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Rhode Island Governor's Newsletter June 2024

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Kwame O. Dapaah-Afriyie, MBchB, FACP, ACP Governor

Kwame O. Dapaah-Afriyie, MBchB, FACP, ACP Governor

 


Governor's Welcome

Summer is almost here! Let us take a moment to reflect on our numerous activities this past spring.

We had a successful Annual Scientific chapter meeting on March 20th, 2024. Our Co-chairs : Drs Jennifer O'Brien, Karen Woolfall-Quinn, Alisa Merolli, and Jinen Thakker worked diligently to ensure we have an impactful educational time.

¹Ü¼ÒÆÅÐÄË®ÂÛ̳ National meeting was held in Boston from April 16th to 19th, 2024. In addition to the insightful keynote address by Eric Toprol about AI and its implications in healthcare, we celebrated the recognition of a number of our colleagues for their successful achievements.

ACP Leadership Day was held in Washington D.C. on 05/14, 05/15. Our delegation was led by Tom Bledsoe. The other team members were Celinie Nguyen – medical student(AMS),Kanishka Uttam Chandani, Dhruvi Reddy Sanikommu, Charmi Trivedi – medical residents, Yul Ejnes and I. One of our medical residents, Sagar Patel who had been in Washinton D.C. as part of his ACP Health Policy Internship program joined us for our scheduled activities. Yul and Tom's irrefragable in-depth knowledge about ACP activities was very much appreciated by all members of the team, especially first-time attendees as expressed by Kanishka Chandani below:

"Being able to participate in ACP's initiative to advocate for our healthcare system and ultimately our patients that we care for daily has been nothing short of an exhilarating experience. From learning about the various issues that exist in our system to learning about how the ACP as an organization is advocating for them is truly fascinating. The lectures and workshops on Day 1 were very informative, engaging, and eye-opening, and they prepared us for what to expect at Capitol Hill the next day, which was very helpful for first-time attendees like us. It boosted our confidence in approaching our meetings. Our team leaders and senior delegates, Dr. Dapaah-Afriyie, Dr. Bledsoe, and Dr. Ejnes were with us every step of the way and guided us through this journey. On the second day, we met with our Congressmen and our Senators and discussed 3 important bills. The Congressmen and Senators were very kind and receptive to our stories and our perspective and showed strong support, which further encouraged us to continue advocating for our patients even after Leadership Day. Overall, ACP Leadership Day was a deeply enriching and educational experience!"

The following are the three main congressional bills ACP is advocating for speedy passage. All chapter delegations met and reviewed them with their congressional members.

a. Safe Step Act: to ensure patients who are doing well on specific medications are not denied insurance when they switch insurance carriers unless the patients once again prove that less expensive options have not achieved the desired results.

b. Resident Physician Shortage Reduction Act: which seeks to increase number of Medicare supported graduate medical education positions by 14,000 over 7 years.

c. Physician Fee Schedule Update and Improvements Act: which seeks to raise the threshold for implementing budget neutrality payment cuts to Medicare. This is critical issue necessary to help address the primary care crisis which is precarious in our state.

We were warmly received by our members of congress and their staff. We had fruitful discussions, and it was gratifying to know that Representative Gabe Amo is a co-sponsor of the Safe Step Act, and Seth Magaziner is a co-sponsor of the Resident physician shortage reduction bill. We did receive verbal commitments from all 4 members of congress that all the bills being championed by ACP will be reviewed and given due consideration. We firmly believe the passage of these bills will alleviate the increasing burnout and moral injury that Internal Medicine Physicians and other Clinicians are experiencing.

Although the rather late meeting time with Rep. Amo posed a conflict with travel plans for senior members of our delegation, subsequent weather-related changes in flights (an instrument of kismet), allowed us to meet with him and his legislative assistant, a fitting coda for a leadership day's activities.

Next year's ACP Leadership Day will be held on 04/28 and 04/29.

Best wishes of an enjoyable and productive summer to you and your families!

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Chapter News

Committee Highlights: Resident and Fellow Committee (by Dr. Shringi)

This Committee is under the leadership of Dr. Sandipan Shringi and his leadership team whose members are Drs Aryanna Sousa, Vishnu Bayanagari, Stephanie Haddad, and Maharshi Raval.

Committee members have aired 6 episodes on ACPRuleOutPod (Spotify) so far with more yet to be finalized. Topics discussed included medical and professional issues such as balancing and managing acid-base disorders in patients to finding the balance between transitioning from med student, resident, and fellow to attending life. The hosts Raad Muhaisen, Harrison Bai & Alay Nanavati have done a phenomenal job. As with every July, they will be transitioning to new roles, but we will continue to record these sessions with our new team: Heena Kaushal Asnani, Lana Abusubaih, and Adam

Basic knowledge about finance is important so even amid our busy schedules, the committee held a Zoom meeting on Apil 4 about "ABCs of Financial Wellbeing". There was a good discussion with finance experts (Rob Suprenant, senior VP and Mark Boccuzzi, President) from Toll Gate Capital, a financial firm based in Warwick. Valuable lessons in personal investing were learnt and the plan is to have another session this year as we welcome new members to our committee.

