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Kwame O. Dapaah-Afriyie, MBchB, FACP, ACP Governor

Kwame O. Dapaah-Afriyie, MBchB, FACP, ACP Governor

 Governor's Welcome

Dear Colleagues,

I hope you had an enjoyable summer.

The palpable demonstration of oneness of humanity while competing for control of a ball was exciting. The Titans from Scotland certainly made their presence and generosity felt in Rhode Island. Although there were instances of disagreement with decisions of referees and/video-assisted referees, there was a concerted effort to move on for the common good of the game with fans keeping in mind that decisions were made based on best judgement.

In contrast to what we experienced in June /July we have had additional executive orders affecting healthcare delivery pertaining to vaccinations. The recent increases in preventable food borne illnesses and viral infections are emotionally draining. For many of us, these events diminish the motivation and enthusiasm that drew us to this work. It feels like running on empty or being snowed over. The statements “go back the basics” and/or “read the directions” are made when we find ourselves in seemingly unsolvable situations.

Let us remember what got us into this noble profession, redefine our priorities and then recommit ourselves to them.

The commercialization of our healthcare system has promoted the “provider” designation for physicians, an inaccurate label that narrows the understanding of our vocation to direct patient care alone. In addition to caring for patients, we advocate for them and ourselves, mentor others, educate the next generation, and serve in many other roles. We should continue to affirm that we are internal medicine physicians, not simply providers, and that patient care is one essential part of our broader professional calling. This is important because limiting ourselves to this role diminishes our vocation. This is particularly important for our senior and/or retired colleagues whose expertise and insight are invaluable to our profession

There is a renewed endeavor by ACP to expand current activities at the chapter and national levels to engage our senior and retired colleagues. We have engaged our colleagues in many aspects of our chapter activities including serving on the Governor council and as abstract reviewers at our annual chapter meetings. We will continue to enhance activities to create a heightened level of engagement.

Let's use these challenging times and episodic exasperation to recalibrate and resolve to hold fast to the full breath of our profession.

Wishing you a meaningful and impactful fall season!

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 Chapter News

Committee Highlights

Annual Meeting Planning Committee

Committee held its first meeting on July 17th to review suggested topics and the format for our March 2027 Chapter meeting. The committee co-chairs for the 2027 Annual chapter meeting are Jennifer O’Brien, Jinen Thakkar, Alisa Meroli, Karen Woolfall-Quinn and Denise Fernandes

Due to construction work at the Kent Hospital and limited options in our area hospitals, the council at its meeting on June 17th decided to have the 2027 annual meeting at Bryant University campus. We will be using their multipurpose Academic Innovation Center.

Finance Committee

Ankur Shah, who has dutifully served as our Treasurer for over 4 years is handing over to Jinen Thakker. Ankur's input and oversight have been very much appreciated. He will continue to serve as a member of the Governor's council.

Governor's Council Meeting

The Fall council meeting will be held on 09/17. We have the new chief residents of our Internal medicine residency programs serving on our council.

New Fellows

We have members of our chapter who have been elected as Fellows of the American College of Physicians.

  • Atin Jindal, MD, FACP
  • Richard Lim, MD, FACP
  • Michael Santos, MD, FACP
  • Sandipan Shringi, MD, FACP
  • Hadeel Zainah, MD, FACP

The 3 pathways and criteria for earning this recognition are on the ACP website.

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 RIDOH (RI Dept of Health) Update

Portal for Reportable Conditions Related to Occupational Health

Did you know that Rhode Island requires that certain health outcomes related to occupational injuries be reported to the Rhode Island Department of Health (RIDOH)? To help healthcare professionals meet this requirement, RIDOH has launched a portal for reportable conditions

Reportable conditions include but are not limited to asbestosis, silicosis, and chemical pneumonitis. Certain samples must also be reported, including blood samples for arsenic, beryllium, cadmium, carbon monoxide, lead, and mercury, and urine samples for arsenic, cadmium, and mercury.

