SAFE Opioid Prescribing: Strategies. Assessment. Fundamentals. Education
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The mission of the Texas Chapter of the American College of Physicians is to promote quality health care for all Texans by strengthening the practice of internal medicine.
Roger Khetan, MD, FACP, FHM
As I take over this year as president of our chapter of the ACP, I want to highlight some of the fascinating steps your board has accomplished in the last few years and will close with my thoughts on the high standards of our profession.
My first focus is on our newly developed TXCAP Foundation. The foundation is a mechanism for our members and the community to donate money to programs that are focused on the continued development of Internal Medicine with a major focus on getting donations to help programs such as GIMSPP – the statewide preceptorship program managed by our chapter and responsible for matching medical students with ACP members in rural, suburban and urban practice sites during the summer between the first and second year of medical school. It is one of the ACP’s first state foundations and up to us as members to make it successful. The foundation depends on donations as it is in its infancy with its board actively seeking donations from corporate and individual donors just like us. I hope that all of us will donate a little money (no matter what amount) to help our profession stay strong for the future.
The second step is the Council of Early Career Physicians. This council has become a very active group of physicians with a focus on the details that affect us early in our careers – time management between family and career – including concerns such as advancement from just being a doctor to a leader in their medical group or in hospital administration to discussions of how to incorporate healthy lifestyles into our own busy lives. Some key issues raised have been discussions on how to maintain financial health while starting a practice, starting families, buying homes and maintaining retirement and savings as many of these issues are not discussed while trying to pass boards, gross anatomy and preparing for teaching rounds.
The third step is the creation of the Hospitalist Committee. As the ACP, we represent the solo physician to the employed physician in a multispecialty group practice as well as our inpatient hospital colleagues to our subspecialists in internal medicine. Our hospitalist colleagues have brought an enlightened pathway in the care of our patients in the hospital. In it's infancy, the council has recruited several members to reflect the concerns in hospital medicine and to highlight the details of life as a hospitalist with its unique demands of maintaining a physician – patient relationship based on a very short interaction and how to make that interaction a very positive experience not only for the patient, but for the hospitalist’s other customers – that includes the outpatient colleague, the hospital administrators. At the same time, they are challenged with quality metrics focused on core measures, patient satisfaction, and administrative metrics of LOS and meaningful use. Hospital medicine as an internist is a unique situation with its own joys and difficulties, and the council is a venue for our Texas members who may benefit from an organization focused on practicing ideal Internal Medicine.
Fourth, advocacy is a large part of our organization and as some of you are aware and some of you may not be, TXACP has a strong arm in advocacy with the TXACP Services representing the efforts of all of us with key focus on loan repayment forgiveness, increasing the physician workforce by maintaining or increasing GME slots for not just medical students but residency slots, and being at the table to speak at a state and national level on payment reform for physicians. Our advocacy is only as strong as we are in our commitment to our patients.
As I close my first letter to all of you, I want to remind you of something that a dear mentor of mine taught me in Houston in my early years of training. We are physicians because we made the choice to be doctors. It is a profession dedicated to caring for others and it is not just a job – it is an honor to have the right to take care of our fellow human beings in the best of health to the most frightening periods of the lives. No matter if you practice in a concierge model, solo practice, employed practice, or academic practice, WE must remember that this is not just a job, but it is honor to serve as a physician. WE are responsible for maintaining the honor, the dignity and the integrity of being a physician. WE must lead by example and keep our experienced and new physicians engaged and enjoying medicine. We are the only ones who can make a change and as physicians we are the only profession who has the strictest requirements and most education to get us to the point we are. So, the next time you are asked to attend a meeting, remember if you are not at the table to make the change another organization or profession will make the changes affecting patient care and the only profession that knows the most about patients is the physician above all else. Keep up the hard work and thank you for your care for all of our patients.
Jose A. Perez, Jr., MD, FACP
It’s been a great honor for me to serve as your President this year. As I return from the TXACP state meeting I am once again struck by the quality of the organization that I have been and continue to be, proud to be a part of. This year, our state meeting returned us to the humanism of medicine, in my opinion, a giant step. After all, what we do is all about the patient. Hearing some of the speakers describe their joys and also their challenges in caring for patients and loved ones was truly inspiring. The introduction of a musical performance by a renowned pianist and psychiatrist capped a truly nice first conference day. TXACP has many things to be proud of. It’s advocacy at the state level and its strong support for the future of Internal Medicine through the General Internal Medicine Statewide Preceptorship Program (GIMSPP) are just a couple of these.
