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U.S. Navy Governor's Newsletter May 2022

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CDR Mark P Tschanz, DO, FACP, ACP Governor

CDR Mark P Tschanz, DO, FACP, ACP Governor

 


Governor's Welcome,

Happy spring/summer! It was great to see some of you in Chicago for IM 2022 – a live meeting after a few years of Zoom. As an Internal Medicine community, it was a wonderful opportunity to connect, reflect on the past several years, share best practices and medicine updates, and focus attention on the work we have ahead for our community. It was especially great to see Tri-Service chapter members!

The opening keynote speaker was Dr. Quinn Capers, a cardiologist who has done considerable work on diversity in medicine – especially in the Internal Medicine community. Dr. Capers spoke of the ongoing healthcare disparities in our country, with the message that we will not fix the disparity problem until we improve the diversity in our profession. We certainly have to work on this in Navy Medicine, so I point you to some of his works for tangible efforts we can all make to improve our system – in residency selection, in teaching, and in practice.

I was also reminded how motivating it is to connect with great people at a scientific meeting. I remain hopeful that we will have this opportunity in September with a face-to-face Tri-service meeting!

Please don't hesitate to reach out to me with any questions or ideas for the chapter.

Very Respectfully,

Mark

CDR Mark P. Tschanz DO, MACM, FACP

Governor, Navy Chapter, American College of Physicians.

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Save the Date:

2022 Tri-service ACP Scientific Meeting: San Antonio, TX

September 7-9, 2022

Conference will officially kick-off at 1300 on Wednesday September 7, and end at 1300 on Friday September 9th. The morning of September 7th will include pre-sessions and Doctor's Dilemma. This will hopefully allow those who cannot miss an entire week of work to travel on Wednesday morning and still catch the conference. More to come on the schedule of events and speakers as we finalize the meeting hub website.

Abstracts are past due! There is a second deadline (01 August) for the incoming intern class, to allow time to participate.

Lodging:

Hotel reservations can be made now! A block of rooms is reserved at the Hilton Palacio del Rio. Please follow this booking link to make a reservation from our block of rooms. A bus will be provided from the hotel to the conference center. You are welcome to stay at another local hotel (many are available), but would either need your own transportation or would need to walk to the Hilton to catch the bus.

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Congratulations:

Congratulations to all Navy Chapter participants in the IM 2022 meeting! The poster presentations were stellar, and the Doctor's Dilemma team from NMCSD represented the chapter well (they certainly would have won had their buzzer been more responsive…).

A few of the poster presenters:

Dr. Ayeetin Azah (WRNMMC) and Dr. Austin Gable (NMCSD)

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Dr. Allyson Burkhart DeNora (NMCP)

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Dr. William Day (NMCP)

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Doctor's Dilemma Team: Dr. Andrew White, Dr. Austin Gable, Dr. Adam Maier (NMCSD)

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Interested in Fellowship (FACP)?

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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Congratulations to our newest fellows (February 2022 – May 2022):

Marvin Joel Sklar MD FACP

Joseph D. Hebreo, MD FACP

Garrett M. Harp MD FACP

Julia H. Cheringal, DO FACP

David S. Oliver, DO FACP

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First call: Chapter Awards!

The chapter will begin accepting award nominations for 2022, to be awarded at the virtual Tri-service meeting. Please see the information below regarding the awards and nomination process. Past winners are listed on the chapter website.

Due by 01 July 2022. Please email your nomination letters to the Chair of the Chapter awards board, LCDR Matthew Russell (matthew.c.russell22.mil@mail.mil).

  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.

Please let me know if you have any questions about awards!

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Clinical Corner:

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

Asthma Treatment: GINA Guide for Asthma Management and Prevention

(Warning…the link is a “pocket guide” that is 46 pages long. I hope you have big pockets…)

I am a bit late in reading these Asthma guidelines, and I understand there remains controversy about the recommendations. However, GINA presents a significantly different approach to asthma treatment than we have done for many years. I recommend you review the guidelines for the full story, but the brief update is that one should consider an ICS/LABA inhaler to replace the typical SABA inhaler (albuterol) for PRN and rescue use. The guidelines specify only budesonide-formoterol (Symbicort) as the ICS/LABA combination, and it is not readily available in our system – but certainly an interesting read!

Diverticulitis Guidelines: Diagnosis and Management of Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians – Annals of Internal Medicine.

I was surprised when I read these guidelines a few months ago, and it was presented several times at the conference. The recommendation that I found most interesting was avoiding antibiotics in low-risk patients with diverticulitis. I don't know how often this population is evaluated initially by an Internist, and I would certainly ensure close follow-up of these patients! You may want to check out the recommendations in the guideline.

SARS-CoV-2 Antibody Response: What Is the Antibody Response and Role in Conferring Natural Immunity After SARS-CoV-2 Infection? Rapid, Living Practice Points From the American College of Physicians (Version 2).

I am sharing this article as an interest point – it is unlikely to change your practice, but it represents a project from ACP to try and turn rapidly-changing evidence into actionable practice points for clinicians. This process was started before the pandemic, but adapted for the very rapidly changing evidence during the pandemic. This practice point specifically assessed the question of using antibody testing to assess for infection (NO!) or immunity to future infection from past infection (NO!). ACP will continue to review evidence for practice points until the topic is “retired”. This specific question has been retired after the second version as vaccines are now widely available and present the best method for preventing serious infection. I would keep your eye out for Practice Points in the Annals for rapidly-reviewed and timely clinical recommendations.

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