ACP's new President on the state of the College
William A. Reynolds, FACP
It is with enthusiastic optimism, gratitude and humility that I assume the office of President of the College. For my inaugural editorial, it seems appropriate to give a "State of the College" report.
With more than 100,000 members, the College is robust.
Including our 9,000 medical students, we have grown nearly 33% over the past five years. General internists and subspecialists are represented almost equally, and while 20% of our permanent members are women, 40% of student members and 31% of Associates are female. In addition, 41% of Associates are international medical graduates.
Medical education has always been foremost among College priorities. Annual Session, which drew more than 5,500 internists to Philadelphia this year, continues to serve as the premier educational program for internists. ACP's self-assessment program, MKSAP 10, has 48,000 subscribers; MKSAP 11, with its emphasis on preparing for recertification, will be available this year.
Another popular College program is the community-based teaching project, which provides students and residents experience with internists who practice in the community. In addition, ACP spearheaded the widely acclaimed Federated Council of Internal Medicine curriculum project, which will serve as an educational blueprint for training programs in internal medicine.
One of our goals is to be the foremost information resource for internists. Annals of Internal Medicine remains the premier publication in the field and has been joined by ACP Journal Club and this past year by a new publication, Evidence-Based Medicine. We continue to develop and publish evidence-based guidelines through ACP's Clinical Efficacy Assessment Project (CEAP).
Information for internists is increasingly available from the College in electronic form. ACP has a home page on the World Wide Web (http://www.acponline. org) that features information about ACP courses, ACP publications and products. ACP Online also includes articles from Annals of Internal Medicine and prepublication selections from ACP Journal Club and Evidence Based Medicine.
The electronic version of MKSAP 10 on CD-ROM is already available, and an electronic version for MKSAP 11 is in the making. ACP Library on Disc integrates important clinical information into one searchable database and includes current information from MKSAP, clinical practice guidelines, a variety of textbooks and all issues of ACP Journal Club.
The problems of the uninsured and universal health care access have been key issues for the College in recent years. ACP's Health and Public Policy Committee and the Washington office have developed policy papers on critical topics such as managed care, Medicare, Medicaid, antitrust, firearm injury prevention, medical liability reform, inner city health care, medical savings accounts and medical work force policy.
Managed care issues rank high with our members, and the results of a recent survey will help us meet members' needs. The growing number of Medicare and Medicaid patients in managed care is also a major issue. The College has created the Managed Care Resource Center to respond to member needs for information and to link them with qualified experts and consultants in managed care. We have also developed position papers addressing the impacts of managed care on practice, work force and education. In addition, the College has developed the Office Practice Assessment Program, a tool that can help members evaluate and improve their practices, which will be particularly helpful in competitive managed care markets.
Solidifying generalist and subspecialist relationships is another of the College's priorities. In 1995, ACP participated in meetings with subspecialty societies and the Agency for Health Care Policy and Research to develop referral guidelines with an eye toward managed care settings. The College will also continue to publish guidelines through the CEAP process and possibly develop another method to produce referral guidelines.
Associates and medical students
The future of the College is our medical student and Associate (residents and fellows) membership. Last year, more than 45,000 students received the brochure, "Meet Internal Medicine." Associates numbered 22,400 in 1996; more than 1,000 presented abstracts or posters in the Associates competitions in 1996. Associates are represented on College committees and the Council of Associates; the Council's chair is also a member of the Board of Regents.
Recognition of individual excellence and distinguished contributions to internal medicine has been an important role of the College since its beginnings in 1915. ACP gives Laureate Awards to Fellows, Evergreen Awards to chapters and recently began giving chapter management awards. The centerpiece of Annual Session remains Convocation, where Fellowship is bestowed on successful candidates and Masterships are given to outstanding internists in academia, research, practice, government and administration.
ACP's international activities include the work of our chapters in Canada, Mexico, Central America, Venezuela, Brazil and Chile. We have members and Fellows from many nations from around the world. ACP established a new International Activities Office last year to attract internists from other nations to Annual Session and to market our educational products outside the Americas. An ACP co-sponsored meeting will also be held this summer in Jordan. An exciting new project cosponsored by ACP that will fund short stays for volunteer ACP members in the former Soviet Union should also be developed later this year.
Public awareness program
The public education program may be the most important College initiative in recent years. It is clear that the public does not have a clear understanding of what an internist is. With the changes in health care insurance and the growth of managed care, we need to make the public aware of the availability of internists as primary care physicians, particularly with the increasing competition for this market by family practitioners, obstetrician-gynecologists and nurse practitioners.
The College believes that the public's lack of knowledge of the role of internists is affecting individuals' ability to make an informed decision when selecting a physician. The research phase of the public education program has been completed, establishing the need and a framework for evaluating the program at the end of its third year. The campaign will be aimed at the general public and target women over age 35, who tend to serve as the major decision makers in selecting health care providers.
By any measure, the College has been very successful and is poised to meet the many new challenges thrust upon us by the dramatic and rapidly changing patterns of health care delivery and payment. Our commitment to advocate for our patients and to support and provide service to our members should guarantee our continued success.
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