Matt Hollon, MD MPH FACP
In my final column as Governor, I would like to offer a short reflection on the importance of membership in the College and heartfelt thanks to everyone who has contributed to our Chapter’s successes these past four years.
As I concluded in my first column as Governor in July of 2018:
For all of us as internal medicine physicians, the American College of Physicians is our “professional home” – a professional home that plays the central role in sustaining and enhancing the work we do and the settings in which we do this work. Certainly, based on the sacrifices we all make as physicians, we recognize better than most everyone else that we can only expect to get out as much as we put in. Simultaneously, I think we all understand 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.
In these tumultuous times, the College remains a critical organization to foster collegiality, support internal medicine specialists, and advocate for patients and the practice of medicine. This was clearly evident as we returned to gathering in person at the College’s preeminent event – Internal Medicine 2022 in Chicago. From the wonderful opportunity to catch up at the Northwest reception with colleagues who we have not seen face-to-face in several years, to the extraordinary array of clinical learning opportunities that advance our practice of medicine, to the College’s ongoing commitment to advocating for all aspects of our profession – the full value of the American College of Physicians was evident and celebrated by all.
And in the face of continued threats to human health and how we practice medicine including serious threats to the autonomous decisions that a woman and her physician can make together about her reproductive choices, ongoing multi-faceted stress on our planet’s environment that seriously threatens the well-being of most living creatures on Earth, ever increasing burdens on our ability to practice patient-centered care that lead to disenchantment and burnout, continued erosion of the physician role at the heart of healthcare, and I could go on . . . The College needs us and we need the College more than ever! As I said before, we all understand that the valuable thing about organizations like the College is that they are more than the sum of their parts.
And this extends to our Washington Chapter, where, by any number of metrics, we remain among the consistently most outstanding chapters in ACP. This is because of all the amazing contributions of our members: from the student and resident members who regularly submit their academic work to our meetings, to all of our members who attend our membership events including our flagship Annual Scientific Meeting each November, to all the members who volunteer time to help lead the chapter including our Executive Council, Chairs of the Scientific Meeting, and Chairs of our committees and councils. You all are amazing and I thank you for your membership and contributions!
Probably the single best metric of our success is the College’s Chapter Excellence award. Because of the work of our membership, the Washington Chapter has received the highest recognition “Gold Level” every year for the past 4 years. However, none of our success would happen without leadership and in my last few words as Governor I would highlight the extraordinary partner I have had for almost all of my tenure as Governor and the true key to our success, our current Executive Director, Liz Truong. Liz joined us about nine months into my tenure after we had re-evaluated our Chapter’s executive administration needs. In my time working with her, she has been insightful, supportive, strong, and optimistic. In blending these characteristics, she has brought “can-do” energy to our Chapter and as a result I feel confident that with our incoming Governor, Dr. Chris Knight, partnering with Liz, I leave my role with our Chapter in truly outstanding hands!
I look forward to remaining involved where and when I can help. And I especially look forward to seeing many of you again in person when our Annual Chapter Meeting can finally reconvene in person. Until then, thank you for your membership in the College and our Chapter – and best success going forward!
Matt Hollon, MD MPH FACP
Immediate Past-Governor || Washington Chapter – American College of Physicians
Liz Truong, Washington Chapter Executive Director, has been instrumental to our Chapter’s extraordinary success in recent years. Pictured here with outgoing Governor, Matt Hollon at the Northwest Reception at Internal Medicine 2022 in Chicago. If you cross paths with Liz please be sure to express your thanks for all she does for our Chapter!
Congratulations again to our Doctors Dilemma team from Virginia Mason who competed in the National IM2022 competition! Compromised of Quan Truong, Catherine Zhang, and Shikhi Bhansari, our Washington Chapter team made it to the second round where they answered the most questions correctly however did not score the most points and did not move forward. They did a fantastic job under pressure and were cheered on by several Washington Chapter members!
Convocation at IM2022
By Chris Knight, MD FACP, Governor ACP Washington Chapter
The 2022 Convocation Ceremony was both joyful and solemn: a celebration of the accomplishments of our friends and colleagues and a time to reflect on how long it had been since the last in-person Convocation and all that has transpired since April 2019. This year our Chapter’s awardees included:
Three recipients of National Awards:
– John Vassall, MD, FACP (Steven E. Weinberger Award for Physician Executives/Leaders)
– John Sheffield, MD, FACP (ACP Award for Outstanding Educator of Residents and Fellows)
– Irl B. Hirsch, MD, MACP (Samuel Eichold II Memorial Award for Contributions in Diabetes)
Two new Masters:
– Kim M. O’Connor, MD, MACP
– Lucy R. Sutphen, MD, MACP
and 16 new Fellows. Congratulations!
