Association of Chiefs of General Internal Medicine

ACGIM Chiefs Alert

VOLUME 1, ISSUE 3: DECEMBER 16, 2002

PRESIDENT’S PERSPECTIVE

“Retreat, now advance!”
By Mark Linzer

The ACGIM Exec Committee had their annual retreat last week and reviewed the year's progress and goals for the coming year. We took seriously all comments from the listserve, and a retreat report, wonderfully crafted by Bob Centor, is attached. As we approach 100 chiefs in the group, the news is very exciting: we 1) are in the midst of a vote on our proposed participation with SGIM in ASP and the Alliance for Academic Internal Medicine, 2) have voted to join with SGIM in Career Support efforts with site visits to GIM divisions, 3) will look for synergy in our efforts in the area of defining patient complexity in GIM with SGIM's Domain of GIM Task Force, and 4) will move ahead with our commitment to make personal-professional balance an agenda item for chiefs and their faculty.

We've also initiated our mentorship committee, begun a discussion of how best to promote diversity in leadership, put the finishing touches on our Management Institute in Vancouver, and gave a rousing chorus of applause and ideas to the Chief's Curriculum work group. In addition, we clarified who we are and what we stand for: our "brand identity" -- to support, inform and advocate for chiefs in GIM. And so, after our retreat, we look forward to advancing together!

REPORT FROM THE RETREAT
December 3-5 the ACGIM Executive Committee and several committee chairs met to develop plans for the next 18 months. The Committee discussed a variety of programs that will address societal goals. This newsletter will highlight a few of those programs.

Curriculum
Peter Rudd (rudd@stanford.edu - Stanford) and Andy Brown (abrown@medicine.umsmed.edu - U Mississippi) are working on the Curriculum for Division Chiefs. The Exec. Committee expects several benefits from this project. First, we would all like the curriculum as a reference. Second, we plan to develop a special course for new chiefs. This course will highlight selected parts of the curriculum - especially finances and negotiation. If you would like to help with this project please email Peter.

2003 ACGIM Institute
Program Bill Moran (wmoran@wfubmc.edu - Wake Forest) is chairing our programming for the 2003 ACGIM Institute, and he has outlined a wonderful program. The program will have three parts - work life balance, downstream revenue, and the hospitalist movement. See the ACGIM INSTITUTE PROGRAM PREVIEW article below for details. This program is open to all members as well as others in your divisions. Bill is serving as a committee of one. Please contact him if you are interested in helping with this and other programming.

APM meeting
This February Mark Linzer (Mxl@medicine.wisc.edu - ACGIM President, (at University of Wisconsin) and Bob Centor (rcentor@uabmc.edu - Past-President - (at UAB) will meet with representatives from APM (Association of Professors of Medicine - the Chairs). During this meeting we plan to discuss issues that impact on divisions of general internal medicine, hopefully gaining some ideas and focus from the chairs. If you have specific ideas of issues that we should raise in this 2-hour meeting please email either Mark or Bob.

The Listserve
Over the past few months, we have had several questions asked on the Listserve, which prompted excellent discussions. We discussed a number of future such questions and have decided over the next six months to try having a question of the month. Bob Centor will try to have an issue ‘champion’ to help collate the responses and write a brief piece for the newsletter. He will be sending out the first such question within the next week or two. If you have questions that you think would help other chiefs please let him know.

ACGIM INSTITUTE PROGRAM PREVIEW
Following is a preview of the ACGIM Institute program, as it stands at press time:

"Life events (predictable and otherwise):
Staffing a Section of General Internal Medicine”
Speaker: Mark Linzer, MD, President, ACGIM, and Professor and Chief, Section of General Internal Medicine, University of Wisconsin-Madison, and Principal Investigator, Physician Worklife Study and Physician Worklife Study II

Predictable life events, such as pregnancies, illness, and part time practice prior to retirement, can diminish the available workforce in a section of General Internal Medicine. Managing staffing shortages, both in terms of available FTEs and increases in dissatisfaction and physician stress, can lead to major challenges for General Internal Medicine leaders. Dr. Linzer will present implications and solutions to these problems, expanding upon his recent article. He will also present a short Worklife Survey to target interventions for faculty based upon their assessment of satisfaction, stress and burnout, career development, gender climate, work/family balance, teamwork and fairness.

“Financing Primary Care in Academic Medicine”
Speaker: Mary D. Nettleman, MD, MS, Professor and Division Chair, General Internal Medicine, Virginia Commonwealth University

Primary care is critical to the survival of all Academic Medical Centers. However, because primary care does not usually cover its costs from direct billing, it may be erroneously perceived as draining resources from the institution. This talk will explore ways to counter this misperception with specific attention to benchmarking and downstream revenue analysis. Methods of obtaining funding will be discussed.

“Hospital Medicine: Where is its home in Academic Medical Centers?”
Speaker: Mark V. Williams, MD, FACP, Associate Professor of Medicine, Director, Hospital Medicine Unit, Associate Director, Division of General Medicine, Executive Medical Director, EHCA, Emory Healthcare President, National Association of Inpatient Physicians

Dr. Williams will describe the rapid growth of hospitalists in the U.S., the reasons driving this expansion, and identify the potential role of hospitalists in clinical care, administration, and research. Dr. Williams will also forecast future challenges facing hospitalists and the specialty of Hospital Medicine, and identify the role of the National Association of Inpatient Physicians (NAIP) in promoting hospitalists.

