2018 October Newsletter

October 2018

Governor’s Corner

Matt Hollon, MD MPH FACP

Fall always excites me. I love the final garden harvest, the cooler temperatures for running, and the impending sense of winter in the mountains. This year’s harvest from our “urban farm” was productive and we canned tomatoes, pizza sauce, salsa, tomato chutney, pickled carrots, and “dilly beans”. Fall is such a wonderful time of transition from the long days of summer to the short days of winter and in transitions there is always opportunity. The transition to new leadership for an organization is a good time to revisit how the organization runs, which has been an important part of the work that we have undertaken for our Chapter since the last newsletter.

I am as excited about our Chapter as I have ever been in my decade in leadership (and it is not just my excitement about Fall that is spilling into my sense of opportunity for our Chapter). For years running, we have had an outstanding chapter (22 Years receiving Chapter Excellence awards in a row). Now, building on what we have accomplished so far, we are taking important strides at better defining the organizational structure of the chapter to leverage Executive Council and member involvement. We spent the later part of the summer and the last executive council meeting in September thinking strategically about how best to organize the chapter to create opportunities for succeeding across the domains of cultivating collegiality, supporting you all in your professional work, and advocating for the health of our patients and our communities.

With the Executive Council’s support, we are moving forward organizing the chapter around 8 Committees and 8 Councils. In general, committees’ purpose is to accomplish the work of the chapter and councils’ purpose is to engage members and to create a professional home. This new structure will give Executive Council members an opportunity to better define their role within Council and to focus individual contributions. Each elected Council member will be asked to choose a minimum of 1 committee and 1 council on which to serve. This structure will also provide the opportunity for all of you, as Chapter members, to be engaged in Chapter activities even if you are not a member of the Executive Council. Many of you have already expressed interest in time-limited volunteering through the “Chapter Volunteer Interest Form” and with this structure we will better define those volunteer opportunities for you. Additionally, this structure will provide an avenue for us to identify Chapter members whose level of engagement would lead to nomination to the Executive Council.

In defining the Committees, we chose to parallel the structure defined by National’s Chapter Excellence Award. Committees include the following:

  • Communication & Member Engagement – maintain communication plan that includes social media presence, quarterly newsletter development
  • Health & Public Policy – local advocacy and collaboration with WSMA, advocacy training, AIMn participation, ACP Leadership Day coordination (for more on Advocacy see below)
  • Membership & Diversity – maintain recruitment and retention plan across the spectrum of membership (from trainees to Fellows), institute National’s recruitment and retention initiatives
  • Education & Meetings – support Annual Chapter Planning Committee, assist with planning of other educational events including Spring Scientific meeting and other educational endeavors (For more on our amazing upcoming Chapter Meeting see below)
  • Wellness – plan periodic “Wellness” activities and collaborate with other organization to promote physician wellness for internal medicine physicians and residents in the state (for more on Wellness see below by our Wellness Committee Co-Chair, Dr. Cathrine Wheeler)
  • Medical Students – provide guidance, support, and inspiration for all student initiatives related to Internal Medicine Interest Group activities in the state (For more on Student Activities see “Spokane Internal Medicine Interest Group” below)
  • Residents/Fellows – provide guidance, support, and inspiration for all resident activities and initiatives in the state (for more on Resident Activities see below by Dr. Ananth Shenoy who runs our Resident Abstract Competition)
  • Awards – oversees chapter awards and the nominations of Chapter members for National awards and Mastership (for more on Awards see below on our new Masters)

The focus of the 8 Councils centers on outreach to Chapter membership and establishing ACP as the professional home for each Council’s representative groups (in general, the activities by Councils will be open to all members though there may be some events structured for specific groups).  Councils, not all constituted yet, will include:

  • Late Career Physicians
  • Early Career Physicians
  • Hospitalists
  • Primary Care Physicians
  • Women in Medicine (For more on Women in Medicine see below)
  • Internal Medicine Sub-Specialists
  • International Medical Graduates
  • Under-represented in Medicine

With this structure we also anticipate that there will be wonderful opportunity for synergy between the Committees and Councils. For example, if the Council of Hospitalists is interested in holding a session that focuses on professional well-being then they would reach out to the Wellness Committee as a resource in planning an event or events across the state.