Learn more about reportable conditions and samples at RIDOH's website

For more information about this reporting portal, please contact Robert Sucsy

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 Mentorship Zone

What are we learning? Who are we learning from? Who are we transferring insights to?

Iron sharpens iron, so one person sharpens another.

The one who waters will also be watered.

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In this newsletter, we get to learn from Caroline Troise, MD, PhD, FACP who has been a member of our chapter for several years and continues to volunteer in the delivery of patient care services at the RI Free Clinic. She was the recipient of our chapter's Irving A. Beck laureate Award in 2004.

Caroline Troise is also the recipient of Rhode Island Medical Society's 2026 Halifax Award in recognition of her Outstanding Medical volunteerism.

Caroline Troise MD:

How I Got Here:

I grew up in Astoria, Queens, New York City and graduated from St. John's University with a B.S. in Chemistry and entered Harvard University to pursue a Ph.D. and a career in Organic Chemistry. During my Ph.D. studies, I supervised a pre-med Smith College student who planted the seed of a medical career in my brain. After completing my Ph.D., I was accepted to the University of Miami Ph.D. to MD program. This totally immersive program compressed the 4 year medical school curriculum into 2 years, 6 days per week. After receiving my MD degree, I matched at Rhode Island Hospital for residency. During that time, I realized I loved every aspect of medicine, and I wanted to be able to take care of the whole patient. So, following residency, I joined the internal medicine practice at RI Group Health Association (RIGHA ), the first HMO in RI. RIGHA ultimately became Harvard Pilgrim Health Care of New England until its doors closed in Dec 1999. From these ashes, Anchor Medical Associates was born in January 2000 where I practiced until June 2025 when this practice also closed. Times were different when I first entered practice. An internist truly took care of the whole patient. We had an ambulatory practice, directed the care of our hospitalized and nursing home patients and had a smattering of home visits thrown in. Now that medical care has become more specialized and fragmented, being a primary care doctor is perhaps even more important to help patients negotiate the bureaucracy of today's medical system.

Factors That Have Helped:

Throughout my 40+ years of practice, I have been blessed with the most supportive colleagues in the office and in the hospitals. I have enormous gratitude and love for my family who have allowed me to put my patients first on many occasions. And finally, I thank my patients, who have given back to me more than they know.

Why Am I Still Here?

In 1999, I started volunteering at RI Free Clinic, whose mission is to provide free, comprehensive medical care and preventive health services to adults without medical insurance and cannot afford those services. In 1999, this was a welcome change to the real world of medicine marked by prior authorizations, RVUs, forever changing prescription formularies, etc. During the early years, what we could provide was a good history and physical exam, limited lab and x-ray testing and sometimes free medication. It was basic medical care. Over the years, RIFC has developed into a state-of-the-art medical facility that now also functions as an educational training site for aspiring young health professionals. Also, the array of services provided has expanded to include on site specialty care, dental services and physical therapy. I served as volunteer medical director from 2001 to 2022 and now continue to see patients twice weekly. Our patients are demonstrably grateful knowing that their diabetes, hypertension or other medical problems are being addressed. If you speak to any of our volunteer medical professionals, at the end of a session they always feel they have made a difference in someone's life. At the end of the day, as a physician, that is all that one can really ask.

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 From National ACP

National ACP Leadership Day Events

As usual, our chapter participated in the national ACP Leadership Day events. Over four hundred ACP members from 49 States participated in this year's Advocacy program. Our chapter attendees met with the Rhode Island Congressional delegation to advocate for 3 major ACP 2026 legislative session priorities, which are:

  • Resident Education Deferred Interest (REDI) Act.
  • Protecting Free Vaccines Act
  • Provider Reimbursement Stability Act

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 Fall BOG resolutions

Fall Resolutions Summary:

Here is a summary of the Fall 2026 Board of Governors (BOG) resolutions, including the background, staff assessments, and estimated costs for each.

