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U.S. Navy Governor's Newsletter November 2019

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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 Fall 2019 Newsletter! Perhaps it is the change in season or upcoming Thanksgiving, but I have been reflecting on the many incredible contributions of Navy Internal Medicine around the world. If you read any of this newsletter, please focus on the reflections from a few of our deployed members. The challenges are great everywhere, but we as a community are essential to ensure our patients have the best care, in any situation, anywhere in the world! As I sit in San Diego, I want to say a big thank you to all of you who are deployed, just returned, or are preparing to go forward. For those members who don't fit any of these categories, please talk to those who are, and think about your opportunities to take on one of these unique experiences.

Don't forget to plan your trip to Norfolk January 17-18, 2020 for the Navy Chapter meeting. LT Ashley Fang and her team have been hard at work planning the scientific meeting, with the theme “Navigating the Changing Tides of Navy Medicine”. For those of you who have been around for a few years, the theme will resonate as we frequently speak about changing tides, sea state, and storms on the horizon. The theme this year captures our situation perfectly – tides change so course corrections are required and safe navigation can be assured!

Many of you may have seen the letter ACP sent to the Armed Forces Committees of the House and Senate to advocate for undergraduate and graduate medical education in the military. I often note that ACP is working for us in many ways that do not immediately impact us (payment reform, healthcare delivery models). In this circumstance, ACP took an active role in an issue of direct pertinence for us, urging Congress to carefully consider impacts of funding changes on primary care and UME/GME in the military.

Finally – the Navy Chapter recommend five applicants this year to the ACP Early Career Physician (CECP) and resident/fellow councils (CRFM). I am humbled writing recommendations for such accomplished physicians, and am assured of the bright future of the profession with such outstanding talent in our LT and LCDR groups!

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

Very Respectfully,

Mark P. Tschanz DO, MACM, FACP

Governor, Navy Chapter, American College of Physicians.



Important dates

15 November 2019: Deadline for 2019 award submission. See the award info here

15 November 2019: For those in Southern California, Medicine in Motion: Advancing Medicine Through Equity

17 - 18 January 2020: Navy ACP Scientific Meeting: Register Today

10 - 12 September 2020: Tri-Service ACP Chapter Meeting – San Antonio, TX



Seeking a Chapter Treasurer

I am looking for an interested member to serve as the Chapter Treasurer. CDR Manish Singla has nobly served in this position over the past few years, and can answer any questions about the position. Applicants can be any ACP Navy Chapter member in good status in the college. FACP is preferred. Responsibilities include managing the Chapter finances, filing appropriate tax information, and serving on the Governor's Council. Please contact either myself or CDR Singla with questions. If interested, please send me your CV and a Letter of Intent for consideration. Deadline to apply is 15 December 2019.



Reflections from the Fleet

Navy Internists are currently serving around the world in a number of unique and interesting positions. I wanted to provide a venue to capture some of the unique and important work being done, and highlight the accomplishments of many in our community. I felt it would be fitting to start this blog with reflections from “haze gray (or white) and underway”!

Please check out the following posts:

Fleet Surgical Team 5 (FST5): LCDR Catherine Larned on the USS BOXER
USNS COMFORT 2019 Mission: LCDR Karen Zeman



Update on MOC

ACP continues to advocate for internists with the American Board of Internal Medicine (ABIM) and the requirements for Maintenance of Certification (MOC). This continues to be a significant challenge for many members, and many have been surprised by the requirements at time of re-certification.

Due to the ongoing and frequent changes to the process, I cannot detail the requirements here. The ACP maintains an up-to-date webpage for MOC information, so I recommend you check here if you need updated information or want to know what ACP is doing to advocate for you in this process.

A few great ways to earn MOC:

  • Come to national or regional ACP meetings
  • Utilize ACP resources such as MKSAP, or podcasts such as The Curbsiders, Bedside Rounds, and Annals on Call
  • Involved in residency program QI/PI? Talk to the program director about MOC points!



Clinical Corner

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

Long-awaited update on pneumonia: Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America

Am J Respir Crit Care Med. 2019; 200(7):e45-e67.

Too much to summarize here – you really need to review the entire guidelines. It encompasses the use of testing (sputum, blood cultures, urine antigens, etc.), treatment of aspiration pneumonia, targeted treatment for resistant organisms, and a number of other pertinent topics. A “must review” if you treat patients with pneumonia!

Pre-exposure prophylaxis to prevent HIV: Prophylaxis for the Prevention of HIV Infection: US Preventive Services Task Force Recommendation Statement.

JAMA. 2019;321(22):2203-13.

“The USPSTF recommends that clinicians offer preexposure prophylaxis (PrEP) with effective antiretroviral therapy to persons who are at high risk of HIV acquisition.” (Class A)

This is not a major update, but a recommendation from the USPSTF carries significant weight, and highlights the significant evidence behind the use of PrEP. This is obviously critically important especially in our Active Duty and deploying population.

ACP Publishes Guidance Statement for Colon Cancer Screening

Ann Intern Med. 2019;171(9):643-654

The ACP Clinical Guidelines Committee (CGC) develops guidance statements on topics where several guidelines are available but have conflicting recommendations. This is common in many conditions, and colon cancer screening is no different. Although this new guidance statement does not have any sweeping changes from common practice, it does include an excellent summary of the evidence behind the different screening modalities. This is a highly recommended read if you see patients in a primary care setting.

The ACP Clinical Guidelines Committee (CGC) develops guidance statements on topics where several guidelines are available but have conflicting recommendations

What have you read about recently that is important to Navy Internal Medicine? Send me your articles for inclusion in the “Clinical Corner”



Around the Horn

Disclosure: Tracking deployments is challenging, and OPSEC influences this list. If you are deployed and not mentioned, please email me your location and I will include you in the next newsletter!

Currently deployed members:

JTF GTMO: LCDR Hampton Crimm
USNS Comfort:
CDR Todd Morris
CDR Tyler Warkentein
CDR Travis Harrell
LCDR Karen Zeman
LCDR Dan Dean
LCDR Evan Butlin
LCDR Pete McIntyre
KAF (just returned):
LCDR Nicholas Rohrhoff
LCDR Kia Gallagher
LCDR Donovan Mabe
Medical Director/5th Marine Expedition Brigade Surgeon (Bahrain)
CAPT William Shimeall

Follow us on twitter! @AcpNavy

Find us online! Navy Chapter Website