Most importantly, I want to strongly encourage you to take advantage of this re-organization and volunteer now. If you a self-starter interested in developing educational opportunities, policy-setting at the state level, or collaborating with colleagues to address the professional needs of internists then we have opportunities for you. If you want more leadership experience to prepare you for future endeavors, then we have a place for you.

We are looking for interested, committed, passionate members who are willing to contribute towards a vibrant and diverse chapter serving the needs of our members. The process is easy!

  • First, log into ACP Online to complete the chapter volunteer interest form. This will streamline the submission process by pre-populating your membership information.
  • Second, complete the interest form.
  • Third, we will follow-up with you directly within 2 weeks.

You can access the form by clicking here: “Chapter Volunteer Interest Form

I will reiterate from July’s newsletter that the valuable thing about organizations is that they can be more than the sum of our individual contributions. We most definitely would not be the outstanding Chapter we are without you all. We deeply appreciate your support and involvement. We thank you for volunteering and, again, If you have ideas about how we continue to enhance our Chapter and the value of your membership please do not hesitate to email me at mhollonmdfacp@gmail.com.

Matt Hollon, MD MPH FACP


Executive Council Votes Unanimously to Endorse “Yes on Initiative 1631”

“The American College of Physicians (ACP) recommends that physicians and the broader health care community throughout the world engage in environmentally sustainable practices that reduce carbon emissions; support efforts to mitigate and adapt to the effects of climate change; and educate the public, their colleagues, their community, and lawmakers about the health risks posed by climate change. Tackling climate change is an opportunity to dramatically improve human health and avert dire environmental outcomes, and ACP believes that physicians can play a role in achieving this goal.” Ann Intern Med. 2016;164(9):608-610

The reality is that climate change is the public health crisis of the 21st century – leading most of the major national physician organizations to have strong policy positions on addressing the health impacts of climate change: https://medsocietiesforclimatehealth.org/

There is a critical and rapidly closing window of opportunity to try and protect the health of the citizens of Washington State from the consequences of climate change including worsening air quality, increasing heat-related deaths, and increasing vector borne illness.

Our state has a legacy of protecting the home we all share: prioritizing our health and a world-class economy. We enjoy that quality of life because we invest in our communities.
As Washingtonians, we all do our part to keep our state clean. But right now, the largest polluters can pollute for free while the rest of us pay the costs. I-1631 would put a fee on the state’s largest polluters and invest in protecting clean air, clean water, and building new clean-energy infrastructure across the state.

With National ACP’s policy position, detailed in the statement above, as backdrop, at the last Executive Council meeting in September, Council members voted unanimously to endorse “Yes on I-1631”. In doing so, we joined the Washington Academy of Family Practice and the Washington Chapter of the American Academy of Pediatrics to advocate in the interest of the public’s health in our state. We know with this initiative, we can protect our health and pass a cleaner healthier state to future generations.

That’s why we have endorsed I-1631 and urge you to vote ‘Yes on I-1631’ on November 6th.

For more details of ACP’s efforts to address the health impacts of climate change see:
https://www.acponline.org/advocacy/advocacy-in-action/climate-change-toolkit

And stay tuned for a joint public statement from all three organizations announcing our support for I-1631 in the middle of October.


Well Being

Cathrine Wheeler, MD, FACP

Facing concerns about increasing rates of physician burnout, the ACP is taking action to improve the well-being of it’s members. With over half of physicians reporting symptoms of burnout, the risks to physicians’ health and consequently their patients’ health are high. Growing understanding about the factors that can lead to burnout is providing opportunities for both individuals and organizations to counteract this worrisome trend. Heavy administrative burdens is a major factor. Trying to keep up with the demands of Electronic Medical Record (EMR) usage, complicated billing and quality measure reporting, and insurance company interactions (ex: prior authorization and appeals) can be crushing. These burdens have been found to have a significant negative impact on professional satisfaction, and are leading factors in the epidemic of burnout. With this in mind, the ACP recently launched a “Patient’s Before Paperwork” initiative to advocate for decreased administrative burdens on providers (link below).

