Matt Hollon, MD MPH FACP
From the Summer newsletter: “Regardless, we move forward. There is no other choice. Hopefully, with decent maps and the right amount of effort we can see our way . . .”
Turns out we don’t always have maps! Toward the end of summer, I found myself with my two boys and a good friend high on the Serpentine Arete struggling to find the route to the top of Dragontail Peak and worried that, in the waning light of late summer, the steep snowfield descent on the other side would freeze solidly into an icy, 500-foot slide with large, lethal, body-smashing boulders at the bottom if any of us lost our footing. Sometimes, even when the way forward is not clear, we must forge ahead . . . and ‘forging ahead’ is certainly the theme for this newsletter. Returning to the story, we did eventually summit around 6 pm, spent just a few minutes getting a bite to eat then started our descent to find the north-facing snowfield frozen but with just enough surface melt to kick treacherous steps down. In the face of uncertainty, often our only choice is to just keep going and navigate the challenges as they arise.
As you know, having never done anything like this before, we are moving ahead with this year’s Annual Chapter Meeting held virtually. With thoughtful, creative planning under the leadership of our Co-Chairs, Anna Hagan and Leah Marcotte, and with the added help of our Pre-Course Co-Chairs and other Planning Committee members, this will be a truly outstanding and unique meeting! And we are navigating all the challenges of staging a virtual meeting with the exceptional help of our executive director, Liz Truong, and her team at Association Management Inc. They have put in extraordinary effort to put together an incredible plan using the latest technology available to create a meeting that is as engaging as possible. With a new platform called “Airmeet”, we anticipate that we will be able to experience at least some of the camaraderie that draws so many of us to our annual meeting. I strongly encourage you to please join us for any or all of these events by registering here.
This fall, in addition to selecting our executive council at the annual chapter meeting, our chapter will also be voting for our next Governor. The last year of my term will start this next April and the Governor-elect will overlap one year with me before assuming the role of Governor in April 2022. We are fortunate to have two wonderful candidates, Dr. Chris Knight and Dr. Ki Shin, and I encourage you to vote now (your ballot was emailed to you from ACP National).
Speaking of wonderful chapter members, we are excited to announce our Chapter’s newest Master in the College, Dr. Genevieve Pagalilauan . Dr. Pagalilauan joins our 23 other active Masters – a truly prestigious group.
In the face of uncertainty and often without a map, our Chapter and the College move forward on other fronts as well. In early September, the Chapter staged our second annual Resident Career Forum. This successful event aimed at third-year internal medicine residents features recruiters and early career physicians discussing tips for finding a first job out of residency as well as an expert in employment law discussing all aspects of negotiating a first contract. Also, our re-invigorated Health and Public Policy Committee has held a series of “listening sessions” through late summer and early fall to stimulate interest in our advocacy efforts at the state level focusing on racism in healthcare, firearm violence, and climate change. Of course, our Chapter members throughout the state have continued to make substantial contributions to our profession and our communities including starting a new internal medicine residency in the face of a pandemic! And on a national front, the College continues to be a leading voice for our profession and the practice of medicine – I personally thank you for being a member!
As I wrote in my summer column, “The road is in front of us. While we won’t be coming together in person as a community this fall, I am confident we will see this through together. I look forward to celebrating our members’ and Chapter’s stories and successes that lie ahead as we step up and navigate these historic challenges.”
I look forward to seeing many of you virtually at our Annual Chapter Meeting!
Governor || Washington Chapter – American College of Physicians Twitter: @HollonMD
2020 Annual Chapter Meeting
This year’s annual chapter meeting will be spread over several days. Featuring the latest updates and compelling topics covering the breadth of internal medicine, attendees will be able to earn up to 13 Category 1 CME credits as well as ABIM MOC points. The meeting leads off on Saturday, October 24th with our traditional outpatient and inpatient precourses, this year free for ACP members. Leading up to the main Chapter meeting we will have focused session on incorportating point-of-care-ultrasound into clinical practice as well as our annual ABIM SEP Modules. The main meeting is on Friday, November 6th and includes several special plenaries, our annual clinical debate, our crucially important annual public health update and a host of other topics! This is followed on Saturday, November 7th by our Associates Day featuring the highest rated oral abstracts and the ever popular “Doctor’s Dilemma” (medical Jeopardy). We look forward to you joining us for any or all of these events by registering here.
