Together internal medicine and the subspecialties are stronger

One of my priorities for my year as ACP's president was to increase the effectiveness of the College by advocating for our profession and our patients.

With this in mind, American College of Rheumatology president James R. O’Dell, MD, FACP, and I discussed the importance of our associations' governing bodies getting to know each other and discussing areas of mutual concern. That discussion led to the American College of Physicians and Internal Medicine Subspecialty Society Leadership Summit on Nov. 28 in Washington, D.C.

Everyone invited chose to come, 64 leaders from 26 organizations in all, which shows that our call for more effective collaboration and coordination resonated with the other internal medicine societies, as well as leaders from the American Academy of Neurology, who were also invited.

The impressive list of attendees included society presidents and presidents-elect, society executive leaders, deans, professors, practice directors and noted educators and clinicians. It was an all-star cast. The goal of the summit was to enhance the dialogue between ACP and other internal medicine subspecialty societies “to improve the profession through collaboration, coordinated policy efforts and effective advocacy.”

ACP president-elect Molly Cooke, MD, FACP, and I served as moderators. We heard discussions on the challenges of our work from Dr. Cooke's perspective as a general internist, Dr. O’Dell's perspective as a “non-procedural” internal medicine specialist, and from the perspective of a “procedural specialist,” William A. Zoghbi, MD, FACP, of the American College of Cardiology. The comparative economic challenges of practice were discussed, but we spent the vast majority of our time discussing medical education, quality and quality measurement, and clinical care coordination issues.

After lunch, we broke into five small groups, each with a different assignment: medical education reform, clinical practice and high-value care, advocacy, workforce issues, and the development of a plan to continue our dialogue and consider new organizational possibilities. The discussions were open, frank and professional, and the participants focused on the issues of universal concern for our patients and our profession.

At our summary session, more than 20 ideas were presented as potential areas for further discussion. At the end of the meeting, we voted to continue the dialogue and endorsed for next year a follow-up meeting designed to build on the combined efforts of our leaders, councils and boards to develop common policies and proposals to improve the practice of medicine for our patients and our members.

ACP has sent a survey to the participating organization leaders and will come back with a set of two to four objectives for collaborative work this year, so that we can deliver a great product at the next meeting.

The items of greatest interest seem to be:

• developing a “Coordinating Care Wisely” program to design care paths and guidelines for collaboration between subspecialists and generalists in caring for patients with complex problems commonly seen in practice,
• attracting the “best and brightest” medical students into our profession,
• redesigning undergraduate and graduate medical education,
• improving the Maintenance of Certification and Maintenance of Licensure programs,
• supporting the academic research enterprise and
• facilitating professional liability and payment reform.

I believe we left the meeting with a renewed commitment to work together, realizing that our combined voice will be a powerful voice for the profession.

I personally believe that forming a “federation of internal medicine specialty societies” would bring our divergent interests closer together, build a foundation for improving our profession and become an exceptionally strong voice for internal medicine nationally. All these efforts would ultimately lead to improved care of our patients and improve professional lives for our members, through better care coordination, education reform and a payment system that supports our patients and our goals.

Internal medicine remains a great life in a great career. If we work together we can ensure that this statement remains real for the next generation of internists.