Additionally, the ACP is building an army of Well-Being Champions to offer more local support to members. Multiple “Well-Being Champions” are being trained for each chapter, these individuals can support their colleagues in such ways as providing information about how to approach their employers about improving provider well-being, as well as providing one-on-one coaching and support for providers who are already feeling the strains of the current work-environment. I am one member from our chapter that has had the opportunity to receive this training, and I look forward to supporting our chapter and it’s members in this area. Other Washington Chapter Well-Being Champions include Carrie Horwitch (Seattle) and Carmen McDermott (Spokane). We are interested in hearing from our colleagues about what type of local ACP support would be most valuable. Please stop by our table at the Annual Scientific Meeting in November to say “hello” and join in the conversation about how to preserve (and/or recover) the joys of practicing medicine.

https://www.acponline.org/practice-resources/physician-well-being-and-professional-satisfaction

https://www.acponline.org/advocacy/where-we-stand/patients-before-paperwork


Washington ACP Annual Scientific Meeting 2018

Rachel Safran, MD

Join the chapter at the Bell Harbor Conference Center in Seattle from Thursday, November 1st through Saturday November 3rd for the Annual Meeting! This year’s meeting is shaping up to be fantastic with some long-standing traditions as well as a few new twists:

  • Interactive workshops including bedside ultrasound technique (NEW!), skin biopsies and the knee exam
  • Expert updates in rheumatology, infectious disease, pain care and MORE
  • Spicy hypertension debate (NEW!)
  • Resident medical jeopardy competition
  • Networking opportunities
  • Story slam and trainee presentations

This year we will again offer a live webcast to participants in Spokane. Attendees of the meeting can earn up to 21.5 credits of Category 1 CME.

To register online, visit us on the web linked below.

Register Online

Ambulatory Pre-Course I Revision Announcement

Jocelyn James, MD & Leah Geyer, MD

In the WA Chapter Meeting outpatient pre-course, we’ll be taking on some particularly challenging clinical scenarios relating to chronic pain and addiction. While guidelines around opioid prescribing can be helpful, balancing benefits and harms in caring for individual patients is often highly nuanced. This session will provide practical tips for managing patients on chronic high-dose opioids, sorting out pain vs addiction, offering non-opioid management, and talking to patients about substance use.

New! Pre-Course I Schedule Revision

1:00-1:30       Guidelines for opioid prescribing: where are we now?
1:30-2:05      What to do with high-dose opioids?
2:05-2:45     Considering opioid use disorder in patients with chronic pain
2:45-3:00     Break
3:00-3:45     Practical aspects of caring for patients on chronic opioids: panel discussion of difficult cases
3:45-4:20     Caring for people with opioid use disorder: what is our role?
4:20-5:00     A new look at non-opioid and non-pharmacologic approaches to chronic pain

To register for this Ambulatory Care Pre-Course, click here.


Inpatient Care Pre-Course II

Tristan Osborn, MD & Ashleigh Leonard, MD

We were honored to be invited to coordinate the Inpatient Care pre-course for the ACP Washington Chapter Scientific Meeting. Hospital medicine focused CME is crucial to the practice of this rewarding and exhilarating, but also challenging and ever-changing field. We reviewed feedback from previous conferences and surveyed our colleagues to identify six high yield topics. We assembled a group of dynamic speakers who are leaders in their respective fields to ensure each session is packed with clinical value. Venous thromboembolic disease is common and increasing in complexity with many new treatment options becoming available the last decade. Delirium is also common, often frustrating, and critical to address for the sake of patients and their families. Stroke is a condition increasingly treated primarily by hospitalists with or without neurology consultation, and there are incredibly important and exciting updates in this field. We are also covering infections including Staphylococcus aureus bacteremia and influenza, and will finish with a highly requested topic from last year: inpatient management of cirrhosis. Our goal is for you to walk away feeling better equipped to manage these conditions with confidence and efficiency. We hope you look forward to this pre-course as much as we do!

To register for this Inpatient Care Pre-Course, click here.


Live Webcast of the Chapter’s Annual Scientific Meeting – Year 3

Registration is open for the live webcast of the nationally recognized Washington Chapter ACP meeting. This collaboration, now it its 3rd year, between the Spokane Society of Internal Medicine (SSIM) and our Chapter brings high quality internal medicine CME to Eastern Washington. The webcast will be held at Gonzaga University’s Hemmingson Center.

