NC,ACP Council Friday, October 23, 2015 / 7:30am

Beaumont Room / Grandover Resort / Greensboro, NC

A G E N D A

Continental Breakfast ………………..……….….……………….…..….…..… 7:00am :

I. Call to order / Welcome (Lichstein) ………….…………………..…………… 7:30am

II. Approval of February 13, 2015 and June 17, 2015Minutes (Lichstein) .………... 7:31am

III. Financial Report (Towarnicky) ………………….…………...…….…………... 7:35am

IV. Investment Committee Report (Hoffman/Towarnicky) ….….…….….……….. 7:45am

V. Membership Update (Towarnicky) …….………………….….……....…...…… 7:50am

VI. Medicare Carrier Advisory Committee (CAC) Report (Hoffman) .………….…. 8:00am

VII. Medicaid Physicians Advisory Group (PAG) Update (Towarnicky) …………… 8:10am

VIII. Residency Program Grant Project (Lichstein) ..….……………..............….….… 8:20am

IX. Residents/Medical Students Update (Vincent) ….….….……....…...….….…..... 8:35am

X. ACP Update (Lichstein) ..….……..………….….….…..….........................….….. 8:45am

XI. Early Career Physicians (Wardrop) …………...……………….……………….. 8:55am

XII. NC/ACP Annual Meeting (Hoffman/Feiereisel/Lowe) ............……..…….......... 9:05am

A. Annual Meeting Attendance & Financial History

B. 2016 Annual Meeting Plans

1. Schedule/Program 3. Special Interest Functions

2. Awards 4. Etc.

3. Resident Participation

C. Future meeting plans

1. 2016 - February 26-27 / Grandover, Greensboro

2. 2017 - February 24-25 / Sheraton Imperial, RTP.

3. 2018 - February 23-24 / Grandover or Sheraton, Greensboro

XIII. Advocacy Update .….….…….….……..…..…....………….….…...………..….. 9:25am

A. Legislative Update (Baggett)

B. NC Coalition for Patient Protection (Whited)

XIV. Strategic Planning Session Follow-up (Lichstein) . …..….…....………....……… 10:00am

A. Membership Survey Results

XV. 2016 Nomination/Election Plans (Lichstein) ….…......………...........………….. 10:15am

XVI. Other Business (Lichstein) ……….……......….….……....................….……..….. 10:20am

A. T. Reginal Harris Award – Presentation to James Bryan, MD

XVII. Adjourn ….……………………….…....…..…………………………………... 10:30am

NC,ACP Council Friday, October 23, 2015 / 7:30am

Beaumont Room / Grandover Resort / Greensboro, NC (Second Floor)

