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President's Column

How innovation at Annual Session is helping build a better meeting

From the June 1999 ACP-ASIM Observer, copyright © 1999 by the American College of Physicians-American Society of Internal Medicine.

In this month's column, I would like to discuss one of the College's most important missions: serving as the foremost education and information resource for all internists.

In my opinion, the College accomplished this goal magnificently at this year's Annual Session in New Orleans. Kudos are richly deserved by the Scientific Program Subcommittee, chaired by Donald E. Girard, FACP, and by the entire Education Division, led by Senior Vice President Herbert S. Waxman, FACP.

While I was unable to make it to all the sessions I had planned to attend, the presentations that I did attend were superb. The comments that I have heard and read from our members have been positive and enthusiastic.

Throughout this issue of ACP-ASIM Observer, you'll find reports on a variety of presentations and events. To provide a more personal perspective, however, I would like to share some of what I thought were the highlights of this year's meeting.

Quality improvement

First, the keynote address by Donald M. Berwick, MD, was a masterpiece. Dr. Berwick, president and CEO of Boston's Institute for Healthcare Improvement, identified serious discrepancies between recognized best practice and actual practice. He described how long-lasting changes in behavior require a serious evaluation of our traditional educational efforts, and he challenged the College to take the helm of quality improvement efforts to help effect change in medicine.

The College's outgoing President, Harold C. Sox, MACP, touched on similar themes during his beautifully crafted speech at Convocation Ceremony. He described initiatives that all physicians can undertake, even in today's increasingly hostile practice environment. Dr. Sox urged physicians to use the College's new clinical leadership theme of antibiotic resistance to organize educational programs and to embrace preventive interventions that can improve patient care.

When Robert B. Copeland, MACP, discusses professionalism, everyone should listen. The College's past Chair of the Board of Regents brings to the subject a lifetime of exemplary practice of professionalism, and at an Annual Session presentation, Dr. Copeland made a powerful case for why physicians must put their patients' interests ahead of all else. He truly demonstrates what professionalism means and demands.

On a slightly different subject, Jock Murray, MACP, Chair of the Board of Regents from 1995 to 1997, talked about the intersection of fine art and medicine during the Nicholas E. Davies Memorial Lecture. By showing the audience a wide range of paintings, Dr. Murray demonstrated how art not only reflects society's ever-changing view of physicians but also provides doctors with valuable insights into how patients view illness and caregivers. He showed the work of a Canadian artist, Robert Pope, who actually spent time at a local medical school creating paintings that illustrate his efforts to cope with cancer.

Multiple Small Feedings of the Mind

During a more somber moment, the late Oscar E. Edwards, a former College Regent and Governor, was awarded a posthumous Mastership at Convocation Ceremony. While the College lost a close and trusted friend with Dr. Edwards' unexpected death last year, his contributions to internal medicine continue to be felt, particularly at Annual Session. One of those contributions, an educational forum known as Multiple Small Feedings of the Mind, continued to grow in popularity and size at this year's meeting.

The success of the concept reflects the very best in the symbiotic relationship between the College and its chapters. The idea for Multiple Small Feedings of the Mind came largely from Dr. Edwards and the Virginia Chapter's current Governor, Jeffrey P. Harris, FACP, who recognized that most physicians find bite-size pieces of information most useful, particularly when that information has been created in response to well-conceived, sharply focused questions.

Drs. Edwards and Harris took that realization and created a useful learning format for their chapter's meeting. Practitioners in Virginia were asked to contribute the types of questions that they were asking in real world circumstances. Those questions were reviewed by a program committee and major content areas were identified.

Gifted teachers from the state's medical schools were recruited to respond to questions from each content area. Each faculty person was instructed to respond specifically to the questions in a short period of time (five minutes or so per question), using only a few slides to illustrate key points in the discussion.

Success

The leadership shown by Drs. Edwards and Harris was critical in ensuring that the faculty did not slip into their accustomed patterns of delivering academic lectures. The format quickly proved to be successful in Virginia, and it was an instant hit when introduced at the 1998 Annual Session. The sessions were so popular that they immediately had to be moved to large halls to accommodate the demand.

Based on that success, the College this year began distributing handouts from Multiple Small Feedings of the Mind sessions to all registrants. The feedback has been uniformly positive, and the next challenge is to extend the benefit of the program to all College members.

Much of the credit for the success of the Multiple Small Feedings of the Mind curriculum goes to Drs. Edwards and Harris. They both took responsibility for planning the 1998 Annual Session program and recruiting faculty. For this year's meeting, Dr. Harris took on those duties alone. Dr. Harris continues to play an important role in planning Multiple Small Feedings of the Mind at future Annual Sessions.

I have enormous respect and admiration for the important contribution Governors make to the success of the College, but the efforts of Drs. Edwards and Harris go above and beyond even the high standards of Governors. Drs. Edwards and Harris have been truly exceptional in their generous commitment of time and effort to make the program a success. They both merit the College's most heartfelt gratitude.

While the bar has been raised for next year's Annual Session in Philadelphia, I am confident that the meeting will be even better. Please contact me with any suggestions at waddingt@rsh.net.

Whitney W. Addington, FACP

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