- Saturday, October 24th: Outpatient Precourse & Inpatient Precourse in Collaboration with SHM
- FREE CME sessions from 9AM – 1PM starting with the Outpatient precourse
- We are proud to deliver the inpatient precourse in partnership with SHM this year including an opening workshop from SHM Immediate Past President, Chris Frost, on “The Future of Hospital Medicine”. You don’t want to miss it!
- Wednesday, November 4th: Insights on the Role of POCUS: Quick Cases for Primary Care Internists
- This Outpatient POCUS is back by popular demand!
- Thursday, November 5th
- ABIM SEP Modules – Inpatient with Moe Hagman, MD FACP
- ABIM SEP Modules – Outpatient with Chris Knight, MD FACP
- Insights on the Role of POCUS: Quick Cases for Hospitalists
- Friday, November 6th: ANNUAL CHAPTER MEETING
- Saturday, November 7th – Associates Day!
- Residents Abstracts Presentations
- Resident Medical Jeopardy LIVE!
- Residents Posters Final Round of Judging
- Join us to support our Associates in viewing their work through abstracts and poster sessions, and watching LIVE our Doctor’s Dilemma Jeopardy session – a crowd favorite usually on the second day of our meeting during lunch.
Member Spotlight: Anna Hagan, MD
By Nobel Nguyen, MS3
Graduating from Vanderbilt University School of Medicine in 2013, Dr. Anna Hagan knew at a very young age that she wanted to pursue medicine. Dr. Hagan comes from a family of physicians, and by her 11th birthday, she told her parents that she wanted to become a pathologist and asked for autopsy videos as a birthday gift! To this day it was one of her most memorable birthday gifts.
After originally intending on a career in pediatrics, she discovered her passion for developing relationships with adult patients on her internal medicine clerkship. After medical school, Dr. Hagan completed her Internal Medicine residency at the University of Washington. What she values most is to learn about a patient’s health, and how it impacts their life, through conversations and counseling with the patient. “Treating the whole patient” and “connecting with patients beyond their medical needs” are the cornerstones of Dr. Hagan’s patient care philosophy.
After residency, Dr. Hagan became the outpatient Chief Resident at the Seattle VA. There she found her other passion: teaching and mentoring trainees. She has found her dream job combining her teaching and patient care passions as a Hospitalist at Harborview Medical Center. She enjoys working with residents and medical students as the Director of Resident and Student Education Opportunities for the hospitalist group at Harborview. She hopes to develop a curriculum for trainees interested in hospital medicine in the coming years.
When asked for her best advice that she could give to students, she says: “First, residency and fellowship is a time to get out of your comfort zone and go somewhere new. Second, don’t feel too overwhelmed about career decisions, because the unique thing about a career in medicine is that it is never too late to try something new.”
Dr. Hagan currently serves as a co-chair of the annual ACP Washington chapter meeting in November with Dr. Leah Marcotte. The COVID-19 pandemic has led them to completely change the format of the meeting. She hopes to still protect the social value of the meeting despite it now being in a virtual format. She was thrilled that the virtual format did allow them to recruit speakers from a broader geography. As an example, they have selected Dr. Fatima Cody Stanford from Harvard University to speak about obesity medicine. Dr. Hagan feels optimistic that the annual meeting will be a success!
Member Spotlight: Leah Marcotte, MD
By Anna K. Holman, MS2
Dr. Leah Marcotte’s interest in medicine began when she was an 11-year-old gymnast diagnosed with spondylolisthesis. The orthopedic surgeon who performed her spinal fusion later gave her the opportunity to shadow – an opportunity that Dr. Marcotte continued to take them up on years later while attending the University of Pennsylvania for medical school. Though she had originally been drawn to the idea of being a proceduralist, she began to develop a newfound interest in public health and primary care over the course of her medical education.
In the midst of medical school, Dr. Marcotte took a year away from the classroom to work for the Department of Health and Human Services in Washington, DC. While performing work focused on health IT implementation, Dr. Marcotte met many primary care physicians who made an impression on her. The experience molded her view of “how pivotal primary care is if we want to truly reform the health system and make it more affordable and accessible to everyone.”
