Leaders to focus on internists' image and public policy issues
From the June 2000 ACP-ASIM Observer, copyright © 2000 by the American College of Physicians-American Society of Internal Medicine.
By Phyllis Maguire
The College's new elected officials, who took office at Annual Session, plan to focus on a wide range of issues that include the public image of internists, generalist-subspecialist relations and medical errors. Here are some of their goals for the coming year:
President: Dr. Fryhofer
College President Sandra Adamson Fryhofer, FACP, has set an ambitious goal for her tenure as College President: "To establish internal medicine as the most qualified and best-recognized discipline to deliver primary care to the whole adult population, male and female."
A primary care physician in Atlanta, Dr. Fryhofer has worked for several years to enhance the College's public image. Since 1997, she has served as The spokesperson for the College's public Awareness campaign, speaking extensively to the media about internists. In that role, she has become increasingly aware of the public's hunger for information about health care.
"Patients want to be informed about their options and choices," Dr. Fryhofer said. "That's why we need to get the message out about internists' broad range of training. Once patients have that knowledge, they are going to want an internist to take care of them."
To get the word out, Dr. Fryhofer intends to use both print and electronic media. "The Internet is full of untapped opportunities," she said.
She said that two programs will bring the College more visibility this year: the first-ever ACP—ASIM clinical theme, which focuses on emerging antibiotic resistance, and the Decision 2000 Campaign, which educates policy-makers, political candidates and the public about the importance of health care access as a public health issue.
Dr. Fryhofer commended Immediate Past President Whitney W. Addington, MACP, for his efforts in launching the campaign, but she said that the job will not be done "until we have health insurance for all Americans. The other College leaders and I plan to get very involved in campaign efforts as we approach the election."
Chair, Board of Regents: Dr. Zetterman
Rowen K. Zetterman, FACP, the new Chair of the Board of Regents, identified three major challenges the College and the Board will face in the coming year.
The first challenge is what Dr. Zetterman called the continuing "fractionalization" of internal medicine into generalists, hospitalists and subspecialists. In the coming year, he wants the College to work more closely with subspecialty groups and general internal medicine organizations.
He said that the College's affiliation with the National Association of Inpatient Physicians, the national hospitalist organization, is an excellent model for how the College can bring other medical groups "into our fold." He acknowledged, however, that the current friction between the College and several subspecialty groups underscores how much work needs to be done.
"With reimbursement of Medicare funds, it's a zero-sum game," he said. "Where one gains, the other loses. We need to work together to increase reimbursement for all physicians and to look at various options for patient care." He pointed to the ACP—ASIM merger as proof of how different organizations can gain strength by pooling their talents.
Dr. Zetterman said that a second challenge will be addressing patient concerns about medical errors. "How do we deal with public awareness and improve the care of our patients?" Dr. Zetterman asked.
Finally, he said, the College must continue to work against the forces that erode medical professionalism. "Increasingly, our members feel that they're under attack," Dr. Zetterman said. "We need to return a sense of value and good judgment to the practice of medicine."
Dr. Zetterman, vice chair of the department of internal medicine at the University of Nebraska Medical Center in Omaha, has been a Regent since 1995 and is a former Chair of the Board of Governors. He sees the College playing a growing role in both organized medicine and the national debate on health care issues. He said that he also sees changes in store for the Board of Regents.
"We've undertaken an evaluation of the Board and of how it carries out its work," he explained. "We're already in the process of decentralization." The Board is now allowing various College committees to conduct their own strategic planning to speed up decision-making.
Chair, Board of Governors: Dr. Sweet
For Donna E. Sweet, FACP, the new Chair of the Board of Governors, the turmoil in health care today presents major opportunities for physicians.
"We tend to focus on the tumult and all the fears and issues," Dr. Sweet said. "But I think this is a great time to be in organized medicine because we can effect change."
According to Dr. Sweet, last year's Institute of Medicine report on medical errors will affect the College on both a national and a chapter level. As physicians explore ways to prevent errors in their practices and communities, Dr. Sweet said she foresees a prominent role for both state chapters and local physician leaders.
"We want internists to be a big part of that voice of change, but we don't want our physicians to feel beleaguered and blamed," Dr. Sweet said. "They need to be a part of the solution, not just at the end of a finger pointing to them as bad doctors." In her role as Chair of the Board of Governors, she said that she will keep communication open among the Governors to make them aware of both local efforts and the College's national resources that can be used in the effort to eliminate medical errors.
Dr. Sweet, who has served as Governor of the Kansas Chapter since 1996, is an immunologist and member of the national task force on rural HIV/AIDS for the National Rural Health Association. She is also professor of internal medicine at the University of Kansas Medical School in Wichita. She said that she brings to her new role the perspectives of both a practicing physician and an academician.
"I know all the private sector tumult with managed care as far as cuts in salaries and being deselected from different health plans," she said. "I also understand what it's like to have residents worried about whether or not there's going to be a future for them, and to see academicians facing grave cuts in their clinical instructors." One of her priorities as Chair of the Board of Governors will be to help coordinate the College's commitment to preventing further Medicare cuts.
Another priority for Dr. Sweet is safeguarding medical education. "We have to try to make sure that academic centers won't be hurt any worse than they have been," she said.
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