Finally , the current council members including me will be transitioning to new roles, handing over to the new group of leaders who will carry on the baton for ACP RI chapter. Our new council members: Mery Deeb, Olive Ochuba, Freya Shah, Warda Hameed, Charmi Trivedi, Qusai Masad, Paola Pena

Pictures from the Annual Meeting and Leadership Day

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Keynote address by Dr. Thomas Lee

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Jacob Zinn, MD(Third year medical resident): Winner of Podium presentations

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Delegation's picture with Senator Jack Reed

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Delegation's picture with Representative Gabe Amo

Council Meeting

The Governor's Council voted to have in-person meetings in the Summer and to continue using the Zoom format for three other virtual meetings. Next Governor's Council meeting will be an in-person meeting. This will be held on June 27th at Kent Hospital.

The planning committee meeting for 2025 Annual scientific meeting will be held on June 13th at Miriam Hospital. We will review your input about this year's meeting and select topics and speakers for the March 2025 meeting.

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Mentorship Zone

What are we learning? Who are we learning from? Who are we transferring insights to?

Iron sharpens iron, so one person sharpens another.

The one who waters will also be watered.

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I reached out to some of our experienced colleagues to have them share pertinent insights which will be beneficial to our medical students, residents, and Early Career Physicians.

In this newsletter, we get to learn from Jenn Jeremiah, the recipient of a 2025 National ACP Faith T. Fitzgerald Award for Outstanding Educator of Residents and Fellows.

Brief background:

Hello, I am Jennifer Jeremiah and have had the privilege of being both a clinician and an educator for the last 32 years. I believe I have the best job. I care for patients who I have known through long periods of their lives. I have been honored to take care of multiple generations of families and support patients through challenging illnesses and successful lifestyle changes. I have seen my patients' joy and witnessed their resilience. I have also had the chance to impact future physicians through my work as an educator. I am an Associate Program Director in the Internal Medicine Residency Program at Brown, a Professor Medicine and have advised and mentored countless students and residents. To watch a student or newly minted intern grow to independent doctor and then an attending whom I admire and often consult is a true joy. To know I have played even a small part in this transformation makes all that I do worthwhile.

I chose internal medicine because I love to answer the question why and I love having the opportunity to have long term relationships with my patients. General Internal Medicine, which I practice, is a thinking specialty. We have few instruments. We must always question why to make the accurate diagnosis and provide the best treatment possible. It is also a specialty where we care for patients for many years. When a patient trusts you, seeks your input, and collaborates with you on their care, you know you are making a difference.

General Internal Medicine is also a specialty that requires great collaboration. I have been privileged to work with colleagues who have become friends. They have helped with diagnosis, offered advice on handling challenges with patients, and supported me as a person. They have kept me going despite the frustrations we all feel with health care these days and they, along with my patients, make it all worth it.

Working with learners has also been a huge impetus to keep going in the midst of the challenges we are facing in the medical system. There is great excitement in watching them build their medical knowledge, develop strong clinical reasoning skills and advance their communication abilities. Learners also cause you to constantly learn. They ask questions and you need to have the answers. I often hear myself say, "you never learn more than when you have to teach."

It's been a road of ups and downs, but mostly ups, and one that I have been fortunate to travel on. It's still the best job I could imagine.

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From National ACP

Actions Taken on BOG Resolutions, April 20, 2024, by Board of Regents.

Thank you all for your input about the Board of Governors’ Resolutions which were discussed at our last Governor’s Council meeting in March.

Below are the actions taken on some of the major resolutions:

Adopted as a Reaffirmation:

1. Developing Educational Resources to Train Physicians about the Evolving Threats of Climate Change on Human Health
2. Advocating for Continued Coverage of Colon Cancer Screening
3. Acknowledging the Individual Right to Decisional Privacy
4. Reducing the Risk of Medical Workplace Violence

Adopted and referred for implementation:

Advocating for Vaccination Incentives

RESOLVED, that the Board of Regents will partner with other medical specialty organizations to advocate for insurance companies including Medicare and Medicaid, to reduce their premiums or offer some other financial incentive to those members who are vaccinated according to Advisory Committee on Immunization Practices (ACIP) recommendations.

Adopted with BOR Amendments for Implementation:

Updating ACP Policy to Support Physicians Pursuing Collective Empowerment

RESOLVED, that the Board of Regents update policy to:

a) Support of the right of physicians to engage in collective empowerment through a variety of modalities.
b) Advocate for the expansion of the numbers of physicians eligible for this right.
c) Provide comprehensive guidance on physicians’ regulatory and ethical obligations in balancing direct patient care and advocacy within health systems during any collective bargaining process; and be it further RESOLVED, that the Board of Regents bring a resolution to the American Medical Association (AMA) seeking study of opportunities for the AMA and other physician associations to support the above.

Adoption/Implementation with Amendments:

Improving the Experience of International Medical Students (IMS) and International Medical Graduates (IMG) Seeking Clinical Observerships and Letters of Recommendation in the United States of America and Canada.

(RRC Referral Recommendation: Education Committee with input from Diversity, Equity, and Inclusion Committee).

RESOLVED, that the Board of Regents further studies the problem and works with the Accreditation Council for Graduate Medical Education (ACGME), Alliance for Academic Internal Medicine (AAIM), Association for Program Directors in Internal Medicine (APDIM), Education Commission for Foreign Medical Graduates (ECFMG), and other partners to develop a transparent, ethical, and fair system to enhance IMS and IMG medical training and incorporation into the U.S. healthcare workforce.

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