Resolution 1-F26: Defining Physician Responsibilities for Electronic Smoking Device Cessation

  • Goal: Encourage physicians to screen for all electronic smoking devices (including non-nicotine) and use motivational interviewing for cessation.
  • Previous Resolutions: 11-S14 (FDA regulation of electronic nicotine delivery devices).
  • Staff Background: ACP lacks current clinical policy on screening/cessation for these devices. Existing policy only addresses inhaled cannabis.
  • Estimated Cost: $250,000 or more. Developing clinical policies requires commissioning at least two systematic reviews, which would strain current resources and delay other priority projects (e.g., hypercholesterolemia, anxiety, low back pain).

Resolution 2-F26: Ensuring Access to Medical Care and Sanitary Conditions for Immigrant Detainees

  • Goal: Call for independent oversight of medical care in immigrant detention and advocate for vulnerability screening at intake and community-based alternatives for high-risk individuals.
  • Previous Resolutions: 7-F24 (Healthcare as a Human Right), 10-S18 (Equitable Access), and 4-S11 (Health impact of legislation on undocumented immigrants).
  • Staff Background: Current ACP policy supports enhanced governmental oversight (from “Health Care During Incarceration”), but this resolution proposes a higher level of independent oversight and new screening requirements that require policy development
  • Estimated Cost: $0 – $999.

Resolution 3-F26: Reducing the Privatization of Veterans' Health Care

  • Goal: Advocate against further privatization of VA health care, restore funding to VA facilities, support VHA academic missions, and ensure VA-based physician representation on committees.
  • Previous Resolutions: 2021 policy paper on veteran care; 2018 ACP letter regarding the Mission Act.
  • Staff Background: This resolution was accepted as a reaffirmation of previous ACP policy and will not be debated.
  • Estimated Cost: Not explicitly stated (accepted as reaffirmation).

Resolution 4-F26: Developing Policy on Alternate Pathways for Licensure to Support Internationally-Trained Physicians (ITPs)

  • Goal: Develop policy on alternate licensure pathways for ITPs, identify resources to keep members informed on state laws, provide training/evaluation support, and explore membership eligibility for ITPs in supervised practice.

Previous Resolutions:

  • 4-S24: Condemning exploitative for-profit observerships; ongoing cross-organizational work with Intealth/FAIMER.
  • 12-S22: Integrated approach to IMG inclusion and governance representation.
  • 12-S07: Streamlining J-1 and H1B visa processes.
  • Staff Background: ACP lacks policy on alternate licensure pathways. Staff notes that while ITPs strengthen the workforce, ACP must balance this with public safety and the need for standardized competence thresholds to prevent a “two-tiered” system. Existing resources like MKSAP (including CORE) and the ACP IM In-Training Examination are already available to support training and evaluation for these physicians.
  • Estimated Cost: ● $0 – $999 for Medical Education and Membership (assuming membership clause is a reaffirmation).
  • $1,000 – $14,999 for Health Policy development.

Resolution 5-F26: Developing CME-Accredited Online Climate Health Education Modules 

  • Goal: Develop a series of CME-accredited modules on climate and health for ACP Learning Hubs and promote these resources. 
  • Previous Resolutions: 3-S23, 5-S23 (Expand educational resources/toolkit), 8-F19 (Excessive heat), 13-S19 (Carbon reduction), 6-F14 (Comprehensive climate effort).
  • Staff Background: While robust climate health content exists, no CME-accredited modules are currently planned. Development would require significant unbudgeted resources and would need to be framed around clinical preparedness/safety rather than environmental advocacy.
  • Estimated Cost: $50,000 – $100,000. Resolution 6-F26: Approving Multi-Chapter Membership Capability
  • Goal: Integrate technology to allow members to join more than one chapter, addressing the reality of modern regional medical practicePrevious Resolutions: 7-S12 (Leader in technical innovation).
  • Staff Background: Current membership systems are built on a “one-to-one” relationship. Moving to a “one-to many” model would require a massive overhaul of infrastructure, including bylaws, voting rights, dues allocation, and conflict-of-interest management, posing significant administrative complexity.
  • Estimated Cost: $250,000 or more, with potential for millions in technology/vendor costs due to the deep integration required in existing systems.

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