If you are interested in earning up to 13.5 high quality Category 1 CME credits as well as ABIM MOC credits focusing on the core of internal medicine practice without the challenges of traveling to Seattle then we encourage you to attend the webcast in Spokane. To register contact SSIM Executive Director, Kirsten Young by email at spokanesocietyim@gmail.com or by phone at 509.448.9709

We hope you help make the webcast a success by attending!


Fall Conference Resident/Student/Fellow Abstract Competition

Ananth Shenoy, MD

Our Washington State Meeting is coming up (Nov 1-3rd) and our annual abstract competition for medical students and residents and fellows again has a fascinating range of presentations and topics! Our yearly competition is one of the many highlights of our conference and offers a wonderful opportunity for our developing physicians to build their research skills and CV while expanding the breadth and content of our conference.

This year we had 63 submissions from across the state. Our ACP committee judges’ selected nine abstracts for oral presentations which will be spaced between plenary talks on November 2nd and 3rd while the poster presentations will take place during the Governor’s reception on November 2nd when our students and residents and fellows will be by their posters and ready to present and answer questions. We are hoping you will be able to join us for both the oral presentations and the Governor’s reception!

Topics this year include a range of instructive and unusual clinical vignettes (like hemophagocytic lymphohistiocytosis due to HSV infection or an overdose on scabies eradicant or numerous complications of mycoplasma pneumonia) as well as quality improvement projects and bench research (like novel teaching tools, the implementation of insulin titration algorithms and resuscitation for ventricular fibrillation in the field) being carried out in our medical centers and clinics.

If you will be attending our Chapter meeting this year (and of course we are hoping you are!) and are interested in joining us as a judge for the competition (all told about a 45 minute commitment during the conference, will not cause you to miss any of the talks) then please contact Ananth Shenoy (Ananth.Shenoy@VirginiaMason.org) by Friday October 19th.


Spokane Internal Medicine Interest Group

The past decade has seen marked growth in medical education in Washington State. Much of this growth has occurred outside of the Seattle area. While Eastern Washington and Spokane have been a site for clinical education for decades, in the past 10 years there has been unprecedented expansion of pre-clinical medical education. With the development of Washington State University’s Elson S. Floyd College of Medicine and the expansion of the University of Washington School of Medicine’s program in Spokane in partnership with Gonzaga University, there are now more medical students admitted to Spokane programs (120 students per year) than Seattle (100 students per year).

In the context of this growth, we have revisited the strategic plan for supporting Internal Medicine Interest Groups (IMIGs) across the state. The Chapter’s vision is to use available resources to support geographically defined IMIGs (Seattle, Spokane, and Yakima). While both medical schools in Spokane have nascent IMIGs with established faculty advisors, we are about to launch a Spokane-specific, collaborative, bi-institutional, community-based interest group drawing not only on the support of both schools and WA-ACP but also a local society of internists – The Spokane Society of Internal Medicine (SSIM).

The “kick-off” of the Spokane Internal Medicine Interest Group will be on Thursday, November 1st at Gonzaga University’s Hemmingson Center, the evening before the live webcast to Spokane of our Chapter’s Annual Scientific Meeting. We are inviting students from both schools in Spokane as well as internal medicine physicians in the community. The evening event includes dinner, a short discussion panel on careers in general internal medicine, promotion of membership in ACP, and plenty of opportunity to mingle. If you are attending the webcast this year or just want to support student interest in internal medicine careers in Eastern Washington we strongly urge you to attend this event. If you are interested in attending, please email SSIM Executive Director Kirsten Young at spokanesocietyim@gmail.com for more information.


Washington Chapter Honors 3 New Masters!

ACP recognizes Masters as Fellows who have been selected because of “integrity, positions of honor, eminence in practice or in medical research, or other attainments in science or in the art of medicine.” Masters must be highly accomplished persons demonstrating eminence in practice, leadership, or in medical research.

In an unprecedented year, three Washington Chapter members have been chosen to receive Mastership from the American College of Physicians.

Mastership

Gregory C. Gardner, MD, FACP

Carrie A. Horwitch, MD, FACP

Joyce E. Wipf, MD, FACP

Heartfelt congratulations and thank you for representing our Chapter so well!


