LT Jeff Cleaver (current GMO), and CDR Mike Kavanaugh
LT Melanie Wiseman (Walter Reed) presented poster “When Latent Tuberculosis Stirs the Pott: A Case Series of Spinal TB” Coauthor LCDR Christa Eickhoff
Doctor's Dilemma Team from Walter Reed represented the Navy well! Congrats and well done to LT Ben Moberly, LT Mike Roth, and LT Jeff Gray.
Not pictured, but other Navy achievements at the National meeting – well done to all!
CAPT (ret) Patrick Young was the scientific chair for the entire meeting!
LT Matt Nelson serves on the Council of Resident and Fellow Members.
Resident Podium Plenary Presenter
LT Matt Nelson: Media in Healthcare: Podcasts, Social Media, and Beyond
Quality Improvement Poster Presenters
CPT Abhimanyu Chandel - Co-presenters: LT Pat Bagley, LT Sean Ouimet, LT Zachary Grice-Patil, LT Thong Tran, and LCDR Geoff Cole
Clinical Vignette Poster Presenters
LCDR Marshall Hoffmann
LT Melanie Wiseman
LT Matt Nelson
LCDR Hillary Chace (accepted, but unfortunately unable to travel)
LCDR Richele Corrado, Dr. Jeanne Mitchell and CAPT (ret) Kim Gibson: Best Foot Forward: Common Foot and Ankle Complaints That Stumble into the Office - Skills Workshop
CDR Manish Singla - Inflammatory Bowel Disease Panel; ACP 2019 Presentation Challenge powered by PechaKucha
CAPT (ret) Pat Young - Clinical Triad: Upper Gastrointestinal Tract, ACP 2019 Presentation Challenge powered by PechaKucha
Congratulations to CAPT (ret) Patricia Pepper and CAPT William Shimeall who walked in the convocation as Navy Chapter Laureate Award winners, and LCDR Benjamin Vipler who walked as a new Fellow.
The American College of Physicians has a very active Wellness Program - focused both on physician wellness as well as practice priorities to improve joy in the practice of medicine (endeavors such as “Patients Before Paperwork“).
From CDR Justin Lafreniere, Navy Chapter Wellness Champion and Program Director at NMCP:
I, along with 42 other representatives from ACP chapters across the country received 2 days of training as Well-being Champions at ACP 2019 earlier this month. ACP Well-being Champions foster communities of well-being by supporting chapter members, practices and organizations through targeted programming, teaching, and coaching to amplify and promote well-being as the standard, not the exception in medicine. Navy Chapter members can expect to receive some practical advice on how to improve their own well-being and at our next meeting (hosted by NMCP). The College's goal is to have at least 1 Champion within each Chapter, and they've nearly met it after providing this training over the last 2 years. Well-being Champions are nominated by their chapter governor and serve a three-year term.
CDR Lafreniere shared the following TEDtalk as a primer for discussion on the topic.
Congratulations to all new Fellows of the American College of Physicians (FACP) from the last 6 months!
CAPT Pamela L Krahl, MD
CDR Suneil R Ramchandani, MD
CDR Heather J Tracy, MD
CDR Alden V Chiu, MD
LCDR Jason J Weiner, MD
LCDR Caitlin Cruz, MD
LCDR Richele Corrado, DO
LCDR Justin M Stark, DO
LT Michael Dore, MD
Around the Horn
Follow us on twitter! @NavyACP
Find us online! Navy Chapter Website
Opportunities for Engagement
The Chapter is always looking for volunteers and engagement from members. The following opportunities are available – email for more information:
- Medical Practice and Quality Committee members
- Social Media Chair – is twitter, Facebook, or Instagram your thing! I need your help!
- Clinical updates in Governor's email
- Awards Committee members – seeking a diversity of experience on the committee
- Early Career Physician representative (first 16 years of practice after medical school)
Updates from the College
Maintenance of Certification: The college remains engaged in communication with ABIM regarding the best approach to MOC. The ACP Webpage has extensive information about options for earning MOC credit as well as ACP's advocacy efforts in this realm. I encourage you to read about what the ACP is doing on your behalf.
Have you been watching the journals and reviewed the latest?
Aspirin for primary prevention? Maybe not! Check out the new ACC/AHA Guidelines!
Spoiler alert! “Aspirin should be used infrequently in the routine primary prevention of ASCVD because of lack of net benefit.”
Which guidelines do you follow? Did you review the latest recommendations from ACP for breast cancer screening? Here is what the authors recommended: https://annals.org/aim/fullarticle/2730520/screening-breast-cancer-average-risk-women-guidance-statement-from-american
Guidance Statement 1:
In average-risk women aged 40 to 49 years, clinicians should discuss whether to screen for breast cancer with mammography before age 50 years. Discussion should include the potential benefits and harms and a woman's preferences. The potential harms outweigh the benefits in most women aged 40 to 49 years.
Guidance Statement 2:
In average-risk women aged 50 to 74 years, clinicians should offer screening for breast cancer with biennial mammography.
Guidance Statement 3:
In average-risk women aged 75 years or older or in women with a life expectancy of 10 years or less, clinicians should discontinue screening for breast cancer.
Guidance Statement 4:
In average-risk women of all ages, clinicians should not use clinical breast examination to screen for breast cancer.
(Qaseem A, et al. Screening for Breast Cancer in Average-Risk Women: A Guidance Statement from the American College of Physicians” Ann Intern Med. 2019;170(8):547-560)
What is your target SpO2 in a hospitalized patient on supplemental oxygen? An international guideline committee would recommend “For patients receiving oxygen therapy, aim for peripheral capillary oxygen saturation (SpO2) of ≤96% (strong recommendation).” See the evidence and rest of the recommendation - https://www.bmj.com/content/363/bmj.k4169.long
Siemieniuk RAC, Chu DK, Kim LH, et al. Oxygen therapy for acutely ill medical patients: a clinical practice guideline. BMJ. 2018;363:k4169. 30355567