Elevators

2015-2016 NC,ACP Officers/Council Members

OFFICERS

Office Officer Term

Governor Peter Lichstein, MD 2015-18

Secretary-Treasurer Michael R. Towarnicky, MD 2014-17

COUNCIL MEMBERS

Category Councilor Term

Councilor Larry Klima, MD 2013-16

Councilor Michael Norins, MD 2013-16

Councilor Richard Wardrop, MD 2013-16

Councilor Nancy Henley, MD 2014-17

Councilor Jasvinder Singh, MD 2014-17

Councilor Robert Hasty, DO 2014-17

Councilor Johnathan Williams, MD 2015-18

Councilor Dawn Brezina, MD 2015-18

Councilor Lalit Verma, MD 2015-18

Councilor - Hospitalist Matthew Blackwell, MD 2013-16

Councilor - Hospitalist Scott Furney, MD 2014-17

Councilor – UNC Paul Chelminski, MD 2014-17

Councilor - WFU Kirsten Feiereisel, MD 2014-17

Councilor – Brody Suzanne Kraemer, MD 2013-16

Councilor – Duke Sharon Rubin, MD 2013-16

RESIDENT COUNCIL MEMBER

Category Councilor Term

Resident Member Duncan Vincent, MD 2015-16

EX OFFICIO

Office Officer Term

Past Governor Byron Hoffman, MD n/a

Past Governor Timothy Lane, MD n/a

Past Governor Janelle Rhyne, MD n/a

Past Governor James A. Bryan, II, MD n/a

Past President Clare Sanchez, MD n/a

Past President Marco Aleman, MD n/a

Past President R. Doug Barrow, MD n/a

Past President Thomas Kaluzynski, MD n/a

NC/ACP Council Friday, February 13, 2015

Durham, NC

M I N U T E S Present

Byron J. Hoffman, Jr., MD, FACP, Governor Duncan Vincent, MD, Residents Chair

Peter Lichstein, MD, FACP, Governor-Elect Jan Rhyne, MD, FACP, Past Governor

Jasvinder P. Singh, MD, FACP, Councilor James Bryan, II, MD, MACP, Past Governor

Michael E. Norins, MD, FACP, Councilor Clare Sanchez, MD, FACP, Past President

Johnathan D. Williams, MD, FACP, Councilor Hal Atkinson, MD, MS, FACP, Guest

Lalit Verma, MD, FACP, Councilor Stephen Beuttel, MD, MACP, Guest

Sharon Rubin, MD, FACP, Councilor Debra Bynum, MD, Guest

Richard Wardrop, MD, PhD, FAAP, FACP, Councilor Charin Hanlon, MD, Guest

Nancy S. Henley, MD, FACP, Councilor Alan Skipper, Executive Director

Dawn Brezina, MD, FACP, Councilor Denna Suko, Deputy Director

Lawrence Klima, MD, FACP, Councilor Nancy Lowe, Associate Director

Kristen Feiereisel, MD, Councilor Evan Simmons, Coordinator

Matt Blackwell, MD, FACP, Councilor Steve Keene, Guest

M. Suzanne Kraemer, MD, MS, FACP, Councilor Chip Baggett, Guest

Absent

Michael Towarnicky, MD, Secretary-Treasurer

Scott Furney, MD, Councilor

Paul Chelminski, MD, MPH, FACP, Councilor

The meeting was called to order by Byron Hoffman, MD, Governor. The minutes of the October 24, 2014 meeting were presented and approved. The following 2014-2015 year-to-date financial report was presented and approved.

Balance Sheet/Current Assets: Checking Account I $ 45.67 Checking Account II $ 29,658.65 Promotional Rate Account $ 46,189.28 Morgan Stanley Smith Barney $ 285,983.81 Total Assets $ 361,877.41

Statement of Activity: Income $ 85,397.83 Expenses $ 70,595.90 Net Income $ 14,801.93

The deficit in net income for the past fiscal year was discussed. Factors noted included $45,000 in grants to residency programs, support for UNC’s event in honor of James Bryan, II, MD, and subsidization of the Annual Meeting. The outlook for the current fiscal year was discussed. It was noted that it is likely that the year will finish with a negative net income again but that a projection was pending due to the annual meeting variables.

Agenda Item II

There was a discussion of the chapter’s investment plan. It was noted that the funds in the plan were presently in cash and that the account balance had grown from $250,000 to $285,000 since its inception in 2012. It was determined that the chapter should re-enter the investment market with the guidance of the Quantitative Group. There was a discussion of the Investment Committee and interest to participate was invited from among the Council members. The following volunteered to join Dr. Hoffman and Michael Towarnicky, MD on the committee: Michael Norins, MD; Lawrence Klima, MD; and Johnathan Williams, MD. The following membership report was presented.

Masters 15 Fellows 680 Members 1,660 Resident/Fellows 509 Medical Students 428 Affiliates 8 Total 3,300

An effort to pursue past-due members to help member retention was discussed. Council members were encouraged to reach out to past due members to encourage them to remain current. The chapter’s dues amount ($50) was discussed. The consensus was to continue to charge $50. A legislative update was presented by Chip Baggett from the NC Medical Society. He reported that Medicaid reform was the primary issue that the 2015 General Assembly will address and noted that Medicaid expansion is not likely to be considered in 2015. He also mentioned that legislation had been introduced to help stabilize the state’s Health Information Exchange and that a bill to allow for independent practice for advanced practices nurses is anticipated. An update on the NC Medical Society’s “Toward Accountable Care” initiative was presented by Steve Keene. Noting that the NC,ACP is a member of the TAC Consortium, he reported that an internal medicine accountable care toolkit was being finalized. He added that the biggest challenge and opportunity for medicine in shifting to a value-based care system is that quality guidelines can be established by physicians. The issue of physician burnout was discussed, noting that this is a growing area of interest and concern. A report on the Medicaid Physicians Advisory Group was provided by Peter Lichstein, MD. Mentioned as recent issues addressed by Medicaid were: Hepatitis C, Preferred Drug List, Genetic Testing, Mental Health, and Dental Care. Dr. Lichstein presented an update on the chapter-funded resident projects. He reported that the chapter had supported six projects in 2013 and 16 in 2014 and a summary of each year’s projects was distributed. There was a discussion of the future of the funding program. It was suggested that a committee be appointed to evaluate the program and to determine any refinements to implement. Volunteering for the committee were: Dawn Brezina, MD; Peter Lichstein, MD; Richard Wardrop, MD; Duncan Vincent, MD; and Karen Feiereisel, MD. It was further determined that the next round of project grants would be put on hold until the group could evaluate the program and bring recommendations back to the Council.