IM2022: Medical Student Perspectives from Washington Chapter Grant Winners
By Makenna Stavins, UW
I am incredibly appreciative for the ability and support to attend the ACP National Conference. As I complete medical school and transition into new roles as a resident, I was able to reflect on my growth thus far and continue to get excited about my chosen specialty of internal medicine. Not only was I able to partake in didactic learning, but I was able to meet like-minded physicians from around the country who were interested in primary care and medical education, just as I am.
Some specific highlights included workshops on targeted physical exam skills, attending sessions on the best ways to assess fluid balance and correcting electrolytes, and new approaches/recommendations for common primary care problems such as nocturia and asthma. I also was fortunate enough to have the opportunity to be an author on a poster presentation of a research project focused on clinical trial disparities in the under-representation of women in oncology clinical trials. Talking with other clinicians interested in healthcare disparities gave me hope in improving these disparities in the future and awareness of other areas where I can support healthcare equity in my own panel of patients.
My final take-away from the ACP National Conference is the importance of continuing to interact and learn from other physicians that have passions and interests in various areas of medicine. The ability to reflect upon sessions with thoughtful conversation was both personally rewarding and will allow me to better collaborate and take care of my patients in the years to come.
By Nobel Nguyen
Having gone to the last in-person ACP Conference back in 2019 as a first-year, I was thrilled to attend this year’s conference as a way to end my medical school journey. I was reminded why it is important for physicians to attend medical conferences throughout their careers. I gained so much knowledge listening to amazing speakers in various sessions, and I also had the opportunity to attend an Ultrasound-Guided Lumbar Puncture Clinical Skills event. As someone who is not yet confident in procedural skills, I came out of the class excited to perform a lumbar puncture in residency. The best part about attending ACP was connecting with others and creating new relationships. Though I will be leaving ACP Washington due to starting residency in Southern California, it was bittersweet to see and connect with people at the Northwest Reception. I am grateful to have worked with so many fantastic people, mentors, and future colleagues these past 3 years! Finally, I made so many new medical student friends at this conference who I hope to connect with at future ACP Conferences. Thank you ACP Washington for this travel grant and for being a family away from home. Until next time – Nobel.
By Jessica Brar, WSU
Attending the 2022 National ACP Conference was such a wonderful and impactful experience. I was able to interact with leaders, innovators, and mentors from across the nation. Meeting other medical students with similar interests and passions truly makes me excited to call them my future colleagues. I engaged in sessions oriented around patient advocacy, addressing biases and barriers in medicine, and updates in clinical guidelines. I am taking away a vast amount of new knowledge and clinical pearls which I hope to build upon during my intern year of residency at Brown University this fall.
By Dana Arenz, UW
A sense of awe overcame me as I walked into McCormick Place Convention Center. The giant ACP banners hanging from the ceiling, the 8-foot poster boards with room schedules, the massive exhibition hall, and the hundreds of attendees walking around me was far different than any other conference I’ve experienced. This is because the majority of my time in medical school has occurred during the pandemic. The national conferences I’ve attended thus far have been over Zoom. Therefore, it was an absolute pleasure to physically be amongst so many brilliant physicians and medical students who share my love for internal medicine. One moment that particularly stands out from the weekend was the “Stump the Professor” lecture. As this was part of the medical student curriculum, I was shocked to walk into the hall and see the chairs were almost completely filled with physicians. Gupreet Dhaliwal sure can draw in a crowd! The energy in the room was electric as medical students presented cases and physicians and medical students in the crowd tried to solve them. Hearing Dr. Dhaliwal rapidly reflect on these cases and build a differential was astounding. As seasoned physicians sitting near me “ooo’d” and “ahhh’d” over the revelation of a patient’s case of lupus, I was reminded that the reason internal medicine is the field for me, is because I too have an enduring excitement when cracking a complicated medical case. Another experience I greatly enjoyed at the ACP IM Meeting was the medical student poster session. Although presenting my own research was fun, I found it much more enjoyable to peruse the posters of my peers–in particular, the fascinating case presentations. I love seeing the brilliant minds of my future colleagues at work, and these experiences make me so excited for the care teams we will build in the future. Despite a couple of long and busy days at the conference, I also had the opportunity to explore Chicago a bit. The Willis Tower made for a beautiful nighttime view, and Chicago pizza lived up to the hype. Thank you so much to the ACP WA Chapter for supporting my trip to the ACP IM Meeting!
Washington Executive Director Elected to ACP National Chapters Subcommittee
Congratulations to our Washington Chapter Executive Director, Liz Truong, for being elected to the ACP National Chapters Subcommittee! The Subcommittee is involved in a wide variety of topics, from reviewing and scoring each of the John Tooker Evergreen submissions to approving the recipients of that year’s Chapter Excellence Award. In addition, the Subcommittee is responsible for administering Chapter Funds including the Chapter Development Funds, and has oversight of the Governors-elect Transition/Training and the Chapter Leader Workshop traditionally held during the annual Internal Medicine meeting.