Statewide Mixers Hosted by Women In Medicine

During the first weekend in October our Chapter hosted simultaneously across the state breakfasts sponsored by the Council on Women in Medicine. Events were exceptionally successful with the event in Spokane, held at Blackbird, reaching full capacity of 35 attendees.

Spokane Women in Medicine Breakfast at capacity. A great opportunity for collegiality and conversation about careers in medicine and life outside of medicine.

Promoting gender equity and eliminating the inequities in compensation and career advancement that physicians can face is a longstanding goal of ACP. As an organization, we are committed to addressing the unique challenges female physicians confront over the course of their careers in order to foster an inclusive environment that promotes growth and development for female physicians. ACP believes that addressing the barriers that women in medicine face is essential for the internal medicine community to benefit from the full potential of women physicians in the workforce.

For more on what ACP is doing to advocate for women physicians see:
https://www.acponline.org/advocacy/where-we-stand/women-in-medicine


Advocacy Made Easy

On July 19, the WA chapter of ACP help an event entitled: Advocacy Made Easy. The speakers, Nancy J Amidei, UW School of Social Work and director of Civic Engagement Project, and Laura Skelton, Executive Director of Physicians for Social Responsibility, spoke to a group of approximately 20 people.

The goal of the event was to learn quick and easy ways to engage others and engage our elected officials on issues that are of importance to internal medicine physicians. Advocacy does make a difference and we all need to be engaged in the process.

Here are some quick tips for “bite size” advocacy:

  1. Sign up for advocacy alerts – you can do one organization or many depending on your interest
  2. Sign up for Advocates of Internal Medicine (the ACP advocacy alert group): the more voices talking about our issues the better
  3. Advertise your issues- when visiting elected officials- wear buttons, carry signs
  4. Reduce the time to take action to items that will take 5 minutes or less so time constraint is not a burden

We will be having more advocacy events throughout the year. Keep these dates in mind:

  • Nov 2-3, 2018: WA ACP Annual Chapter Meeting: come and learn what ACP is doing, connect with fellow internists
  • Nov 2-3, 2018: WA ACP Annual Chapter Meeting: come and learn what ACP is doing, connect with fellow internists
  • May 14-15, 2019: ACP Leadership Day- Washington DC

If you are interested in getting more involved in advocacy through our WA ACP chapter please email
Carrie Horwitch MD, MACP at carrieho@comcast.net or Leah Marcotte MD, FACP at Leah.m.marcotte@gmail.com.


ACP Innovation Challenge 2019: Fostering Partnerships between Physicians and Patients

Are you an innovator in healthcare? Do you have a project idea that fosters partnerships between physicians and patients? If so, ACP wants you to enter the ACP Innovation Challenge!

ACP Internal Medicine Meeting 2019, being held April 11-13 in Philadelphia, PA, will be hosting the third “Shark Tank”- styled competition where finalists will present their projects to a distinguished panel of judges in front of a live audience. Project ideas may be submitted by ACP physician, resident/fellow, or medical student members, and should focus on fostering partnerships between physicians and patients. A Grand Prize winner will receive $20,000 in funding for project development and an Audience Choice prize of $5,000 will also be awarded. All finalists are eligible to receive complimentary meeting registration and travel funds to attend ACP Internal Medicine Meeting 2019.

For additional information and to submit an application by the November 30, 2018 deadline, see the Innovation Challenge 2019 web page. Please note participation in the ACP Innovation Challenge is open to ACP members only. To access the submission form, you must be signed in to ACP Online and be a member in good standing. If you currently are not an ACP member, join now.

Please feel free to distribute this information to anyone who may have a project eligible for submission.

For questions regarding this event, contact ACP staff at acpgovernance@acponline.org.


ACP Partners with Bedside Rounds Podcast to Offer Continuing Education

ACP and Bedside Rounds, a podcast focusing on the history of medicine and how those issues affect our society and culture – both past and present – are partnering to offer CME credits and MOC points. The first ACP-Bedside Rounds podcast covers the birth of population health. The episode, “Blood on the Tracks,” is about how growing controversies about bloodletting led a French physician named Pierre Louis to develop his “numerical method” to run the first population study in history. After listening to the podcast, ACP members can log on to ACP’s Online Learning Center to claim CME credit and MOC points. Bedside Rounds is available on iTunes and other podcast platforms.