Association of Chiefs of General Internal Medicine

ACGIM Chiefs Alert

VOLUME 2, ISSUE 2: MARCH 6, 2003

PRESIDENT’S PERSPECTIVE

"WELCOME IN MIAMI"
by Mark Linzer, MD

My visit to Miami for the ASP meetings began with a short stay at the University of Miami with Mark Multach and his splendid crew of internists: thoughtful, productive clinicians, educators, and scholars. One learns so much by visiting other institutions. Mark and I spent many moments discussing how best to portray the financial attributes of general medicine, and how to feel good about it. (I am very much looking forward to Mark's summary of the ACGIM listserve discussion on parental leave! Fantastic info!)

Mark and I then represented ACGIM at the ASP (Association of Subspecialty Professors) council meetings the next day. The meetings were terrific! We were welcomed, vocal, and heard. We brainstormed, challenged each other, argued, collaborated, supported, and learned. There were no hierarchies: just a group of section heads and fellowship directors, sitting around a table, working out paths to the future.

On day two of the meetings we went into small groups to determine priorities for the year. Our group hatched a task force to determine collaborative (generalist-subspecialist) models of managing chronic illness. The Council voted this their number two priority for the year, with the aim of convening a consensus conference, offering recommendations and sponsoring future research.

I realized a couple of things. First, although we are not subspecialists, we are specialists (in complex, adult patients), and have a natural affinity with the others around the table. Second, if we had joined the Alliance for Academic Internal Medicine as an independent entity rather than within ASP, all of this wonderful discussion and collaboration among general internists and medicine subspecialists would not have occurred. We would have been poised at the other side of the table to argue our cause against ASP, rather than sitting alongside them.

This month, it is on to the APM (Association of Professors of Medicine) meetings in Santa Barbara where we will present the case for academic GIM to the department chairs. More to come in the next Chiefs' Alert! Until then, take care, and hope to see you all in Vancouver on April 30th (see the SGIM Preliminary Program for details)!

by Mark Linzer, MD
President, ACGIM

ACGIM MANAGEMENT INSTITUTE:
IMPROVING MANAGEMENT TRAINING AND LEADERSHIP
Each year the Association of Chiefs of General Internal Medicine sponsors the Management Institute, the goal of which is to improve management training and leadership for faculty in General Internal Medicine. This year the institute will be held on the afternoon of April 30, preceding the annual meeting of the Society of General Internal Medicine, with three presentations focused on "Managing Demands on Faculty and Chiefs". In addition a special ACGIM-sponsored workshop "Leadership that Fosters Health and Balance in the Workplace" is scheduled during the annual meeting.

Chiefs are increasingly faced with staffing challenges, and Dr. Mark Linzer, Chief of General Internal Medicine at the University of Wisconsin Madison, will lead off the Management Institute with a presentation entitled "Life Events (predictable and otherwise): Staffing a Section of General Internal Medicine." Dr. Linzer is the Principal Investigator on the Physician Work Life Study and Physician Work Life Study II and has studied predictable life events as a cause of staffing shortages in sections of General Internal Medicine. These life events, such as pregnancy, illness and part-time practice prior to retirement can reduce the available work force in Sections of General Internal Medicine, precipitating faculty dissatisfaction and stress. Dr. Linzer presents the implications of this challenge and suggests that chiefs can to anticipate and compensate for the work force consequences of predictable life events. Dr. Linzer believes that Chief's of General Internal Medicine need to recognize predictable life events as a staffing challenge, and work with their Chairs to reduce the impact of these events on the remaining faculty in the section. Dr. Linzer will also present a short work life survey upon which chiefs can build interventions to improve faculty satisfaction and enhance career development while reducing the occurrence of job stress and burn out. Financial losses in primary care plague many chiefs of Sections of General Internal Medicine, yet all believe that primary care is critical to the mission of Academic Medical Centers. Dr. Mary Nettleman, Professor and Chief of General Internal Medicine at Virginia, Commonwealth University feels that the perception that primary care drains institutional resources is erroneous. In her presentation "Financing Primary Care and Academic Medicine", Dr. Nettleman will explore ways to counter this misperception with specific attention to benchmarking and downstream revenue analysis. Dr. Nettleman will present suggestions for using these techniques, as well as other methods of obtaining funding, to help chiefs and other leaders of General Internal Medicine to achieve financial stability for their sections.
   