TXACP only works however, through your participation at various events including the state meeting every year. You can also participate in many other ways and I encourage you to do so. Recommending candidates for awards, serving as a preceptor for a young medical student and contributing to the TXACP Foundation for the GIMSPP program are just a few of these. TXACP is also active in helping to improve medical practice for physicians. The organization has been active at the state level and through the prominence of the chapter at the national level, through our ACP Governors, has helped raise concerns and helped guide discussion.
Thanks to the membership, TXACP works. I encourage you to be active and also to connect with your representatives on the TXACP Board so that we can better serve you. Thank you for a great year.
Jose A. Perez
Robert E. Jackson, MD, FACP
Governor, TX Southern Region
The American College of Physicians at 100 Years
The ACP is turning 100 years in 2015 and all I can say is…"you’ve come a long way, baby!" The College was founded by Heinrich Stern after a 1913 visit to the Royal College of Physicians in London. Dr. Stern felt that American internists needed an organization similar to the Royal College to allow colleagues to come together with…"the purpose of facilitating scientific intercourse among physicians." On January 8, 1915 The American Congress of Internal Medicine was founded
The American College of Physicians was actually founded two years prior to the founding of the American College of Surgeons. Right from the beginning the dichotomy of being a College and a Congress existed. Dr. Stern’s organization was originally called the American CONGRESS of Internal Medicine. When he died suddenly and unexpectedly in 1918 Dr. Stern left to the future leaders to sort out the distinction between ACPs mission as a Congress vs a College. I am not sure we are there yet!
The Annals was founded in 1927 and has become one of the premiere journals of medicine in the world. The American Board of Internal Medicine (ABIM) was founded with ACP support in 1936. The College has always focused on scholarly activities and continues to pursue excellence in clinical care. In 1967 the first edition of MKSAP was published and now is on its 16th iteration. Keeping up with technology, the College has published an on-line version that may be purchased. There are are numerous resources at the members fingertips…Smart Medicine, Journal Club, Guidelines, Videos, and many other features to assist our members.
Over time the College has grown from its original 152 members in 1917 to 17,000 in 1970. By 2013 the ranks in the College had soared to over 130,000 members, a feat that would surprise even Dr. Stern! ACP is the second largest organization of physicians in the United States and the largest group of specialty physicians in the world.
In order to be effective in Washington DC, the College has a small “army” of effective lobbyists and analysts. The American College of Physicians Services (a “PAC” or political action committee) was established in 2004. Over the years, Leadership Day has gathered internists from all over the United States to descend on Washington to advocate for our patients and internal medicine. The College has always taken the “high” road when it comes to advocacy and for this reason we are the most well respected group of physicians in our nation’s capital.
So what is in store for the next 100 years? Well, that’s up to you! The College Leadership and its members should begin to plan and plot the ACP’s course. Without effective planning and stewardship the College will be ineffective in adapting to change. This planning begins in the medical schools, evolves in training programs and matures with the seasoned physician. Members of the American College of Physicians are the future! I will close with a favorite quote from Confucius:
IF YOU PLAN FOR A YEAR, PLANT RICE
IF YOU PLAN FOR 10 YEARS, PLANT TREES
IF YOU PLAN FOR 100 YEARS, TRAIN MEN
George Crawford, MD, MACP
TXACP Governor-Elect, Southern Region
Dr. Crawford Wins Governor-Elect Race
George Crawford, MD, MACP, San Antonio, was elected governor-elect for the Texas Southern Region through a member vote. He will officially take on the role in April at the ACP IM2014 meeting in Orlando, Florida.
Dr. Crawford is Program Director, Internal Medicine for University of Texas Health Science Center San Antonio.
Born in Tucson, Arizona, Dr. Crawford attended the University of Notre Dame and received his medical degree in 1972 from Northwestern University. Dr. Crawford completed his medicine residency at Massachusetts General Hospital and infectious diseases fellowship at the University of Washington. Dr. Crawford retired as Colonel in 1997 after serving 23 years in the U.S Air Force. He later earned his Geriatrics CAQ in 2004.