Duncan Vincent, MD, resident representative on the Council, provided an update on efforts to establish a Residents/Medical Student Council. He reported that representatives from each institution and medical school had been identified. He also noted that there would be a meeting of residents and medical students on Saturday, February 14, in conjunction with the NC,ACP’s annual meeting to discuss increased resident and student involvement. Richard Wardrop, MD reported that he had been appointed to the ACP’s Council on Early Career Physicians and noted that “early career physicians” are defined as those within the first 16 years following medical school. H indicated that he would provide further information as his term on the CECP got underway. Dr. Wardrop also reported on UNC’s experience with the implementation of the High Value Care curriculum. Matthew Blackwell, MD also noted that Carolinas Medical Center had been involved in the initiative and Charin Hanlon, MD similarly noted SEAHEC’s experience. Dr. Hoffman updated the Council on recent ACP activities. He noted the recent letter to ACP members from the American Board of Internal Medicine regarding Maintenance of Certification. He reported that the ABIM would be modifying the MOC process. Dr. Hoffman also noted that the ACP’s 2015 Leadership Day is scheduled for May 21-22 in Washington and encouraged participation in the event. Dawn Brezina, MD provided an overview of the 2015 NC,ACP annual meeting. The 2016 meeting was announced for February 26-27 at the Grandover in Greensboro, NC. The slate of Council nominees for 2015-2016 was discussed. The slate was confirmed as:

Secretary-Treasurer Michael R. Towarnicky, MD Councilor Johnathan Williams, MD Councilor Dawn Brezina, MD Councilor Lalit Verma, MD Councilor Robert Hasty, DO Resident Member Duncan Vincent, MD

There being no further business, the meeting was adjourned.

North Carolina Chapter, American College of Physicians Council Conference Call

June 17, 2015

M I N U T E S Participants

Peter Lichstein, MD Michael R. Towarnicky, MD Larry Klima, MD Michael Norins, MD Richard Wardrop, MD Robert Hasty, DO Johnathan Williams, MD Dawn Brezina, MD

Suzanne Kraemer, MD Sharon Rubin, MD Duncan Vincent, MD Byron Hoffman, MD Alan Skipper, CAE Denna Suko, MA Nancy Lowe, CMP

Call to Order The meeting was called to order by Peter Lichstein, MD, Governor. After a roll call of participants and welcome by Dr. Lichstein, discussion turned to strategic planning. Strategic Plan The Council discussed options for holding a strategic planning meeting this year with the goal of developing a four-year plan of priorities for the Chapter. It was clarified that this strategic planning session is not intended to be an annual event. After considering the options of holding the meeting in conjunction with the NCMS Annual Meeting or having it at a separate time, the Council decided to schedule the retreat on the afternoon and evening of October 22, 2015, in conjunction with the 2015 NCMS Annual Meeting at the Grandover Resort in Greensboro. Dr. Lichstein called for a small group of volunteers to help with the planning. Including a conference phone for the participation of those who could not attend was suggested. The regular Fall Council meeting was confirmed for Friday, October 23, from 7:30am-10:30am at the Grandover. It was noted that the NCMS Annual Meeting agenda will include an educational session on Physician Resilience that morning at 10:30am, followed by a session on Physician Wellness at 1:00pm. A discussion about how to set the agenda for the strategic planning session ensued. It was suggested that having a facilitator could be beneficial and staff was charged with inquiring with ACP and the NCMS Foundation on some possible options. All agreed that further input from the Council leading up to the session would be desirable. Membership Survey Following discussion of the strategic planning retreat, the discussion turned to the membership survey. It was noted that responses to the membership survey will be helpful in guiding the priorities of the strategic planning retreat. It was also noted that 5% of the membership participated in the last membership survey in 2011. To encourage participation, it was suggested that all respondents should be eligible to win a prize such as an iPad and that the survey should be sent through both the ACP portal and the NCMS system. Edits to the survey suggested:

1. “Only do it once” language to be added since some recipients may receive the survey multiple times. 2. “Provide your name to be entered into the drawing” language to be added. 3. Replace “MOC” with “Maintenance of Certification (MOC)” throughout. 4. Use the ACP definition of “Early Career Physician,” which is the first 16 years of practice: 0-5, 6-10, 11-

16, 17+. 5. Add ECP event interest question, “If you are an ECP, would you be interested in ECP activities/events,

such as…” (Dr. Wardrop to provide)

Agenda Item II

Early Career Physicians Update As a member on the ACP’s Council of Early Career Physicians, Dr. Richard Wardrop reported that he is working with a group of 11 colleagues who are charged with representing the interest of ECPs on a national level and advocating for them throughout the College. He added that the ECP Council liaises with residents with the goal of retaining their membership through the transition to active practice, works to promote ECPs into Fellowship, and works to identify and offer the products and services that are of particular interest to ECPs. Education Committee Dr. Lichstein announced that Dr. Matt Blackwell has accepted the position of Education Committee Chair. Legislative Activities It was suggested that the Council discuss ways to identify and engage advocacy-minded members during the upcoming strategic planning session. Dr. Michael Norins reported that he will be meeting with legislators in Raleigh on July 22 to discuss Medicaid reform and patient care issues, and encouraged others to join him on that day. The Council was informed that the final two weeks of July will be a critical period for Medicaid reform in the North Carolina General Assembly since this is when the state budget will likely be in conference committee. Council members were encouraged to commit a morning (up to the lunch hour) on any of the following dates in July for meetings with legislators in Raleigh: Tuesday, July 21, Wednesday, July 22, Thursday, July 23, Tuesday, July 28, Wednesday, July 29, or Thursday, July 30. Council members were encouraged to sign up by emailing Denna Suko at dsuko@ncmedsoc.org. Dr. Lichstein reported that the Chapter sent letters to key leaders in the Legislature regarding Medicaid expansion and support for adequate funding of the Brody School of Medicine at ECU. Investment Plan It was noted that a formal, robust finance committee is necessary. Dr. Scott Furney expressed interest. Other Business The Council discussed the nomination of and support of Dr. Jim Bryan for the 2015 T. Reginald Harris Memorial Award which is presented annually by The Carolinas Center for Medical Excellence at the NC Medical Society’s Annual Meeting. All members of the Council were encouraged to send nominations letters to Alan Skipper by email to askipper@ncmedsoc.org no later than Friday, June 26,2 015. A motion was made and passed as follows: The NC,ACP Council gives its full support for recommending James A. Bryan II, MD for the 2015 Harris Award. The motion carried unanimously. Adjourn There being no additional business to discuss, the meeting was adjourned.

