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

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From the July/August 1999 ACP-ASIM Observer, copyright © 1999 by the American College of Physicians-American Society of Internal Medicine.

Hospitalist update

The fight against mandatory hospitalist programs continues, with ACP-ASIM and its affiliate organization taking further steps to denounce health plans that force primary care physicians to transfer patients to hospitalists.

In April, the College organized a joint letter signed by 24 medical societies and sent to a number of the nation's leading managed care companies criticizing mandatory hospitalist programs. (See "Use of mandatory hospitalists blasted" in the May issue of ACP-ASIM Observer).

In early May, the College received a response to that letter from Karen Ignagni, president and CEO of the American Association of Health Plans (AAHP). She offered to host a meeting on the subject at AAHP and pledged to work to ensure a productive dialogue.

In addition, the National Association of Inpatient Physicians (NAIP), an affiliate of the College, expressed opposition to mandatory hospitalist programs in a May 3 letter to Blue Cross/Blue Shield, AAHP and the Health Insurance Association of America. The letter, written by NAIP Co-Presidents John R. Nelson, FACP, and Winthrop F. Whitcomb, ACP-ASIM Member, said that the success of hospitalist systems depends upon support from primary care physicians and giving patients an opportunity to discuss care options.

Finally, the College's Florida Chapter, which has been affected by health plans' use of mandatory hospitalist models, is trying to work with legislators to craft legislation that would outlaw the practice.

College joins coalition protesting Aetna-Prudential merger

The College joined a coalition of 29 medical societies representing nearly a half million physicians to express concern about the recent merger of Aetna U.S. Healthcare with Prudential HealthCare.

In a March 25 letter to the Department of Justice's Antitrust Division, the coalition expressed concern that the merger would interfere with patient choice and with physicians' ability to provide needed care to their patients. The letter complained that because vigorous antitrust protections are not being applied to national health insurers, a few large companies are gaining too much market control.

The coalition asked the Department of Justice to review the following areas of concern in the merger:

  • Aetna already controls one-third of the market in nine of the most populous states and contracts with 40% of the nation's Fortune 1000 companies.
  • Aetna has consistently restricted physician networks, particularly for specialist care, and interferes with primary care doctors' ability to make referrals to specialists.
  • Aetna has created complex and lengthy approval processes for care and defines medical necessity as the "least costly alternative."
  • Aetna's market power limits the ability of physicians to negotiate for reasonable medical policies on behalf of patients.
  • Mergers create "dislocations" of care that jeopardize the continuity of patient care and create claims-approval backlogs.

A copy of the letter is available in the "Where We Stand" section of ACP-ASIM Online.

Chapters honor 15 internists with Laureate Awards

ACP-ASIM chapters gave 15 internists Laureate Awards this winter and spring.

The awards honor College Fellows and Masters who have demonstrated a commitment to excellence in medical care, education and research, and have provided service to their community and the College. Awardees generally have been Fellows for 15 to 20 years and have a long history of excellence and peer approval in internal medicine. These requirements may be modified in exceptional circumstances.

Here is a list of the most recent award-winners:

Alabama
C. Glenn Cobbs, FACP
Richard O. Russell, FACP

Southern California I
Donald A. Adams, FACP
Telfer "Pete" Reynolds, MACP
David H. Solomon, FACP

Connecticut
Joseph P. Cleary, FACP
Everett B. Cooper, FACP
David N. Podell, FACP

Iowa
John H. MacIndoe, ACP-ASIM Member
Thomas J. McIntosh, FACP

New York Downstate I
Harold N. Adel, FACP

New York Downstate II
Regina M. McGinn, FACP

North Carolina
William R. Hazzard, FACP
Neil C. Bender, ACP-ASIM Member

Rhode Island
Charles B. Kahn, FACP

Clinical skills modules now available to chapters

The College's Education and Career Development Department has released five educational modules that chapters can use to teach clinical skills to physicians.

The modules, which are based on Annual Session presentations, are designed to help internists refine their clinical skills through proven methods of interactive learning. The programs use a local on-site instructor, videotapes and "hands-on" activities for participants. The modules contain all the materials for both faculty and participants and include evaluation forms to fulfill CME requirements.

The modules will be loaned free of charge to College chapters, but they must be returned for use by other chapters. The following is a list of clinical skill modules and their availability:

  • "Skin Biopsy and Cryosurgery" (available now);
  • "Communication for Behavior Change" (available now);
  • "Arthrocentesis and Joint Injection" (available now);
  • "Women's Health: Breast Examination" (scheduled for release in September);
  • "Women's Health: Pelvic Examination" (scheduled for release in November)

If you're interested in using any of these modules at your next chapter meeting, contact your chapter Governor.

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