This understanding motivated Dr. Marcotte to pursue a primary care track in her Internal Medicine residency at the University of Washington. After working in an innovative primary care practice for several years following residency, she returned to UW to take on the role of Associate Medical Director of Population Health. In this role, Dr. Marcotte’s work focused on supporting primary care practices in maintaining preventative screening efforts and managing chronic conditions.
Recently, her role has evolved to incorporate more health systems research. Her current projects focus on quality metric performance and breast cancer screening equity. Dr. Marcotte also continues to see patients at UW’s Roosevelt clinic where she enjoys the opportunity to be involved in resident and medical student education.
For the past year, Dr. Marcotte has served as co-chair of the upcoming ACP Washington chapter meeting with Dr. Anna Hagen. From the early stages of planning nearly a year ago, both co-chairs were on the same page: “we both saw it as an opportunity to be really intentional about diversity, equity, and inclusion in the meeting.” Though planning a meeting during a pandemic has presented challenges and required adaptability, they are proud of the meeting they have put together and Dr. Marcotte looks forward to hearing from speakers like Edwin Lindo, who will be giving a keynote session on racism in medicine.
Elections: Executive Council Slate
- Jennifer Balde MD, FACP
- Gary Forbes MD, FACP
- Jared Klein MD, FACP
- Divya Gollapudi MD
- Joey Parker MD, FACP
- Ananth Shenoy MD, FACP
- Rachel Safran MD, FACP
- Rachel Reeg MD
- Susan Merel MD
- Treasurer: Rebecca Ruud MD, MACP
Elections: Governor-Elect Candidates
Governor Elect Candidate: Christopher Knight, MD FACP
Medical School Education: University of Washington
Post-Doctoral Training: University of Washington
Board Certifications: American Board of Internal Medicine
Present Employment Position: Associate Professor of Medicine
ACP Chapter and Leadership Activities: Member, Executive Council since 2007; Associate/Resident Liaison since 2011; Faculty, Scientific Meeting since 2010
ACP National Activities: Fellowship 2005; Member, Planning Committee, Internal Medicine Meeting 2018 & 2020
Board Member, National Board of Medical Examiners (NBME) 2016-2020; Member, Management Committee, United States Medical Licensing Examination (USMLE) since 2018; Chair, USMLE Step 3 Computer Case Simulations (CCS) Committee, NBME since 2018; Member, Society of General Internal Medicine (SGIM) since 2003; Director, TEACH Faculty Development Program, SGIM 2015-2018; Faculty, TEACH Program, SGIM 2013-2018; Member, Clerkship Directors in Internal Medicine (CDIM) since 2006; Councilor, CDIM 2014-2017; Member, Annual Meeting Committee, CDIM 2010-2014
Areas of Professional Interest and Expertise: Medical Education; Primary Care
The next few years must be spent working to improve the flaws in our health care system unmasked by the COVID-19 pandemic. Some priorities:
- The flaws of employer-based health insurance without an adequate safety net are now even more obvious. We must achieve universal coverage.
- Disparities of care for Black, Indigenous, and other people of color cannot be tolerated. We must achieve equity in health care.
- Our funding model–in which hospitals can be full of sick patients and yet lose money–is untenable. Hospitals and physicians who provide lifesaving care must not depend on procedures to keep the doors open.
- Many changes in CMS regulations enacted because of the “public health crisis” are necessary improvements that must be sustained and built upon.
- The United States must rejoin the global public health community as an active contributor and partner.These are huge issues, but I believe ACP is up to the challenge.
