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Governors approve steps on PAC, recertification, more

From the November ACP Observer, copyright 2003 by the American College of Physicians.

By Phyllis Maguire

Traverse City, Mich.—At its fall meeting, the Board of Governors approved 21 resolutions to be sent to the Board of Regents covering a wide range of clinical and policy issues.

Here is an overview of some of the issues the Governors addressed:

  • Political action committee. The Governors voted to ask the Regents to recommend that ACP Services Inc. form a political action committee (PAC) that would be financially independent from the College, to which members could voluntarily contribute. ACP Services is a separate, membership-based corporation, funded by a proportion of ACP member dues dollars, that can engage in certain political and business activities. Because the College is a tax-exempt, charitable organization, Internal Revenue Service rules prevent it from forming a PAC.

    Several chapter leaders said their chapter councils had voiced unanimous support for a PAC. Serafino Garella, FACP, Governor for ACP's Illinois Northern Chapter, however, said that forming a PAC would be "a fundamental change in the College's character and direct its focus away from education."

    Melvyn L. Sterling, FACP, Governor for the Southern California Region II Chapter, replied that "we won't have anyone left to educate" if the College doesn't help give members a more powerful voice in economic, regulatory and political decisions.

    The resolution was scheduled for discussion at the Board of Regents' meeting late last month.

  • Residency fair at Annual Session. The Governors recommended that the Regents establish a residency fair at Annual Session that would begin with the 2005 meeting. The resolution was co-sponsored by 20 chapters, the Council of Student Members and the Council of Associates.

  • Payment for medically necessary tests. The Governors recommended that the Regents advocate for third-party payment for medically necessary, clinically indicated studies or procedures—regardless of the outcome of those tests. All too often, pointed out Frank G. Gress, FACP, Governor for the New York Downstate III Chapter, insurers refuse to cover tests ordered by physicians when results come back negative.

  • Malpractice surcharges. The Governors recommended that the Regents monitor the practice of liability insurers levying additional surcharges against physicians who maintain privileges at hospitals that serve a large population of uninsured and indigent patients.

  • Obesity treatment coverage. The Governors recommended that the Regents support a federal study to examine the short- and long-term benefits of insurance coverage for multidisciplinary obesity treatments.

  • Tobacco. The Governors approved a recommendation that the College advocate for additional nicotine addiction warnings on packs of cigarettes that would cover at least 50% of the package surface.

    The Governors also called on the Regents to lobby the federal government to join and support the Global Framework Convention on Tobacco Control, which was developed by the World Health Organization.

  • Herbal supplements. The Governors recommended that the Regents work with the AMA to support placing warning labels on herbal supplements known to have potentially harmful side effects; to advocate for testing products to ensure supplement safety and efficacy; and, until such testing is available, lobby for warning labels indicating that supplements have not been scientifically evaluated.

  • Fellowship application reform. The Governors recommended that the Regents endorse a uniform schedule for starting and concluding the fellowship application process for residents who want to subspecialize, and support a uniform fellowship application proposal to ensure that applicants receive enough time to make informed career decisions before pursuing fellowships.

  • Electronic communication among College members. The Governors recommended that the Regents make the collection and maintenance of members' e-mail addresses a priority. Yul D. Ejnes, FACP, Governor for the Rhode Island Chapter, said that the College has so far passively relied on members to supply those addresses.

    "That paradigm isn't working," Dr. Ejnes said. "We need to have staff actively working to collect this information."

Recertification

The Governors also called for College leaders to support a new pathway to recertification that lets members use a literature-based CME model. They recommended that the Regents adopt a resolution directing the College's Liaison Committee on Recertification to propose that type of recertification pathway "as soon as possible."

The Governors heard a progress report from Regent William E. Golden, FACP, a College representative on that committee. The group meets twice a year with representatives from the American Board of Internal Medicine (ABIM) and several subspecialty societies.

According to Dr. Golden, the committee, which acts in an advisory capacity, has already helped persuade the ABIM to adopt computer-based testing and interactive courses to help complete recertification modules. (For more, see "Board exams about to make the move to computers" on page 5 of this issue, and "New College courses can help complete recertification" in the October ACP Observer online.)

Dr. Golden said the College's representatives now want a mechanism that will allow the committee to propose alternative recertification pathways. Once that mechanism is in place, he explained, the College's representatives will propose the literature-based testing model identified in the Governors' resolution.

The Governors also heard from Christine K. Cassel, MACP, ABIM president and chief executive officer, who spoke about recertification during her address on the ABIM's vision for the future. Dr. Cassel is a former President of the College.

She shared ABIM recertification data on internists whose original certificates expired in 2000-02. For internists who originally certified only in internal medicine, 77% have enrolled in the ABIM's continuous professional development (CPD) process, while 64% have completed the process.

When it comes to subspecialist recertification, 60% of subspecialists have enrolled in CPD for internal medicine and 42% have completed the process. In their subspecialty, 86% of subspecialists have enrolled in the subspecialty recertification process, and 73% have completed it.

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