Dr. Crawford has been a member of the ACP for more than three decades, earning his Fellowship in 1983, Laureate from the Air Force Region in 1998 and Laureate from the Texas Chapter in 2011. Dr. Crawford was awarded Mastership in the college in 2011.
Active in the Air Force Region of the ACP through 1992, Dr. Crawford became involved in the Texas Chapter and Residents activities, serving as a judge for the poster competition as well as serving as Moderator for the annual Doctor’s Dilemma competition and as a member of the Residents (Associates committee).
In his vision statement, Dr. Crawford shared the following:
“Internal Medicine faces several challenges. At a time of unprecedented advances in the science of medicine, we are challenged to improve quality of care while restraining cost. Reimbursement policies and administrative burdens have conspired to create a looming shortage of primary care physicians, especially general internists.
The ongoing implementation of health care reform offers challenges and opportunities. The aging of the population and broadening of health care coverage will create demand for more primary care providers. I will support medical student and residency programs to attract the best to our specialty and programs for their development in residency and beyond. The ACP High Value Care Initiative will be crucial to improving the quality of care and outcomes, while limiting waste in our system. Health care policy decisions must be informed by our members and organization. As Governor, I will promote programs that support our specialty and our patients.”
Dr. Crawford will serve as governor-elect for one year, working closely with Governor, Robert Jackson, MD, FACP, Houston, during the final year of his four-year term. Dr. Crawford will assume the role of Governor in April 2015.
Physicians from around the state and from varied practice settings were elected to represent the membership as volunteer leaders on the TXACP and TXACP Services board of directors during the annual awards and business meeting luncehon in San Antonio.
Directors serve a three-year term. The secretary-treasurer serves a two-year term. The president-elect advances to president in November 2014.
Roger Khetan, MD, FACP, FHM
Alejandro Moreno, MD, MPH, JD, FACP, FCLM
Julie Nguyen, MD, MBA, FACP
New Regional Directors:
Steven Ray Hays, MD, FACP, Dallas - NE Director
Emran Rouf, MD, FACP, Belton - NW Director
Ruth Falik, MD, FACP, Houston - SE Director
Amy LaViolette, MD, FACP, Austin - SW Director
S. Claudia Didia, MD, FACP, El Paso- Far NW Director
Sabina Lee, MD, FACP, Houston- At-large Director
Eleven distinguished members were honored with the Texas Chapter highest awards during the November 2013 Annual Chapter Scientific Meeting in San Antonio.
The Laureate Award honors those Fellows and Masters of the College who have demonstrated a life of commitment to excellence in medical care, education, or research and in service to their community, the Chapter, and the ACP. Drs. Philip Bentlif, MD, FACP, Houston; Stephen Greenberg, MD, MACP, Houston; Antonio Gotto, Jr., MD, DPHIL, FACP, Houston; and Kenneth Shine, MD, MACP, Austin were the 2013 Texas Chapter Laureate awardees.
The Volunteerism and Community Service Award honors Texas Chapter members who have demonstrated an abiding commitment to excellence in medical care, education, research, and dedicated service to their community, the Chapter, and the ACP. James Wagner, MD, MSc, FACP, Dallas was honored with the Chapter Volunteerism and Community Service Award.
Pete Yunyongying, MD, FACP, Dallas, TXACP’s recipient of the Young Physician Leader of the Year Award. He is an active ACP member that demonstrates leadership in community services that has been in practice for at least ten years. The Young Physician Leader of the Year Award is the most prestigious recognition of achievement for young physicians.
The General Internal Medicine Statewide Preceptorship Program Decade of Service Award honors highly active and dedicated preceptors who have taught medical students in their practices for the past ten years.
It is with genuine pleasure that this year, the Texas Chapter presents the GIMSPP Decade of Service Award to GIMSPP Decade of Service Award to:
Gopinath C. Chandrahasan, MD, San Antonio
Carmelita P. Escalante, MD, FACP, Houston
Carlos R. Herrera, MD, Houston
Wenli Liu, MD, MD, FACP, Houston
Paraic J. Mulgrew, MD, FACP, San Antonio
The Awards committee welcomes and accepts nominations from the membership year round. Nominations from the chapter should include a detailed letter of recommendations and curriculum vitae (CV). Additional letters of support are welcome and may strengthen the nomination.
Send nominations, CVs, and letters of support to: Texas Chapter of the American College of Physicians, Awards and Recognitions Committee, 401 W. 15th St., Austin, Texas 78701 or email.
