One voice for internal medicine?
ACP , ASIM pursue merger negotiations
By Deborah Gesensway
If the '90s have been the decade of merger mania in the American health care industry, internal medicine may be about to join the craze.
ACP appears to be close to joining forces with the American Society of Internal Medicine (ASIM), which was formed 41 years ago when some internists who wanted their association to address the socio-economic issues of medical practice splintered off from the more education-oriented College. The two largest internal medicine organizations agreed this summer on the principles of a merger. The proposal is now before the governing bodies of both groups, which will be meeting, discussing and voting on the plan later this month and in October.
If the leaders of both professional societies agree, a new organization—to be called ACP-ASIM for a period of at least three years—could be in place by the latter half of 1998.
"Both [organizations] are now working for all internists on basically all the same issues so there really is no longer a reason to have two different organizations," said ACP President William A. Reynolds, FACP. "It doesn't make sense for there to be two organizations both speaking in the same areas but not with one voice. We'll be much stronger speaking with one voice."
In addition to providing internal medicine generalists and subspecialists with a single representative organization—and one set of dues—the merger also could give internal medicine a stronger position within organized medicine, specifically the AMA, where the two groups have sparred on occasion, said ACP Executive Vice President Walter J. McDonald, FACP.
During negotiations leading to the merger proposal, "we constantly held a vision of what the internists of 2005 needed in an organization," explained ASIM president M. Boyd Shook, FACP. "That vision was of an organization that will have effective listening posts to hear from working internists and then have at least two powerful arms to respond—one for education and one for advocacy."
Since a letter was sent to all members of ACP and ASIM last month informing them of the possibility of a merger, reaction in most states has been running about five to one in favor, Dr. McDonald said. ACP members are asked to contact their College Governors with their thoughts about consolidation.
Although ACP is about four to five times larger than ASIM and about half of ASIM's membership also belongs to the College, officials of both organizations stress that what is being proposed is a merger, not a takeover. "What we're trying to do is create an organization that takes the strengths of each of the old organizations and capitalizes on them but doesn't lose them," Dr. Shook said.
In the past, the College was known primarily for its educational efforts, while ASIM was known for its lobbying activities. Recently, however, the College and ASIM have coordinated many of their public policy efforts, and ASIM has begun to move into the educational arena. "We're doing many of the same things, which leads to a duplication of effort that neither organization needs," Dr. McDonald said.
Also in the past, the two organizations were known for taking very different positions on political issues relating to health care, the latest being during the health reform debate of the early '90s. "Now that is ancient history," said Dr. Reynolds. "Now, we both agree that universal coverage is desirable. We both agree that it is not going to happen in one sudden change."
In addition, differences in objectives, policies and governance had doomed past efforts to merge the two organizations, but leaders of both organizations say each has grown closer to the other in recent years.
In many states, the College and Society chapters already share services and join together in educational meetings; some states, like Oklahoma, Dr. Shook's home state, have already merged their local chapters. "It's been very effective and very harmonious," he said.
In fact, said Dr. McDonald, much of the demand for merger discussions has come from the internists who currently belong to both groups.
According to the proposal up for a vote this fall, the new organization would have its headquarters in Philadelphia and maintain a Washington, D.C., office. It would be committed to democratic grass-roots principles, and its leaders would be elected rather than appointed. Dues would remain at the current ACP level for one to two years. Membership categories would stay as they currently exist for ACP, including Fellows and Masters. There would be a three-year transition period for governance of the new ACP-ASIM organization. The first national membership meeting of the new organization would be held in April 1999.
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