Governor Elect Candidate: Y. Ki Shin, MD FACP
Medical School Education: University of Washington
Post-Doctoral Training: University of Washington Affiliated Hospitals
Board Certifications: Internal Medicine
Present Employment Position: Private Practice, Montesano Internal Medicine; Medical Director, Grays Harbor County Jail
ACP Chapter and Leadership Activities: Laureate Award 2017
ACP National Activities: Fellowship 2005; Herbert S. Waxman Award for Outstanding Medical Student Educator 2018
Other Appointments/Activities: Board President, Western Washington, Area Health Education Centers 2017-2019
Areas of Professional Interest and Expertise:
During my last 24 years of practice at a small rural community, I witnessed significant loss of workforce especially in care of geriatric population. For six years, I have worked for the University of Washington School of Medicine to address the workforce shortage in the rural communities. I have much deeper understanding on how best to recruit and train, both undergraduate and postgraduate level, in a rural community to address the workforce shortage. Through my work as the medical director for the county jail, I witnessed how poverty, mental illness and addiction has affected my community. I am passionate about how to work with the community to address the social determinants of health and how best to improve the quality of care within the correctional facility especially in regards to patients with mental illness and substance abuse disorder. Working with the medical students continues to inspire me to be a better physician. It is very important to me to work with the students and I got pretty good at it by practicing that for last 24 years.
I am very happy that I chose a career in general internal medicine. I am very proud to be a member of ACP. ACP stands for why I chose to be a doctor and what is important to me and to my patients. It would be an honor, for that reason, to be elected to the Board of Governors. My special expertise and qualification come from being a physician in a small private practice in a small rural community for all my career. I understand the challenges facing the small private practices especially with the added challenges from the new payment system transformation and the financial burdens from the COVID 19 pandemic. I also understand the challenges rural internists face both inpatient and the outpatient setting. Rural independent internist is a dying breed but there still some of us trying to make that wok. I will be a voice for them both in a chapter and a national level. I will advocate how ACP can continue to serve our interest and our survival.
ACP Bylaws state that Masters shall be Fellows who have been selected because of “integrity, positions of honor, impact in practice or in medical research, or other attainments in science or in the art of medicine.” Masters must be highly accomplished persons demonstrating impact in practice, leadership, or in medical research. Evidence of their achievements can come from many types of endeavors such as renown within their field and/or ACP chapter, research, education, health care initiatives, volunteerism, administrative positions, care of patients, and service to their community. For Dr. Genevieve Pagalilauan’s contributions and leadership to our chapter and our profession in medical education, patient care, service to the chapter, and service to the community, we are please to welcome her to Mastership.
2nd Annual Resident Career Forum
In September, we hosted our 2nd annual resident career forum virtually online with approximately 30 resident and medical student members from across Washington State. We opened up the forum with a deep dive into the recruitment process with our recruitment panel including Marisa Walters with NW Permanente, and Allyson Hollingsworth with Provider Solution & Development. Marisa and Allyson navigated the recruitment process for us and spoke about how to leverage recruiters to residents advantage during the search for their ideal job, ways to best evaluate different workplaces, and setting themselves apart during the recruitment process. This included asking the tough questions of your potential workplaces and holding them accountable for their answers (for example: how do you implement equitable hiring practices and a diverse staff?)
Next the group split into two breakout groups for primary care physicians and hospitalists. Members from our early career physicians committee facilitated these groups to get a better picture of what each career path may be like. These were open discussion groups to get any and all questions answered about going into primary care or hospital medicine.
Avi Lipman, an attorney in Seattle, concluded our evening as he took us through employment contracts – specifically what to look for, what is negotiable, and a run-down on non-compete clauses.
All in all, the evening was a great online success. Deepest thanks to Elissa Poorman, Jaclyn Lemon, Alina Plavsky, Carla Vazques Santos, Aleksandra Kardasheva, and Douglas Hayes for spearheading the career forum this year. And a big thanks to our other panelists for providing valuable information to our Residents. The College and our Chapter are committed to being a wonderful resources for our resident and fellow members. For more career guidance from the College see the College’s resources online – Resident Career Counseling, Guidance, and Tips.
Health & Public Policy Committee
Co Chairs: Carrie Horwitch MD, MACP, Genevieve Pagalilauan MD, MACP
With our elections just around the corner- we want to remind all of you that your voice matters so PLEASE VOTE..
Regardless of what happens in 2 weeks this will be a challenging year for medicine. Covid 19 cases continues to rise in many states. People have lost their lives and many their livelihood due to this pandemic. ACP is continuing to advocate for expansion and preservation of telehealth payment parity, making sure there is enough PPE for health care workers, supporting the ACA and having affordable health care insurance, and making sure that we continue to practice evidence based medicine and have vaccines and other treatments based on sound scientific principles and research ethics.