The Resident clinical vignette competition featured six residents who were selected in their regional competitions to compete at the statewide meeting. Outstanding presentations were made by Prem Subramaniyam, MD, TTUHSC-Odessa; Gautam Ranjan Patankar, MD, Baylor University Medical Center; Hye Yeon Jhun, MD, The Methodist Hospital; Vanessa Gray, MD, S&W/TAMU; Mohammed Saadi, MD, Texas Tech University HSC – Paul L Foster SOM; and Mildred Opondo, MD, Texas Health Presbyterian Hospital Dallas.
Gautam Ranjan Patankar won first place in the competition with his vignette, “Erythropoietic Protoporphyria Causing Liver Failure”. Gautam will automatically advance to Orlando to compete at the national level during the ACP Annual Session in April.
In a dramatic conclusion to the annual Doctor’s Dilemma, the team from SAUSHEC Internal Medicine, San Antonio emerged as champions. Congratulations to SAUSHEC Internal Medicine team members David Lindholm, MD, Paul Hiles, MD, and David Anderson, MD. The team will represent the Texas Chapter in the Doctor’s Dilemma competition at the ACP Annual Session in Orlando this April.
Congratulations to the UT Southwestern at Seton family of hospitals Austin team that took second place. This competition would not have been possible without the help of Dr. George Crawford, MD, MACP, San Antonio and Dr. Suma Pokala, FACP, Temple for organizing this event. A special thank you to Drs. Amy LaViolette, MD, FACP, and Laura De Moya, MD for their assistance with the competition.
Of the 122 abstracts that were submitted for the competition, 16 residents participated in the Poster Competition. The submissions came from seven residency programs.
Thanks to the work of dedicated TXACP volunteers who reviewed the abstracts and served as onsite judges. The competition would not be possible without your help. The following winners were announced during Saturday evening’s reception:
Oral Clinical Vignette:
1st Place: Erica Fidone, TAMHSC
Erica will automatically advance to the National Competition to present as a poster in April, 2014.
Clinical Poster Winners:
1st Place: Neelima Navuluri, University of Texas Health Science Center San Antonio
2nd place: Tasneam Shagroni, BCh, from University of Texas Medical Branch
Clinical Poster Winners:
1st place: Bhavika Kaul, MD from Baylor College of Medicine, Houston
2nd place: Shira Sachs, MD from Baylor College of Medicine, Houston
Clinical Research Poster Winners:
1st place: Heather Wainstein, MD from Texas Health Presbyterian Hospital
2nd place: Charles Calais, MD from SAUSHEC
Susan Lampley, Paul L. Foster School of Medicine, El Paso, Texas
As winner of the 2013 On Being a Doctor essay competition, Ms. Lampley presented her essay during the Texas Chapter Annual Meeting.
The little girl watched, fascinated by the quick and rhythmic strokes of her mother’s hands across the colorful quilt. This would be the last one she had promised. Susha hoped that meant they could go home! Her mother didn’t get up anymore; she looked thinner and less like her Mama all the time. She sighed heavily, confused, hadn’t they been at the hospital long enough to be better?
A voice in the hall, “What a shame, a mother should live for her children…” Then interrupting harsh, stern, “Shhhh enough!”
Martha’s hands paused momentarily; echoing her daughter’s sigh, “They can’t understand; this is the will of God. The cancer was meant to test my faith, I must fight the good fight, finish the race…”
Susha had been excited to go to the big city, but it was so strange here. No one talked or dressed like they did. “Mama why did you tell Doctor Jones we are Mennonites?” she asked. Martha smiled, “Climb up Susha. This one is for you, do you like it?” Susha stared at the fabric, seeing pieces of her old clothes, her sisters’ too, but mostly her mother’s. The dark brown, she wore that one to church, the shiny black which had been her wedding dress, the flowery ones, the everyday dresses, her favorite dresses. “I don’t know,” she said. It made her sad. Her mother never wore pretty dresses anymore, just a white one that didn’t look like the others; it didn’t even have buttons on it! She hated that one, she was glad Mama hadn’t put any of those pieces in there. She didn’t think Mama liked the white dress either. She said it made her feel cold and naked, but the nurses said she had to wear it.