North Carolina Chapter/ American College of Physicians PO Box 27167 222 North Person Street • Raleigh, North Carolina 27611

(919) 833-3836 • (919) 833-2023 Fax •ncacp@ncmedsoc.org

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2015 Year-to-Date Financial Report

(As of October 14, 2015)

Balance Sheet - Current Assets

Checking Account I $ 52,058.03 Checking Account II $ 1,836.15 Morgan Stanley Smith Barney $ 253,273.70

Total Assets $ 307,167.88 Statement of Activity – July 1, 2015 to October 14, 2015

Income $ 47,064.30

Expenses $ 14,788.62

Net Income $ 32,275.68

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Agenda Item III

Financial History - 2006-2015

INCOME 2005-2006 2006-2007 2007-2008 2008-2009 2009-2010 2010-2011 2011-2012 2012-2013 2013-2014 2014-2015 2015-2016

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year To Date

Membership $71,134.00 $62,889.00 $63,000.00 $74,725.00 $79,350.00 $76,995.00 $75,819.00 $76,220.00 $73,663.33 $70,935.00 $55,560.00

Governor's Allowance $3,114.87 $25,463.50 $13,375.00 $13,170.51 $11,567.70 $11,567.70 $11,567.70 $439.74 $3,623.35 $1,000.00 $0.00

Interest/Dividend Income $1,975.04 $2,246.11 $4,145.26 $5,546.72 $1,045.79 $543.07 $2,090.51 $10,135.64 $10,773.44 $30.20 $669.57

Meeting $21,062.90 $22,450.00 $38,200.00 $41,822.04 $36,943.13 $36,217.55 $48,055.00 $36,675.00 $27,000.00 $34,540.00 $0.00

(Un)Realized Gains/Losses ($2,314.71) $7,159.00 $14,357.42 ($1,952.96) ($9,165.27)

Other $0.00 $0.00 $3,300.74 $0.00 $4,793.47 $2,500.00 $0.00 $0.00 $2,000.00 $2,827.80 $0.00

Total Income $97,286.81 $113,048.61 $122,021.00 $135,264.27 $133,700.09 127,823.32 $135,217.50 $141,182.84 $131,417.54 $107,380.04 $47,064.30

EXPENSES

2005-2006 2006-2007 2007-2008 2008-2009 2009-2010 2010-2011 2011-2012 2012-2013 2013-2014 2014-2015 2015-2016

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year End

Fiscal Year to Date

Meeting $40,493.16 $52,852.97 $50,796.26 $49,407.13 $58,898.07 $51,717.76 $56,090.72 $57,415.36 $64,896.94 $66,541.31 $286.65

Sponsorships/Grants $3,623.37 $0.00 $11,500.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Professional Relations $2,037.57 $4,340.65 $2,876.89 $15,055.14 $6,775.98 $8,988.41 $11,921.63 $9,852.30 $70,127.62 $55,601.75 $2,693.00

Management $19,500.00 $19,920.00 $15,147.00 $34,111.74 $29,330.27 $29,608.37 $36,689.96 $27,628.74 $52,075.54 $45,704.69 $11,017.81

Operational Expenses $3,918.78 $973.04 $2,896.42 $374.70 $557.09 $748.16 $1,738.46 $2,575.27 $4,300.80 $2,684.11 $791.16

Other $0.00 $1,350.35 $17,198.66 $4,568.27 $2,020.78 $345.52 $1,677.72 $0.00 $1,139.29 $854.76 $0.00

ACP Leadership Day $8,176.70 $0.00

Total Expenses $69,572.88 $79,437.01 $100,415.23 $103,516.98 $97,582.19 $91,408.22 $108,118.49 $107,012.52 $192,540.19 $179,563.32 $14,788.62

Net Income $27,713.93 $33,611.60 $21,605.77 $31,747.29 $36,117.90 $36,415.10 $27,099.01 $34,170.32 ($61,122.65) ($72,183.28) $32,275.68

Total Assets $187,431.14 $221,042.74 $242,648.51 $274,395.80 $310,513.70 $346,928.80 $425,344.31 $408,198.13 $347,075.48 $361,877.41 $307,167.88