Joey Parker’s Teaching Corner
Bedside presentations. We either love them or hate them. Few things in internal medicine can be so polarizing. I’m not here to sway you one way or another, but rather ask the question what is the purpose you are trying to accomplish with a bedside presentation? Is it more important for bedside teaching, or a bedside presentation? Is it for the patient or is it for the resident? Many residents won’t be giving bedside presentations after residency, so it’s not a skill residents truly need to learn. From my perspective, one of the best ways to learn at the bedside is after the patient is staffed, to observe the resident giving the updated plan of care, including any diagnostic or treatment dilemmas to the patient and family. Patient centered communication will always be a needed skill, and if bedside time is important (it is!), this is a great way to incorporate it.
Wellness Corner: The Power of One Person
By Carrie Horwitch, MD MACP, ACP Wellness Champion
I have been in medicine for over 30 years and I love being a physician. As for most of us the joy of practice is in spending time with patients, hearing their stories, trying to figure out the mystery of their illness or discomfort and sometimes just being there to listen and show concern. We know about burnout and some of the causes for it. What we know less about is how to reverse the trend but several groups are working on systemic strategies. Wellness/well-being programs have spent most of the work on resiliency techniques such as mindfulness, breathing exercises, yoga , gratitude etc. These are important for well-being but as we all know they do not change the systemic issues that contribute to dissatisfaction in our work/workplace. Organizations need to be doing more.
For me in practice it meant I needed more time with my patients. The initiation of the 15-20 minute appointment time in primary care was not based on evidence that it improves patient care, nor was it based on physicians in practice wanting shorter appointment times. It likely grew out of insurance reimbursement and financial concerns of institutions. Dr Mark Linzer wrote a paper in 2015 about needing to end the 15-20 minute appointment time in primary care. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4617939/
Yet, so few practices have done away with this or at least offered a range of appointment times for their clinicians, which would allow flexibility. Flexibility is another key component for clinician well-being.
I knew that this was essential to change the dogma and allow longer appointment times. I had heard multiple times that it would hurt RVU and patient visits to have longer appointment times. I did not believe the dogma. I worked with a supervisor to do a pilot project with a few physicians in our group to have only 30 minute time slots. We then compared a pre/post burnout survey, pre/post wRVU and pre/post patient visit numbers. We showed that there was improved work satisfaction in the pilot group (both for the MDs as well as for the MAs), there was stable or improved wRVU and there was little change to the number of patients seen. This allowed our organization to offer 30 minute time slots for all clinicians in primary care- a practice which continues to this day.
Here is the core of how to effect important changes in your practice.
- Find out what the main areas of dissatisfaction is for your group.
- Pick one of these that can be turned into a pilot program or PDSA for change. (I would recommend something small, easily doable and measurable )
- Measure burnout or satisfaction prior to the pilot project
- Start project and make sure there is measurement of the key issues (ie wRVU, pt visits)
- Remeasure both burnout/satisfaction and other outcomes at the end of the pilot project time (it needs to be long enough to show effect)
- Report the results to the group as well as to supervisors, sections heads etc
- Repeat PDSAs as needed to continue improving the systemic issues in medicine
Updates From National:
ACP Leadership Academy
ACP and the American Association for Physician Leadership jointly offer an 18-month comprehensive Certificate in Physician Leadership program as part of the ACP Leadership Academy. The certificate program offers tracks in either Hospital Medicine or Primary Care. Exclusive to ACP members, this flexible program includes formal training through 49.5 hours of online coursework, virtual group discussions, and a capstone project that demonstrates successful mastery of leadership concepts.
Apply online by June 1, 2022, to enroll in the cohort that begins July 2022.
Women in Medicine Summit Blog by ACP CEO/EVP Darilyn Moyer
ACP’s CEO/EVP Darilyn V. Moyer, MD, FACP, FAMWA discusses the importance of addressing and finding solutions for health inequities and systemic racism that women and others face in the healthcare workforce. With data showing these disadvantages and barriers, her call to action is to be “loud” and make a difference. Read her Women In Medicine Summit blog post: https://www.womeninmedicinesummit.org/blog/lets-get-loud #womeninmedicine #WIMStrongerTogether
ACP Financial Profit Paper Wins the John A. Benson Jr., MD Professionalism Article Prize for Commentary
ACP’s position paper Financial Profit in Medicine: A Position Paper from the American College of Physicians, has won the John A. Benson Jr., MD Professionalism Article Prize for commentary, as announced by the ABIM Foundation. The prize recognizes the best articles written in peer-reviewed journals on pressing issues facing the medical profession in 2021.
ACP congratulates authors Ryan Crowley, ACP Senior Associate in Health Policy; Dr. Omar Atiq, and Dr. David Hilden and also the rest of ACP’s Health and Public Policy Committee for their contribution to the paper. The paper considers the effect of the growth of corporate interests and influence in health care on patients, physicians, and the health care system, and make a set of recommendations for policies that can foster and sustain the patient-physician relationship.