We have had 3 successful virtual advocacy listening events.
Thank you to those who were able to join in and tell us what is of most interest to you.
Some of what we learned are questions such as:
How to we become more visible?
How do we use our own voices?
How do we find advocacy opportunities and be able to channel engagement?
We also heard that people are concerned about health equity and justice, working with the community and more.
We want to let everyone know that based on feedback we heard at these virtual advocacy events. Your HPPC co-chairs submitted a resolution to the Washington State Medical Association House of Delegates (Sept 26-27) on racial justice, which was passed and will now become policy for WSMA .
To read more on ACP policies on health equity and justice please visit the advocacy page at ACP:
We will be sending out a notice soon for a virtual HPPC committee meeting- to take place after the WA-ACP virtual annual meeting. Please send an email to either Carrie (firstname.lastname@example.org) or Genevieve (email@example.com) or to Liz Truong (Liz@aminc.org) if you are interested in serving on the committee or if you have other interests and ideas.
Together we can make a difference.
New Internal Medicine Residency Program: WSU Everett!
By Matthew Hansen, MD – Program Director
Washington State University and Providence Regional Medical Center Everett (PRMCE) are teaming up to offer a new community-based Internal Medicine Residency in Everett starting in July, 2021. The mission of the Elson S. Floyd College of Medicine Internal Medicine Residency is to recruit, develop and retain compassionate, well-rounded general internists to care for the rural and underserved populations of Washington state. The residency will have 12 categorical residents per year and 4 preliminary positions in PGY1. Residents will train across five clinical sites in the north Puget Sound region, with inpatient wards and outpatient continuity clinic rotations being completed at Providence Regional Medical Center Everett and Providence Medical Group. While this is a new program at PRMCE, many of our attendings have teaching experience at other institutions and have worked with medical students from University of Washington and WSU and SeaMar Family Medicine residents here at PRMCE.
The residency will place a special focus on primary care for all residents, more than doubling the ACGME required outpatient experience. Residents will follow patients across the continuum of care, from outpatient, to the ED, to inpatient, via telehealth at home, actual home visits and to nursing facilities. They will practice in an outpatient continuity clinic with an evolving value-based care model focusing on care coordination, patient outcomes, caregiver satisfaction and optimized healthcare utilization. Residents will monitor performance data in their patient panel to inspire quality improvement (QI) work that will be supported throughout their three years. Annually, they will spend time with a Personalized Care Team through the Everett Clinic, which takes care of the sickest 3-5% of Medicare Advantage patients, utilizing a high value, team-based care coordination approach. In their second and third years, residents will have the opportunity to spend rotations immersed in rural care practices throughout Western Washington, with goals of promoting rural practice and developing a network to support practicing rural physicians throughout the region.
All residents will participate in scholarly activity in an area of interest. Whether it’s conducting supported QI work to improve their own performance, participating in active clinical research at PRMCE, or writing up or presenting interesting medical cases at regional conferences, we will inspire intellectual curiosity in our trainees and support their educational interests. Residents will experience the overall didactic curriculum in the form of morning report, Morbidity and Mortality and Grand Rounds conferences, and protected Wednesday afternoons to participate in flipped classroom model curriculum as a group. They will also participate in an advocacy curriculum longitudinally, meet with legislators to advocate for policies to improve population health, and work together to advocate for change at the system level to promote patient safety and wellness. To support their own wellness and sustainability in medicine, there is an entire curriculum dedicated to resident wellness, scattered throughout their three years of didactics time, and they will have wellness half-days on outpatient months to accomplish life tasks. We look forward to welcoming our new residents next term!