The number of inpatient physicians (AKA Hospitalist) has dramatically increased over the past decade, but the academic roots for inpatient physicians may not be clear at many institutions. Dr. Mark V. Williams, President of the National Association of Inpatient Physicians, will present "Hospital Medicine: Where is it's Home in Academic Medical Centers?" Dr. Williams, Associate Director of the Division General Internal Medicine, Emory Healthcare, will describe the reasons driving the expansion of inpatient physicians and identify the range of potential roles for Hospitalists in clinical care, teaching, administration and research. Dr. Williams anticipates future challenges facing inpatient physicians and will explore the development and future academic home for the specialty of Hospital Medicine. Finally Dr. Williams will also discuss the role of the National Association of Inpatient Physicians (NAIP) in promoting hospitalism as a career, and how the NAIP may interact with other professional associations such as the ACGIM and the SGIM.

ACGIM is pleased to sponsor a very special presentation during the SGIM meeting: "Leadership that Fosters Health and Balance in the Workplace." Drs. Penny Williamson and Tony Suchman will lead this two-part workshop for current and emerging leaders in General Internal Medicine on Friday May 2. Dr. Williamson and Suchman will provide attendees with an opportunity to explore the principles of Relationship-Centered Administration, an approach that parallels and supports their well-known partnership-based clinical approach, Relationship-Centered Care. During this interactive workshop, attendees will work in small groups and engage in an iterative process of practice and reflection to focus on four core skills: being personally present, speaking authentically and listening to understand others, valuing differences and diversity, and trusting the process/letting go of control. Dr. Williamson and Suchman will lead participants as they engage in interviews and dialogue to discover core factors that promote personal balance and a healthy workplace. They will help participants develop individual action plans to be implemented in their sections. This workshop will also provide an introductory exposure to several organizational development strategies including story telling, appreciative inquiry, world cafe and peer mentoring.

ACGIM encourages Chiefs of Sections and Divisions of General Internal Medicine, other leaders from General Internal Medicine, managers and administrators to attend the Management Institute. ACGIM also encourages individuals who anticipate assuming leadership roles in sections to also consider attending the institute.

By William P. Moran, MD
Program Chair, ACGIM Management Institute


CALENDAR WATCH

• ONLINE REGISTRATION OPEN FOR THE ACGIM MANAGEMENT INSTITUTE:
  April 30, 2003: Vancouver, British Columbia: "Old Problems, New Solutions: Managing Demands on Faculty (and Chiefs)". An affiliate meeting of the Society of General Internal Medicine's 26th Annual Meeting, this management and leadership institute for GIM will feature sessions on:

1. Life Events (Predictable and Otherwise): Staffing a Section of General Internal Medicine
2. Financing Primary Care in Academic Medicine
3. Hospital Medicine: Where is its Home in Academic Medical Centers?
   

There will also be an ACGIM-sponsored workshop, "Leadership that Fosters Health and Balance in the Workplace, conducted by Anthony L. Suchman and Penny Williamson. To register, click here.

• THE AMERICAN ACADEMY ON PHYSICIAN AND PATIENT (AAPP) would like to welcome all GIM Section Chiefs to two of it's upcoming courses:

1. June 9-13, 2003: The week-long annual faculty development course, Teaching Medical Interviewing, now in its 21st year, will be held at the University of Wisconsin in Madison, and hosted by Norm Jensen, MD. The dual themes are "Preparing for the New ACGME Standards for Communication" and "Teaching End of Life Communication." This course is ideal for faculty or clinicians wishing to improve their own communication skills, and those currently teaching or preparing to begin a communications training program. Registration is now available at www.physicianpatient.org
2. October 9-11, 2003: Research and Teaching Forum on Physician-Patient Communication, Baltimore, MD. Maritime Institute, Baltimore-Washington International Airport. This conference highlights emerging directions in health communication and will feature workshops, plenary sessions, and concurrent research abstract presentations. The AAPP encourages research in its formative stages, and abstract sessions are facilitated to allow for maximal audience (peer) feedback and dialogue about the research. Those presenting at the AAPP Forum are free to present this work at other conferences. Abstracts are currently being solicited. Please find the abstract submission materials at www.physicianpatient.org

NEW POSITION OPENING LISTINGS: This listing is free to ACGIM members, and open to non-members for a modest fee. To advertise, please contact Lorraine Tracton at ACGIMChiefsAlertEditor@SGIM.org.

• ASSISTANT/ASSOCIATE PROFESSOR: University at Buffalo
• CLINICIAN EDUCATORS: University of Missouri-Columbia
• PHYSICIAN-HEALTH SERVICES RESEARCH INVESTIGATOR: VA/Baylor College of Medicine, Houston, TX