Martha hugged her tightly, “Susha sometimes God gives us tests that can be hard to understand, but they won’t last forever. This life is not as important as the next. The better we do here, the more we suffer, the more we fight to keep strong, we will have greater rewards in Heaven. Do you understand? We are Mennonites because we believe this, so we live in this world but we are not of it.”
Susha nodded, “Doctor Jones said we have to fight.” He had been very angry. “We can fight this,” he had said, “We have an excellent chance!” Her mother had been quiet for a long time, before she replied, “But at what cost? Life’s measure is not made with a universal ruler.” Doctor Jones had stared at her, his anger blatant, undisguised. His voice had been very loud, “Don’t you want to live? Don’t you want to see your little girl grow up?” Her mother had sounded very stern, “I live for God. And you are wrong; I will see my little girl grow up, only from a different view.”
Martha pulled Susha closer, she spoke lovingly, “Not all of us fight the same way Susha, some day you will understand that. But right now I want you to know you are my special little girl ok?”
Not long after Susha’s father came in, and he put his head in her mother’s lap. He was crying, “Why didn't we try? I can't do this alone!" Her mother spoke softly, “John, they would have me cut off what I've been given, everything that makes me feminine. Should I then live as only half of myself? No I will remain whole, both here and after; I will accept what I have been given. You know this is the way. The doctors know only what they've been taught. We know a different way. They will be good children; they'll remember what I taught them. All life is a test of our faith, be strong now, God will take care of you. And them. We will see each other soon, it won't be so long." He didn't say anything after that, but he didn't cry anymore.
Her father went to talk to the doctor. “She doesn’t have much time,” Doctor Jones said sadly, “I still don’t understand her decision. In her place I would want to choose life.” John smiled proudly, “She did choose life. Jesus said, whoever finds his life will lose it, and whoever loses his life for my sake will find it.” Doctor Jones waited a long time to respond, then as if coming to some conclusion he said, “I realize I am not in her place, the decision is hers to make. I will do what I can to keep her comfortable.”
After that everything changed. Susha saw them put her Mama in a box, and they dressed her all in white. But this time the gown covered her whole body. She knew Mama would like that. She asked her father, “Why does Mama have to wear a white gown again?” He explained patiently, “This gown is different, this is our way; we must bury her in accordance with our traditions.”
The young woman in the rocking chair pulled the colorful quilt tighter as she held her baby close. The colorful squares of fabric flooded her with memories of those days in the hospital so long ago. “You are my special little girl,” she whispered as she remembered her mother’s words, so many words, which had for so long been indiscernible. She had struggled for many years to understand why her mother left her. Her hands moved automatically to that final slip of fabric, the last piece her mother had given her, a large square section, from that button less white gown she had hated so much. She remembered the day that she had found her peace, when she can finally understood, how carefully she had stitched the four by four flimsy piece of fabric into her beloved quilt. She knew she had picked the right place for it. It was the centerpiece of her quilt, the strongest piece.
Amy LaViolette, MD, MPH, FACP
Southern Co-Chair Texas ACP CECP
At the recent Texas ACP meeting, the Council of Early Career Physicians was excited to welcome its first outside speaker, Douglas Monroe, MD, MBA. Dr. Monroe currently serves as the System Director for Quality and Patient Safety at Memorial Hermann Health System where his work focuses on strategic prioritization and goals, physician and executive engagement, and oversight of the quality programs.
As with the Council of Early Career Physician’s presentations in year’s past, the emphasis of this talk was designed to be helpful to physicians in any stage of their career but with a particular emphasis on subject matter that is key for young physicians, in this case Quality. Dr. Monroe spoke about Quality and High Reliability Organizations while using multiple examples from his own hospital system. He described certain adverse events in the hospital as “never events”, such as transfusion reactions, and explored why medicine finds “never events” acceptable while other industries (commercial aviation, nuclear submarines, etc.) do not. The concept of Safety as a Core Value was introduced as were some of the ways that a Safety Culture could be created and the great financial cost and commitment that this culture comes at. He also discussed the specific strategies that the Memorial Hermann Health System had implemented in order to decrease "never events," many which were thought of and led by physicians and staff, and in several cases how they were able to eliminate these events completely.
At the forefront of all of this was the necessity for physicians to be involved in this change for the health of our patients. We are all a part of the healthcare team and an invaluable part when it comes to the culture of safety. If we do not become more involved in improving the quality of the care of our patients then we will be left behind as the culture of medicine in general shifts to a more safety driven one.