Joey Parker’s Teaching Corner
Mastering the fundamentals is essential in any field. In athletics, the great teams are often great not because they do extraordinary things, but rather they do ordinary things better than anyone else. It’s been said the legendary basketball coach, John Wooden, would spend an entire hour teaching his players how to properly put their socks on. The same holds true for medicine. Too often we wait for that perfect teaching moment on some rare entity such as Whipple’s disease or Hughes-Stovin syndrome, and often skip over basic fundamental medicine. On my first day of service with my team, I will draw and teach the pathophysiology of the renin angiotensin aldosterone system, a topic covered during medical school. I do this on purpose – understanding this system can create basic connections between the kidneys, heart, liver, and adrenal glands. This is an elementary concept, but one that pays dividends throughout the week, as I have set a strong foundation to build on and teach more advanced material. Next time you are on service, don’t wait for the perfect teaching moment, but rather think about elemental topics you can teach that will set your team up for success.
Updates from National
New Chapter Resource Module: Women in Medicine Chapter Resource Module
Mentoring, Coaching, and Sponsorship for Women Physicians Chapter Resource Module is now available in the LeaderNet Toolkits. This module contains activity guides and resources that chapters may use to hold programing for women in medicine.
Chapter resource modules are available on a variety of topics including, Career Paths and Opportunities for Advanced Career Physicians; Core Tenets of Leadership for Women in Medicine; Creating Gender Equality in Your Workplace; Gender Based Differences in Physician Burnout; and more. New chapter resource modules are added regularly.
For more information, please contact firstname.lastname@example.org.
Priority Email: ACP Statements Supporting Science & Expertise
We want to assure you are aware of recent statements ACP has made or joined, supporting scientific, data driven decisions and public health officials during the COVID pandemic.
On September 27, ACP joined close to 100 other organization representing physicians and other clinicians, public health experts, scientists, patients, and other advocates, urging FDA Commissioner Hahn and Director Marks of the Center for Biologics Evaluation and Research to ensure that a COVID-19 vaccine is only authorized or licensed when it meets the Food and Drug Administration’s (FDA’s) existing high standards of safety and efficacy. https://www.acponline.org/acp_policy/letters/joint_letter_requesting_cov…
On August 27, ACP again expressed public support for the use of science, based on the best available evidence, in the fight against COVID-19 and emphasized that public health agencies should not be subjected to pressure or be influenced to issue policies that are not based on evidence and expert recommendations of their own scientists. https://www.acponline.org/acp-newsroom/acp-supports-the-use-of-science-t…
On July 14, ACP issued a statement supporting the use of scientific expertise, based on the best available evidence, in the fight against COVID-19 and urging national, state and local officials to heed the advice and information from leading experts. This statement included explicit support for Dr. Anthony Fauci, who received Mastership from ACP, in his effort to help stop the spread of COVID-19. https://www.acponline.org/acp-newsroom/acp-supports-the-use-of-scientifi…
2020 Commercial Supporters Featured at the Annual Chapter Meeting
2020 Commercial Supporters
2020 Annual Chapter Meeting Sponsored Content
UW consultation line provides free mental health advice to prescribing providers
The UW Psychiatry Consultation Line (PCL) helps busy Washington providers navigate clinical questions regarding adult patients experiencing mental health and/or substance use conditions. UW faculty psychiatrists are on hand 24/7 to consult on assessment, diagnosis and treatment planning, including management of antidepressants, anti-anxiety medications, antipsychotic medications and medications for substance use. No question is too basic or too complex – no one should feel unsupported in the care of their patient.
Prescribing providers call 877-WA-PSYCH and after a short intake with a health navigator, consult with a psychiatrist at the University of Washington. Within one business day, the provider receives written documentation of the recommendations — no need to take notes. Providers can call at any time, or can opt to schedule a consult time convenient for them. There is no limit to how many times a provider can call, and the service is free for the caller and the patient.
Coupled with PAL for Kids and PAL for Moms – specialty psychiatry consultation lines focused on children/adolescents and pregnant/new moms – UW Psychiatry has developed a robust psychiatric consultation system to help health care providers who are seeing an increased caseload of patients with mental health and substance use problems. Although the consultation lines were not set up in response to the pandemic, they are serving as a tremendous resource during these trying times.
If you are in a leadership position, please let your providers know about the PCL. We can help them if they are unsure about prescribing anti-anxiety medications, have questions about comorbidities, or don’t know what to do because their patient’s depression is not improving.
If you’re a provider — give us a try! Call 1-877-WA-PSYCH (1-877-927-7924).