American College of Physicians: Internal Medicine — Doctors for Adults ®


Postmerger unity already setting in

The ACP-ASIM merger takes place July 1, but joint efforts have begun

From the May 1998 ACP Observer, copyright 1998 by the American College of Physicians.

By Deborah Gesensway

SAN DIEGO—When it comes to the battle to revise the evaluation and management (E/M) documentation guidelines and the fight to achieve concessions from the tobacco industry, ACP and the American Society of Internal Medicine (ASIM) are already acting as one.

On July 1, the two longtime rivals will officially become one. The final vote to make the merger of the two largest internal medicine professional societies a reality came late last month before the start of Annual Session. Negotiations had been underway since the 1997 Annual Session in Philadelphia.

As a result of the merger, when internists lobby Congress, HCFA and state legislatures, they will be speaking with one voice. When they sit in the AMA House of Delegates, internists will work together in a strong, combined delegation. And when they join their all-purpose professional society, they will receive only one dues bill—from ACP-ASIM.

"We approached this not with the idea that if we could get this done, it would be a success, but rather with the idea that if we didn't get it done, it was going to be a failure," said Walter J. McDonald, ACP's Executive Vice President. At least two other attempts to merge the two internal medicine societies over the years had failed.

ASIM was founded in 1956 by internists who wanted an organization to focus not on biomedical and clinical concerns—which ACP was known for—but on the social, economic and political developments that affect the practice of internal medicine. Over the years, however, the two organizations have come to be involved in many of the same issues. In 1981, for example, ACP started a Washington, D.C., office, while ASIM got increasingly involved in continuing medical education and quality improvement projects.

"When we began, we had totally different purposes," explained ACP's Immediate Past President William Reynolds, MACP. "Now we have parallel interests, and we're going to put them together." College officials expect the new combined organization—to be called ACP-ASIM for a period of at least three years starting in July—will have about 105,000 members. The new organization will be headquartered in Philadelphia.

ASIM's Executive Vice President, Alan R. Nelson, FACP, will become Associate Executive Vice President of the new organization. He will be in charge of the combined Washington, D.C., office, which will be located in ASIM's current headquarters. Dr. Nelson said that the office will work on issues aimed at improving the health of the public—such as universal access to health care, a reduction in violence and adequate funding for public health initiatives—and on topics that could benefit patients such as strengthened patient protections and adequate funding for research and education. The Washington-based office will also focus on reducing hassles that make it hard for internists to care for their patients.

"The merger allows us to pursue this advocacy agenda because it combines the long-standing commitment of ACP to public health, research and education, and access to care, with the street-wise savvy of ASIM in matters of managed care policy, third-party relations, and coding and payment," Dr. Nelson said. "It combines the authoritative clout of ACP's policy positions with ASIM's ability to interact with and leverage its agency—including with the AMA and state medical associations."

Before casting their ballots last month in San Diego, College Regents asked about everything from how many ASIM employees will work for ACP-ASIM to how both organizations' managed care-related programs and projects will be combined. Many of these decisions will be made by College and ASIM management over the next few months, ACP officials said. There may be as many as 45 ASIM employees who will work for ACP-ASIM, and in the future, a combined managed care operation will probably focus on quality-of-care issues.

The question of what will happen to ASIM's existing political action committee (PAC) consumed much of the debate among the ACP Regents. Under terms of the negotiated agreement, the PAC, which is considered small by political insiders, will continue to operate through the November election and then will go out of business, explained John Tooker, FACP, the College's Deputy Executive Vice President.

Under terms of the agreement, local ACP chapters and ASIM component societies will also merge. The Board of Regents, which will be expanded for a period of time to include some ASIM leaders, will be the ultimate policy-making body of the new organization.

The new organization will also be marked by the following characteristics:

  • A new committee, which may be called the "Medical Services Committee," will be established. This committee will be on equal footing with ACP's existing Health and Public Policy Committee and will be responsible for overseeing policy development on third-party relations and reimbursement issues such as coding and HCFA operations.
  • On both a national and local level, ACP-ASIM will continue to be legally incorporated as a not-for-profit, charitable 501(c)(3) corporation. On the national level, there will also be a separate 501(c)(6) organization called ACP-ASIM Services, which will be the legal home of some of the College's profit-making and advocacy programs. Some local chapters may opt to set up separate 501(c)(6) organizations for themselves.
  • Although 20 transitional Governors will be added to the Board of Governors, each chapter's elected Governor will remain the chief executive officer of the region.

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