Dr. Monroe’s talk was excellent and opened the attendees’ eyes to ways that they could enact change to create a safer environment for their patients and eliminate “never events." We felt that this was a quality start to our annual presentations being led by outside presenters and look forward to another excellent presenter next year who teaches us as much as Dr. Monroe did this year. Stay tuned for future CECP events…
We’d love to continue the picking topics that can help young physicians grow in their professional development, so if you have any ideas for topics you wish to see presented, please contact the TXACP chapter office at TXACP@texmed.org or by phone at (512) 370-1508.
The Texas ACP Council of Early Career Physicians was excited to host its first Austin event at the Blanton Museum (http://www.blantonmuseum.org/) this past September. The group had a specially led tour by Ray Williams, their Director of Education and Academic Affairs where we observed various pieces of art in different mediums and used that observation to explore the role of observation in our medical life. One of the pieces that we looked at was a painting of Lee Harvey Oswald’s assassination and how the artist’s interpretation of the event compared to a photo of the same event. This led to an interesting discussion of perspective and its role in observation. This was an exciting first event in Austin and we hope coordinate some other events soon, so stay tuned!
If you have any questions about this event or any future events of the Texas ACP Council of Early Career Physicians please call the TXACP chapter office at (512) 370-1508 or email TXACP@texmed.org.
Maria V. Gove, MD, FACP
Northern Co-Chair Texas ACP CECP
In March 2014, the CECP in Dallas will host a financial seminar series for early career physicians. This will be offered at no cost to attendees by Mark Vahala, CLU and Carlos Salazar. They will talk to early career physicians about the best financial strategies to use after residency. The main topics they will address are how to approach paying off student loans, approach to retirement savings and investing and how to start a practice including how to obtain a business/practice loan. This will be very informal with ample opportunity for discussion and questions. The Dallas CECP hopes to have a series of 3-4 of these informal seminars over the next year to discuss a variety of financial topics important to early career physicians. More about Mark and Carlos are below:
Mark is a Registered Investment Advisor with Eagle Strategies. He began his financial services career with New York Life in 1994 and holds group 1, series 6, 7, 63 and 65 licenses. He is licensed in over 15 states and is well versed in estate accumulation and conservation strategies. His practice includes investments, retirement planning, life, disability, medical and long term care insurance. After graduating Notre Dame with an accounting degree in 1981, Mark began his public accounting career with what is now Ernst & Young. He worked in Executive management roles with various firms in private industry after leaving public accounting in 1985. One of his leveraged buyouts involved in the manufacturing of equipment for the oil and gas industry grew from $2m in sales to $45m in annual sales before he sold in 2010. He is also a majority shareholder in a holding company with interests in 6 restaurants. Outside interests include his 3 sons, travel, golf and community service.
Carlos Salazar is a Commercial Lender and Vice President at BB&T Bank in Dallas. Carlos has 30 years of banking experience which includes financial analysis, real estate underwriting, international, and domestic lending to small and medium sized businesses. Carlos earned his bachelor’s degree from the University of Notre Dame and MBA from the University of Dallas. The Dallas native serves on the leadership board for the Notre Dame Club of Dallas. He also is a former board member of Senior Citizens of Dallas, former member of the Advisory Board for the Salvation Army and past president of the Dallas-Fort Worth Chapter of the Hispanic Bankers Association.
By Dr. Young
For Pete’s sake...I’m having a lot of trouble keeping my tongue bitten around one of my colleagues at the hospital. They’re not really that much older/experienced than me, but they’ve worked their way up the ladder off of the backs of others. I’m tired of being the under-appreciated one and feeling used all the time when I work hard.
- Frustrated in Ft. Worth
There’s unfortunately not really a good answer to this question. The biggest things that you need to cope with at this point are the feelings that you’re having and how you express these to others. When someone is climbing the ladder quickly, making an enemy of them is probably not the best of ideas. If you need to get some of this off of your chest consider having a frank conversation with them (not always the best course) or just continue to keep your mouth shut. Do NOT under any circumstances email your feelings about this person to others or talk about these feelings in groups of people. Discretion is an important trait if you don’t want to be known as a complainer.
