Looking back and looking forward

As the year begins, ACP's President shares where ACP has been and where membership voices have guided ACP to engage in the coming year.


January is the time of resolutions. As the year begins and we reflect on what is important, I want to take a moment to share where ACP has been and where membership voices have guided ACP to engage in the coming year. As always, please share thoughts, ideas, and interests. The College is its members, more than 150,000 strong, with nearly 15,000 living and practicing outside of the United States.

What is remarkable about us, the membership, is that nearly 90% are somewhat to very satisfied with internal medicine as a career, according to the 2017-2018 Annual Report of the Executive Vice President. Career satisfaction is an important factor that supports personal and professional well-being. From meeting and speaking with members nationally and internationally over the past few months, I know that this finding truly speaks to professional commitment, a commitment to patients and learners and to ourselves to be the best internal medicine specialists or subspecialists that we can be.

Looking at the reasons for satisfaction and lack thereof, some interesting parallels emerge. When asked to identify factors that contributed to career satisfaction, two-thirds noted intellectual stimulation as the most satisfying career aspect and more than half noted interactions with patients and their families. Yes, we are always learning, and all of this we do for the benefit of our patients and their families. For us, this context is important. We learn in order to make a difference in our patients' lives.

When asked about factors contributing to dissatisfaction, more than half of respondents noted regulatory and documentation requirements, with about a third noting the inefficient design and operation of the electronic record. Like many of us, I no longer use the term “electronic health record.” The electronic record has a ways to go to establish its real-world benefit to patients' health and health professionals' well-being.

Another third of members cited lack of time with patients and families as a source of dissatisfaction. These factors are linked and are like opposite points of tension. In short, given our commitment to care for patients, we perceive education as paramount, and we experience frustration at the “hassle factors” that impair our ability to follow through effectively on patient care.

I remember the days when education was ACP's Medical Knowledge Self-Assessment Program (MKSAP), Annals of Internal Medicine, and meetings. These stalwart approaches remain, along with ever more options that support different learning styles and preferences and help us access information at the point of care. Offering 275 CME credits, a new Residency Tracker option, and tools to help us learn on the go, MKSAP 18 is now available. Annals of Internal Medicine remains a leading and prestigious publication and has become a multifaceted learning platform. It has added Annals for Hospitalists and the Hospital Medicine Channel (as well as channels for other clinical specialties), Annals for Educators, Annals Beyond the Guidelines, In the Clinic, ACP Journal Club, the blog Annals Fresh Look, the Annals On Call podcast, and a podcast summarizing Annals' most recent articles, as well as the ever-beloved podcast The Consult Guys.

We know that medical information is rapidly growing. ACP takes the responsibility of helping physicians stay up to date seriously and, through its variety of offerings, helps us to discern the differences that make a difference for our practice and for our patients. Last year, ACP released an updated version of its High Value Care Curriculum, jointly developed with the Alliance for Academic Internal Medicine , with cases, toolkits, and patient education resources. Clinical policy papers from the Performance Measurement Committee, the Clinical Guidelines Committee, and the High Value Care Committee provide recommendations that make sense within the daily practice of medicine.

Recognizing that we are a medical community on the go, ACP is supporting multiple podcasts online that offer CME and MOC credit. Take a peek and see what you like. I bet you'll be impressed. Choose from Annals On Call, The Curbsiders, and the newest addition, Bedside Rounds.

Through ACP's Online Learning Center, we can search content and learn through such offerings as an interactive module on opioids that is free to members, provides CME and MOC, and may meet state and local learning requirements. ACP also offers clinical news through ACP Internist, ACP Hospitalist, ACP Internist Weekly, ACP Hospitalist Weekly, ACP Diabetes Monthly, and ACP Gastroenterology Monthly. And at the chapter or the national level, ACP meetings are a place to learn, to meet old friends, and to forge new bonds. Internal Medicine Meeting 2019 will be the College's 100th annual scientific meeting and will be held in Philadelphia, ACP's home (and now mine). I cannot wait to welcome you!

What about the hassle factors? ACP is tackling them from multiple fronts, partly because physicians are being hassled on multiple fronts and partly because we need a variety of tools to address these different targets. ACP advocacy resources range from position papers to direct advocacy experiences at both the state and national level. Many state chapters now have state advocacy days. Please check with your Governor and ask! If your chapter has not started a state advocacy day, consider contacting your Governor and helping to start one yourself.

For 2019, Leadership Day will be held at the Mandarin Oriental Hotel on May 14-15, in Washington, D.C. For medical students and residents/fellows interested in developing legislative knowledge and gaining advocacy skills, ACP's Health Policy Internship may be just right for you. Please look for the 2020 internship cycle applications later this year.

ACP has been at the forefront of health care issues of great importance to us and to our patients. Laying out the strong position on putting patients before paperwork, ACP is also asking for your best practices, experiences, and innovations for moving these efforts forward. Making the impact of our work on the environment personal, ACP has developed a Climate Change Toolkit to help us decrease our carbon footprint.

Recognizing the role of women in internal medicine and as the health care CEOs of the family, ACP has recently published position papers calling for equity in physician compensation and career advancement and for equity in access to health care services. Please take a few minutes and look at ACP's compendium of influence. Including recommendations on physician payment and delivery, health information technology, and health care workforce approaches, this series of papers represents our voice on Capitol Hill, in state legislatures, and in the exam room.

It is no surprise that linking our experiences across our vast country, continent, and planet are the indelible words of Francis W. Peabody, MD: “For the secret of the care of the patient is in caring for the patient.” Our focus is our patients. In order to care for our patients, we value learning, and we experience frustration at the factors that get in the way. ACP is working with and for physicians to enhance educational and practice resources and to address head-on the factors that get in the way of patient care.

Ana María López, MD, MPH, MACP, ACP's President for 2018-2019, is vice chair of medical oncology at the Sidney Kimmel Cancer Center and Chief, New Jersey Division, Sidney Kimmel Cancer Center of Thomas Jefferson University in Philadelphia.