Agenda Item III

North Carolina Chapter/ American College of Physicians PO Box 27167 222 North Person Street • Raleigh, North Carolina 27611

(919) 833-3836 • (919) 833-2023 Fax •ncacp@ncmedsoc.org

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Membership Summary as of October 14, 2015

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YEAR

CATEGORY 2006 - 2007

Year-End

2007 - 2008

Year-End

2008 - 2009

Year-End

2009 - 2010

Year-End

2010 - 2011

Year-End

2011 - 2012

Year-End

2012 -2013

Year-End

2013 -2014

Year-End

2014 - 2015

Year-End

2015 -2016

Yr-to-Date

Masters 10 10 11 12 12 14 14 15 15 16

Fellows 565 561 584 605 611 624 633 646 680 690

Members 1,563 1,565 1,562 1,594 1,568 1,540 1,534 1,523 1,660 1,686

Resident/Fellows 493 524 610 546 490 481 451 519 509 509

Medical Students 312 307 392 325 388 352 422 456 428 503

Affiliates 4 3 6 4 1 1 5 4 8 12

Total 2,947 2,970 3,165 3,086 3,070 3,012 3,059 3,163 3,300 3,416

Agenda Item IV

NC,ACP Residency Program Grant Project - 2013-2014

Institution Project Name Project Contacts (2015) Grant Amt Amt

Spent Updated Project Status

Duke

Improving Quality Improvement Residency Education and Provider Performance Through a Shared Online Experience

Aimee Zaas, MD, MHS $5,000.00 $0.00 Feb-15 Ongoing with plans to expand the project in 2015.

Wake Forest A Resident Curriculum on Nutition Counseling and Wellness

Vera Luther, MD $5,000.00 $4,185.58 Jun-15 Very positive feedback from participants. Additional sessions being planned.

Wake Forest STAR (Safe Transitions Across CaRe): A Resident Curriculum

Kirsten Feiereisel, MD $5,000.00 $2,209.73 Feb-15

Ongoing with plans for additional seminars to be offered. Presented at APDIM (April 2015). Two abstracts were submitted for SGIM. Manuscript in development for potential publication.

Wake Forest

Resident Education in Reducing Preventable Readmissions: A Continous Feedback Loop

Hal Atkinson, MD Ajay Dharod, MD Wes Milks, MD

$5,000.00 $0.00 Feb-15

PI changed to Hal Atkinson. Plans to present data at ACP 2016 Annual Meeting. Funds spent to date: Unknown.

Duke

Evidence-Based Medicine and Education Prescriptions in the Duke Med-Peds Primary Care Clinic

Amy Zaas, MD, MHS Jane Trinh, MD, FACP, FAAP

$5,000.00 $3,712.89 Aug-15

Next steps include a post-intervention questionnaire to illicit attending and resident perspectives of EduRx and the barriers that led to low completion rates. Coming up with unique and creative ways to formally teach and incorporate EBM into a resident primary care clinic will be necessary going forward.

Institution Project Name Project Contacts (2015) Grant Amt Amt Spent Updated Project Status

Wake Forest Impressions of Internal Medicine, Before & After the 3rd year Clerkship

Cynthia Burns, MD, FACP $5,000.00 $0.00 Feb-15

Data entry of student impressions is complete, and analysis is ongoing. The Wake Forest School of Medicine Office of Medical Education graciously offered analysis by their statistical team with funding from their budget, and I awaiting the results of that analysis. Once I have received their analysis, I will incorporate it into my manuscript. I plan to submit my manuscript in the next 6 months.

Wake Forest Changed Forever Cynthia Burns, MD, FACP $5,000.00 $2,500.00 Feb-15

Wake Forest will provide free qualitative analysis of transcribed data going back to 2007. Manuscript would be started in Summer of 2015.

Brody/ECU Medical Education Innovation Inpatient Unit (MedIU)

Suzanne Kraemer, MD, FACP

$5,000.00 $5,000.00 Feb-15

Ensuring strong faculty development for our Chief Residents has been crucial to sustain a core group of GIM faculty identified as quality champions. Additionally having the ability to send each Chief Resident to a national meeting at a time when funds for travel were severely restricted at our institution, has served to strengthen their commitment to academic General Internal Medicine.

Wake Forest What does the heart sound like?

Killiam Robinson, MD $5,000.00 $0.00 Feb-15

Changes in project team have delayed the project. New team is recruited and project should be moving forward this academic year (2015-16).

9 Grants $45,000 $17,608

NC,ACP Residency Program Grant Project - 2014-2015

Institution Project Name Project Leader Grant Amt Amt

Spent Updated Project Status

Duke

Making Wise Choices Easier: A Competition for the Best Project Proposal Designed to Improve Our Delivery of High Value Care and Cost Conscious Care (HVCC)

Alicia Clark, MD $5,000.00 None Status reports due February 2016.