In order to avoid feeling like a doormat all the time, it is important that you set limits as far as what you will and will not do and stick to these boundaries. Don’t feel guilty about setting them or about saying no when something seems inappropriate or is outside of the limits you have set. There’s a fine line here, because you still need to be a team player, but you don’t need to be carrying the team on your shoulders all the time.
If you have a hard time saying no (some of us have this problem) try to strategize about what your response will be before you’re asked to do something. If you have trouble saying no in person for example, have a stock phrase, such as “I’m a little over-extended at the moment, let me have a look at my commitments and email you back by the end of the day” and then email back your no or what boundaries you have with this particular request.
Try to have confidence that in the end you will be recognized for the work you’re doing and that eventually other people will recognize what your colleague is up to and won’t let him/her continue to get away with it.
If you have questions for the next “For Pete’s Sake…” please email them to Becca Lawson at the TXACP Business office at firstname.lastname@example.org.
The annual meeting would not be possible without the help of the companies that continue to support our organization. The Texas Chapter of the ACP would like to thank the Texas Health Resources for their generous educational grant at this year’s meeting. The following companies provided financial support as well for the meeting. Our chapter is extremely grateful for all of their assistance and for every company that contributed to this year’s meetings success!
2013 Platinum Level Grantor
Silver Level Support
All Star X-ray, Inc
American College of Physicians
Baylor Healthcare Systems
DSHS-- Perinatal Hepatitus B Prevention Program
DSHS - TB/HIV/STD/Viral Hepatitis Prevention & Care Branch
Genzyme Rare Disease
Houston Methodist Hospital
Merc and Co. Inc
Novo Nordisk Inc.
Olympus American Inc
Prometheus Laboratories Inc
Promius Pharma LLC
Sanofi Pasteur, Inc
Teva Respiratory LLC
Texas Medical Liability Trust
TX/OKAIDS Education & Training Center
United States Air Force Health Professions
US Navy Recruiting District San Antonio
Register Today: 2014 Reclaiming the Joy and Building the Value of Your Practice
You can learn how to make quality work for your practice and your patients and transform care for diabetics and others with multiple comorbid conditions by attending a conference sponsored by the American College of Physicians (ACP) Texas Chapter next month in San Antonio. "Reclaiming the Joy and Building the Value of Your Practice: Tools from the Medical Home and Neighborhood to Help with Your Chronically Ill and Diabetic Patients" will take place Jan. 24-25 at the Omni La Mansion del Rio.
The conference, supported by the TMHI and TXACP and endorsed by the TMA TAFP, utilizes tools from the patient-centered medical home and neighborhood with a focus on care for diabetic and chronically ill patients. Quality experts will offer practical advice to help you improve quality of care; promote patient, physician, and staff satisfaction; and reduce costs.
The ACP's Practice Advisor will be used a guide for the conference. The program, as well as the Practice Advisor, are free. A series of webinars after the meeting will reinforce the principles covered.
You can earn continuing medical education credit by participating. The program is free but space is limited, and you must register by Jan. 4. To register online, go to www.surveymonkey.com/s/ACP-TX-PCMH-Diabetes.
This event is open to anyone involved with the treatment, management or administration of patients with chronic diseases.
Hotel and Host Site
Omni La Mansion del Rio
112 College Street
San Antonio, Texas 78205
Call the Hotel at 210-518-1000 to make your reservations or book online now
Use Group Code 17900104080 (American College of Physicians) when making reservations online and by phone
Please contact ACPQI@acponline.org or the Texas Chapter office at 512-370-1508 for more information.
Fellowship recognizes personal integrity, superior competence in internal medicine, professional accomplishment, and demonstrated scholarship.