ACGIM Management Institute: who should attend?
Chiefs of Sections/Divisions of General Internal Medicine, other leaders, managers and administrators in Sections of General Internal Medicine. Individuals who anticipate assuming such roles in Sections of General Internal Medicine should also consider attending the Institute.

Business meeting to follow: 5 PM (ACGIM members)
Annual Dinner: Cocktails at 6 PM, dinner at 7 PM (ACGIM members)

Special ACGIM sponsored workshop during the SGIM meeting:

“Leadership that Fosters Health and Balance in the Workplace”
Penny Williamson, Sc.D., Associate Professor of Medicine, Johns Hopkins University School of Medicine, and independent consultant.

Anthony L. Suchman, MD, MA, FACP, practicing physician and organizational consultant, and Clinical Professor of Medicine and Psychiatry at the University of Rochester.

This two-part workshop will provide current and emerging leaders with an opportunity to explore principles of Relationship-centered Administration - an administrative approach that parallels and supports the partnership-based clinical approach known as Relationship-Centered Care. Working in pairs, small groups and plenary session, participants will engage in an iterative process of practice and reflection to focus attention on four core skills (being personally present, speaking authentically and listening to understand others, valuing difference and diversity, and trusting the process/ letting go of control). Participants will engage in interviews and dialogue to discover core factors that promote personal balance and healthy workplaces. They will then help each other develop individual action plans to be implemented in their home departments. The workshop will provide an introductory exposure to a number of organizational development strategies including storytelling, Appreciative Inquiry, World Café and peer mentoring.

Session 1: Friday, May 2, 2003 3:30-5:00 PM
Session 2: Saturday, May 3, 2003 9:00-10:30 AM (There is no separate fee for this workshop series)

EDITOR’S BOOK RECOMMENDATIONS:
Chief’s Alert Editor Bob Centor has made the following three book recommendations this month, and asks you to please send him your favorites:

1. The Tipping Point by Malcolm Gladwell -http://www.gladwell.com/books.html - quoting the author, “It's a book about change. In particular, it's a book that presents a new way of understanding why change so often happens as quickly and as unexpectedly as it does. For example, why did crime drop so dramatically in New York City in the mid-1990's? How does a novel written by an unknown author end up as national bestseller? Why do teens smoke in greater and greater numbers, when every single person in the country knows that cigarettes kill? Why is word-of-mouth so powerful? What makes TV shows like Sesame Street so good at teaching kids how to read? I think the answer to all those questions is the same. It's that ideas and behavior and messages and products sometimes behave just like outbreaks of infectious disease. They are social epidemics. The Tipping Point is an examination of the social epidemics that surround us.”

Peter Rudd suggested this book. I also highly recommend Gladwell’s web site, which includes many of his wonderful New Yorker essays (my personal favorite being the Art of Failure) - http://www.gladwell.com/books.html

2. Leadership by Rudy Giuliani -This book has great insights on leadership style. Focus on the leadership comments - you may or may not agree with some of the political issues.
3. Follow This Path: How the World's Greatest Organizations Drive Growth by Unleashing Human Potential by Curt Coffman and Gabriel Gonzalez-Molina, Ph.D. This book is a follow up to First, Break All the Rules. I am currently reading and enjoying this book and hope to write a review in the near future.

ARTICLES - recommended by Peter Rudd

1. Christensen CM et al: Will disruptive technologies cure health care? Harvard Business Review 9/00, pp 102-111. Available to download for $6 -
2. Boex JR et al. Measuring the cost of primary care education in the ambulatory setting. Acad Med 5/00; 73:419-25. -pdf available on line -
3. Souba WW. Academic medicine and the search for meaning and purpose. Acad Med 2/02; 77:139-44. - abstract available on line - If you have favorite articles, please let me (Bob Centor) know!

NEW RECRUITMENT LISTINGS

• ASS’T/ASSOC PROFESSOR: Univ. of Louisville, KY
• CLINICIAN SCIENTIST: Northwestern Univ., IL
• FELLOWSHIP, AMBULATORY CARE: Tulane School of Med.,New Orleans, LA For details, and more listings, go to http://www.acgim.net/positionopenings.htm. To post your listing, send it to ACGIMChiefsAlertEditor@SGIM.org, attention Lorraine Tracton.

CALL FOR DISPARITIES IN HEALTH PAPERS
The Journal of General Internal Medicine is soliciting papers for a special issue on disparities in health. Submissions for this issue should be sent to JGIM, attention JudyAnn Bigby, following instructions for authors at . Cover letters should clearly indicate the papers are for consideration in the special issue. See Dr. Bigby's call for papers in the October JGIM, Volume 17, Number 10, page 814 http://www.sgim.org/DisparitiesCall.cfm.

FUNDING OPPORTUNITY:
SGIM’s Lawrence S. Linn grants are awarded to young investigators "to study or improve the quality of life for persons with AIDS or HIV infection." The maximum amount that will be funded is $10,000 for each grant, and a maximum of two grants will be funded each year. The awards, endowed by the Lawrence Linn Trust, will be presented at SGIM’s 26th Annual Meeting, April 30-May 3, 2003 in Vancouver, British Columbia. Click here for the full RFP and Application Form.

SGIM RECOGNITION AWARDS CALL ONLINE
Do people in your Division deserve recognition for outstanding contributions to improving Patient Care, Education, Research, or the profession of GIM? If so, SGIM Secretary Ann Nattinger, MD, urges you to nominate them, or encourage them to nominate themselves. The SGIM Call for Awards is now online at http://www.sgim.org/awards.cfm and the nomination process has been streamlined to make it easier to submit nominations.