Brody/ECU

Transforming an Internal Medicine Academic Teaching Clinic with Resident Teams

James Powell, MD and Aniel Rao, MD

$1,500.00 None Status reports due February 2016.

Brody/ECU

No Lows: A Collaborative Quality Improvement Project between a Hospital Best Practice Committee and Internal Medicine Residency to Reduce Inpatient Hypoglycemic Events

Niti Armistead, MD $4,000.00 None Status reports due February 2016.

Brody/ECU

Implementation of a longitudinal patient safety and quality improvement curriculum

Mary Suzanne Kraemer, MD, FACP and Suchita Pancholi, MD

$2,000.00 None Status reports due February 2016.

UNC

A High Value Care Faculty Development Curriculum: Promoting HVC Education Across the Continuum

Richard M. Wardrop III, MD, PhD

$4,400.00 None Status reports due February 2016.

Institution Project Name Project Leader Grant Amt Amt

Spent Updated Project Status

UNC

Increasing patient safety during thoracentesis with pre-procedural simulation training

Ria Dancel, MD $2,000.00 None Status reports due February 2016.

UNC

The Speed of Ultrasound: Enhancing Procedural Competency and Cementing Physical Exam Skills In The Ambulatory Setting: A Curriculum to Train Internal Medicine Residents in Ultrasound Technology to Promote Safe and Efficacious Ambulatory Procedural Skills and Mastery of the Physical Exam.

Paul Chelminski, MD $2,500.00 None Status reports due February 2016.

NHRMC

Impact of Sickle Cell Management and Readmissions in a Community Hospital Setting

Charin Hanlon, MD $1,500.00 None Status reports due February 2016.

NHRMC Resident education in patient safety and quality improvement

Martin Butler, MD $5,000.00 None Status reports due February 2016.

Wake Forest A Resident Curriculum on Physician Impairment by Substance Abuse

Farra Wilson, DO $1,000.00 $720.00 Feb-15

Expenses thus far: $720 for resident participation in HeartCode, a part of ACLS re-training.

Wake Forest Hospitalist Training Pathway

Chaudry Nasir Majeed $2,000.00 None Status reports due February 2016.

Institution Project Name Project Leader Grant Amt Amt

Spent Updated Project Status

Wake Forest Introduction to POCT Ultrasound

Claudia L. Campos, MD $2,500.00 None Status reports due February 2016.

Wake Forest Refining fundoscopic examination skills in the outpatient setting

Claudia L. Campos, MD; Carolyn Pedley, MD; Abby Koch, MD; and Ramon Velez, MD

$2,500.00 None Status reports due February 2016.

Wake Forest

The Nuts and Bolts of Documentation, Billing, and Coding in Ambulatory Medicine

Kirsten Feiereisel, MD and Nancy Denizard-Thompson, MD

$1,000.00 None Status reports due February 2016.

Carolinas Medical Center

The Effect of a Formal Medical Writing Course on Resident Scholarly Activity

Kristi M. Moore, MD $2,000.00 None Status reports due February 2016.

Carolinas Medical Center

Improving Cost-Conscious Healthcare Awareness through a Novel Morning Report Structure

Matt Blackwell, MD, FACP

$5,000.00 None Status reports due February 2016.

16 Grants $43,900 $720

NC,ACP Annual Meeting

Attendance / Financial Summary - 2010-2015

2010

Washington Duke Inn

2011 Washington

Duke Inn

2012 Grandover

2013 Washington

Duke Inn

2014 Grandover

2015 Sheraton Imperial

Attendance 125 * 159 187 192 177 236

Revenue

Paid Registration Fees (inc. banquet) 18,925 26,400 26,005 23,325 20,225 17,765

Exhibitor Fees 7,500 11,250 15,500 11,000 5,750 16,750 Educational Grants 0 0 0 0 1,000 0

Total Revenue 26,425 37,650 41,505 34,325 26,975 34,515

Expenses Food and Beverage 21,650 24,313 23,454 26,549 28,735 30,651 Exhibits (inc. signs, electricity) 1,056 1,657 1,201 1,672 737 652

Resident Poster Presenter Expenses (inc. prizes) 7,005 6,572 8,149 7,859 9,448 7,405

Medical Jeopardy Expenses (inc. prizes, equipment) 0 0 0 3,087 0 551

Meeting Room Rental 1,940 2,155 0 161 0 0

Faculty Expenses (inc. lodging, travel, honoraria) 5,728 4,499 5,968 2,304 6,342 4,408

Officer/Program Chair/Guest Lodging and Expenses 188 198 381 1,836 2,184 1,245

Staff Lodging and Expenses 407 656 994 564 1,029 332 Audiovisual 2,886 3,956 6,169 4,747 6,788 7,761 Printing/Postage/Supplies 6,868 6,219 7,767 7,919 8,162 12,123

Miscellaneous (inc. amenities, awards, gratuities) 230 400 594 450 750

856

Online Registration Fees 1,089 781 934 778 710 1,129

CME Fees 900 (ACP)

(ACP) (ACP) (ACP) (ACP)