Susan A. Abookire, MD, FACP, Houston
Gabriel M. Aisenberg, MD, FACP, Houston
Tanvir K. Bell, MD, FACP, Houston
Aaron Patrick Best, MD, FACP, Austin
Jennifer M. Bontreger, DO, FACP, Flower Mound
Patrick S. Chaftari, MD, FACP, Bellaire
Roxana L. Cruz, MD, FACP, Greenville
Matthew Dacso, MD, FACP, Galveston
Antonia M. Davidson, MD, FACP, Austin
Vipul Desai, MD, FACP, Lubbock
S. Claudia Didia, MD, FACP, El Paso
Betsy A. George, MD, FACP, Grand Prairie
Ethan A. Halm, MD, FACP, Dallas
Bonnie P. Hannah, MD, FACP, San Antonio
Gregory R. Johnson, MD, FACP, Houston
Alfred S. Lea, MD, FACP, Pearland
Fernando Lopez, MD, FACP, San Antonio
Manuel D. Lopez Leyva, MD, FACP, El Paso
David A. Mayorga, MD, FACP, Mission
Yomna T. Monla, MD, FACP, Houston
Achilia S. Morrow, MD, FACP, Houston
Anuradha L. Mundluru, MD, FACP, Mesquite
Ramamanohara Pai, MD, FACP, Katy
Trela Parker, MD, FACP, Humble
Naveen Pemmaraju, MD, FACP, Houston
Katherine M. Pickett, MD, FACP, Houston
Mateo Porres-Aguilar, MD, FACP, El Paso
Stephen L. Richey, MD, FACP, Fort Worth
Neeraj R. Sharma, MD, FACP, Allen
Abeezar T. Shipchandler, MD, FACP, Plano
Matthew T. Smith, MD, FACP, Lewisville
Christopher D. Spradley, MD, FACP, Temple
Eric M. Steen, MD, FACP, Fort Worth
Julia B. Symon, MD, FACP, San Marcos
Jean Tayar, MD, FACP, Manvel
Robert A. Totoe, MD, FACP, Abilene
Nouansy K. Wilton, MD, FACP, San Antonio
Laila E. Woc-Colburn, MD, FACP, Houston
We are proud to welcome the following new members who have joined the Chapter during the last four months.
Sanjay K. Aggarwal, MD, Lake Jackson
Dionicio M. Alvarez, MD, El Paso
Gabriela E. Brzankalski, MD, San Antonio
Elizabeth H. Dilg, MD, Irving
Chukwuma I. Egwim, MD, Houston
Darshan G. Gandhi, MD, Cedar Hill
Juan L. Garza, MD, Houston
Monica M. Gomez, Austin
Joseph A. Hill, MD,PhD, Dallas
Stephanie Hiraki, DO, Fort Worth
Katie L. Johnson, DO, Dallas
George M. Khalil, MD, Dallas
Sayantani C. Lahiri, MD, Plano
Ya Li, MD,PhD, Cypress
Robin L. McKelvey, MD, Fort Worth
Nicolas A. Melgarejo, MD, San Antonio
Merin G. Muthalathu, MD, Dallas
Trung H. Nguyen, MD, Longview
Steven K. Norris, MD, Amarillo
Kolawole A. Odulaja, MBBS, San Antonio
Oscar A. Paniagua, MD, Tyler
Beatriz A. Parra, MD, Fort Worth
Kara Prescott, MD, Dallas
Ruben Ramirez, MD, Arlington
Shamima Sattar, MD, Lubbock
Jessica M. Schaefer, DO, Boerne
Sudha T. Somasundaravelayudham, MD, San Antonio
George E. Taffet, MD, Houston
Leticia I. Tiscareno-Grajeda, MD, El Paso
Netanya S. Utay, MD, Galveston
Maria Raquel Weaver, MD, Frisco
James A. Young, MD, Kerrville
In an announcement by the ACP, two chapter members have been named awardee and new Masters of the college.
Please join us in congratulating 2013 Texas Chapter Laureate, Antonio M. Gotto Jr., MD, DPHIL, FACP on being named the recipient of the John Phillips Memorial Award for Outstanding Work in Clinical Medicine by the ACP. Dr. Gotto has also been named a Master of the College.
Congratulations to former Governor, Texas Northern, Clark R. Gregg, MD, FACP on being named a Master of the College.
Drs. Gotto and Gregg will be presented their awards at IM2014 in Orlando, Florida as part of the convocation ceremony.
To personally congratulate our Texas Chapter awardee and new Masters, please contact Meghann Williams, Administrator, Awards Program by email at email@example.com, or 800-523-1546 ext.2714
Texas Chapter of the ACP member Jeana Benwill, MD, has joined the faculty of UT Health Northeast.
Send news of your accomplishments, or that of a colleague, to: Becca Lawson, TXACP Staff, 401 W. 15th St., Austin, TX 78701; fax to (512) 370-1635; or e-mail.
Texas Chapter Annual Scientific Meeting
November 17-18, 2018, JW Marriott Austin
Book Your Hotel Now!