Total Expenses 49,947 51,406 55,611 57,926 64,885 67,113

Revenue Over (Under) Expenses ($23,522) ($13,756) ($14,106) ($23,601) ($37,910) ($32,598) * rescheduled date; net loss of 37 registrants

Agenda Item XII-A

Agenda Item X-B

October 16, 2015

2016 NC,ACP Annual Meeting February 26-27, 2016

Grandover Resort and Conference Center Greensboro, North Carolina

Program Draft Friday, February 26, 2016

Outpatient Medicine

1:00pm-1:10pm Introductions and Conference Overview 1:10pm-1:50pm Update in Cancer Screening

David P. Miller, Jr., MD, MS, FACP

1:55pm-2:35pm Update in Diabetes: New Medications Joseph A. Aloi, MD, FACP

2:40pm-3:20pm Rheumatologic Emergencies Kenneth S. O’Rourke, MD

3:20pm-3:40pm BREAK 3:40pm-4:20pm Hot Topics in STD Management

Laura Hinkle Bachmann, MD, MPH

4:25pm-5:15pm Internists Working in Teams: Redesigning Clinic Workflows Andrea L. Sikon, MD, FACP

Inpatient Medicine

1:00pm-1:10pm Introductions and Conference Overview 1:10pm-1:50pm Update in Acute Respiratory Failure D. Clark Files, MD

1:55pm-2:35pm GI Practice Guidelines for Hospitalists: Using the Evidence to

Optimize Your Outcomes Joel Bruggen, MD

2:40pm-3:20pm TBA Speaker TBA – working on speaker

3:20pm-3:40pm BREAK

Agenda Item X-B

Friday, February 26, 2016 - continued

3:40pm-4:20pm Clinical Update of Sepsis in 2016 John Bishop, MD

4:25pm-5:15pm Antibiotic Resistance: A Call to Action Zack Moore, MD, MPH

5:15pm Adjourn 5:15pm-7:30pm Governor’s Reception 7:30pm-9:30pm Governor’s Awards Banquet Speaker TBD 9:30pm-10:30pm Residents/Fellows/Students Cocktail Hour

Saturday, February 27, 2016

8:00am-10:00am Chief Resident Presentations

8:05am-8:20am A Twenty-five Year Old Male Patient Presents with 24 Hours of Abdominal Pain Leslie-Ann Alexander, MD (WFU) 8:20am-8:35am An Unusual Presentation of Acute Psychosis and Seizure Timothy Bradford, DO (SEAHEC) 8:35am-8:50am Insulinoma Marie Caldwell, MD (UNC) 8:50am-9:05am Stump the Professor Stevie Carraro, MD (ECU) 9:05am-9:20am A Puzzling Patient Presenting with Pain and Progressive Pedal Purpura Amanda Kocoloski, MD (CMC) 9:20am-9:35am Raising Awareness to Re-Emergence of a Disease Samaya Qureshi, MD (Cone) 9:35am-9:50am A Case of Unexplained High-Degree Atrioventricular Block:

An Undiagnosed EP Genetic Syndrome? Jennifer Rymer, MD (Duke)

9:50am-10:00am Discussion

Saturday, February 27, 2016 - continued

9:30am-10:30am Faculty Poster Viewing 10:00am-10:30am BREAK 10:30am-11:00am Physician Wellness and Resources Richard M. Wardrop, III, MD, PhD, FAAP, FACP 11:05am-11:50am Choice of Sessions:

1. Doctor’s Dilemma Competition Final Round 2. Faculty Burnout and Resiliency: Shifting the Balance Toward Wellness

Richard M. Wardrop, III, MD, PhD, FAAP, FACP 3. Treatment Duration of VTE Karen S. Oles, PharmD, MS, BCPS, CPP 4. Ultrasound Guided Arthrocentesis Claudia L. Campos, MD, FACP

11:50am-1:15pm Choice of Lunch Sessions 1:15pm-2:00pm NC Chapter Business Meeting Peter Lichstein, MD, FACP, Governor 2:00pm-2:45pm Plenary 1: Medicaid Expansion

Thomas D. DuBose, Jr., MD, MACP 2:45pm-2:55pm Q&A 3:00pm-3:45pm Plenary 2: A Breath of Fresh Air in 2016: Asthma/COPD Update Travis L. Dotson, MD 3:45pm-3:55pm Q&A 4:00pm-4:45pm Plenary 3: The Beat Goes On: Cardiology in Review from 2015 R. Brandon Stacey, MD, MS 4:45pm-4:55pm Q&A 4:55pm Wrap Up 5:00pm Adjourn

The North Carolina Coalition to Protect Patients is comprised of the following organizations:

North Carolina Academy of Family Physicians North Carolina Chapter, American College of Physicians North Carolina Dermatology Association North Carolina Medical Society North Carolina Obstetrical and Gynecological Society North Carolina Orthopaedic Association North Carolina Neurological Society North Carolina Psychiatric Association North Carolina Society of Anesthesiologists North Carolina Society of Otolaryngology and Head and Neck Surgery North Carolina Society of Pathologists North Carolina Spine Society

Agenda Item XIII-B

2015 LEGISLATION

SB 695 / HB 807– MODERNIZE NURSING PRACTICE ACT

OPPOSE: This legislation proposes to not only eliminate the requirement of physician supervision of advanced practice registered nurses but also eliminates the additional patient protection provided by the Joint Subcommittee of the Nursing and Medical Boards. Status – SB 695 referred to Senate Health Committee. HB 807 referred to House Committee on Health. This legislation remains eligible for debate following the 2015 crossover deadline.

SB 118 / HB 913 – NATUROPATHIC DOCTORS LICENSING ACT

OPPOSE: This legislation would create a new category of physician in North Carolina: Naturopathic Doctor (ND). Unlike other physicians, naturopathic doctors would be licensed by their own board rather than the NC Medical Board. These doctors would have the authority to order tests and manage chronic disease as primary care providers, including the management of chronic disease as well as the diagnosis and treatment of cancer. The bill does not place any limitations on Naturopathic treatment (pediatrics, psychiatric care, etc.). Status – SB 118 referred to the Senate Committee on Healthcare, HB 913 referred to the House Health Committee. This legislation remains eligible for debate following the 2015 crossover deadline.

HB 135 / SB 190 – MODERNIZE PHYSICAL THERAPY PRACTICE

Under current law, any physical therapy treatment plan that involves manipulation of the spine must be prescribed by a physician. This bill proposes to eliminate that requirement. Status – HB 135 was passed by the House of Representatives before the 2015 Crossover deadline. It was then referred to the Senate Committee on Rules. SB 190 has been referred to the Senate Committee on Rules. This legislation remains eligible for debate following the 2015 crossover deadline.

SB 543 – HOMEBIRTH FREEDOM ACT

OPPOSE: By creating a council of Certified Professional Midwives, this bill would allow midwives with no formal education or medical training to deliver babies in North Carolina without physician supervision. Currently, all midwives in North Carolina must have a nursing degree and work under the supervision of a physician. This bill lowers safety standards where they are needed most – during planned home births. Recognizing that serious complications can arise during childbirth, it is important

to maintain high standards for maternity care to protect patient safety. Status – referred to the Senate

Committee on Rules. This legislation remains eligible for debate following the 2015 crossover deadline.

HB 714 – BEHAVIOR ANALYST LICENSURE

Creates the NC Bahavior Analyst Board and defines the practice of behavior analysis to include “the empirical identification of functional relations between behavior and environmental factors, known as functional assessment and analysis. Behavior analysis interventions are based on scientific research and the direct observation and measurement of behavior and the environment. In the practice of behavior analysis, behavior analysts utilize contextual factors, motivating operations, antecedent stimuli, positive reinforcement, and other consequences to help people develop new behaviors, increase or decrease existing behaviors, and emit behaviors under specific environmental conditions. The practice of behavior analysis expressly excludes psychological testing, cognitive therapy, sex therapy, psychoanalysis, hypnotherapy, and long-term counseling as treatment modalities.” Status – referred to the House Committee on Health. This legislation remains eligible for debate following the 2015 crossover deadline.

HB 158/SB 125 – JIM FULGHUM TEEN SKIN CANCER PREVENTION ACT

SUPPORT – This legislation would prohibit those under the age of 18 from using tanning beds. Current law is 13 years of age. Status – HB 158 was passed by both chambers, becoming law (S.L. 2015-21).

BILLS NO LONGER ELIGIBLE FOR DEBATE DUE TO CROSSOVER DEADLINE:

SB 240 – DEFINE SCOPE OF PRACTICE OF CRNAS

OPPOSE: This bill proposes to exempt nurse anesthesia from the legal definition of the practice of medicine in North Carolina. In practice this bill would eliminate physician supervision of nurses when providing anesthesia services. Status – referred to the Senate Committee on Rules. This bill failed to meet the crossover deadline and is not eligible for continued debate.

SB 542 – DECRIMINALIZE DIRECT ENTRY MIDWIFERY

OPPOSE: Not only would this legislation allow midwives with no formal education and little training to deliver babies in North Carolina homes without any rules or regulations – but it would also place all standards for practice under the purview of an out of state, unregulated entity. This legislation poses great risk to both expectant mothers and their children yet to be born. Status – referred to the Senate Committee on Rules. This bill failed to meet the crossover deadline and is not eligible for continued debate.

NC,ACP Council Election Outlook - 2016

Category Councilor Term Eligible for Re-

election

Councilor Larry Klima, MD 2013-16 No Councilor Michael Norins, MD 2013-16 No

Councilor Richard Wardrop, MD 2013-16 Yes

Councilor - Hospitalist Matthew Blackwell, MD 2013-16 Yes

Councilor – Brody Suzanne Kraemer, MD 2013-16 No Councilor – Duke Sharon Rubin, MD 2013-16 Yes

Resident Member Duncan Vincent, MD 2015-16 Yes

Agenda Item XV