NOVEMBER 6^th MEETING IN CHICAGO

One additional speaker was added to our November 6^th, 1999 AAPHP meeting in Columbus EF at Hyatt Regency Hotel  151 E. Wacker Drive, Chicago, Illinois. Ellen Sogolow  PhD, Health Scientist,  Centers for Disease Control and Prevention will be talking about the evaluation of HIV and STD outreach programs.  Fax  630-604-3256 or email aaphp@iname.com to let us know if you are coming. The registration fee of $30.00 includes lunch.  Thank you to those who have already registered.   You will not be getting a confirmation.   See page X for the full schedule.

 

MARK YOUR CALENDERS PREVENTION 2000

The next AAPHP Meeting will be held on March 23,  2000.  As usual this meeting is being held in conjunction with the 17th Annual National Preventive Medicine Meeting - March 23 - 26, 2000 in Atlanta, Georgia. Visit the Prevention 2000 Website for More Information www.prevention-meeting.org on the general meeting.  DISCOUNTS FOR REGISTRATION SHOULD BE AVAILABLE TO AAPHP MEMBERS

AMA MEMBERS VOTE FOR AAPHP FOR YOUR SPECIALTY ORGANIZATION

AMA/AAPHP members - Vote for AAPHP (code 220) as your specialty representative to the AMA in the Specialty Society Allocation Ballot.  How?  First,  find  your 11 digit medical education (ME) number.  (If you don't know your number check your AMA membership card or call 1800-262-3211.) Then call 1 800-652-0605, fax 1 847-517-7229, email ballot@ama-assn.org or  mail AMA/Specialty Society Allocation Ballot C/O WJ Weiser and Associates, 111 N. Plaza Drive, Suite 550, Schaumburg, IL 60173 with  ME number and the three digit ballot code for AAPHP - 220.

Douglas A. Mack MD MPH    

BRINGING NEW MEMBERS TO OUR ORGANIZATION BENEFITS ALL

As a physician and public health practitioner for over 30 years, I have seen many and various changes occur in both endeavors. Where medicine once seemed exclusively devoted to healing disease, public health, in its early days, was largely devoted to public sanitation. Today, while the terms “medicine” and “public health” are hardly interchangeable, the two are much closer—both in the emphasis of population-based prevention, and on a more practical level, having to make hard decisions with limited resources.

The American Association of Public Health Physicians represents the leading edge in an increasingly integrated medical and public health paradigm. Our hybrid organization is not only an advocate for best medical practices, especially primary care, but is also poised to provide leadership on public policy and community health. For these reasons, the AAPHP is a valuable organization, and one that can anticipate a large and dynamic role in building the community health systems of the future.

But before I should get too far into the future, we must focus on the present. AAPHP, for all of our resources, expertise, and potential, is still a young organization. Though we have a solid base of members, a shared philosophy, if not vision, and a level of commitment I have rarely encountered in other professional physician or public health organizations, we must continue to build the AAPHP. Recruiting new members to our Association not only strengthens our voice, but our mission as well, and must be a priority for all of us in the AAPHP during the next year.

Toward that end, efforts continue to raise awareness of the American Association of Public Health Physicians. A conference display developed earlier this year has been making the rounds of professional events and conferences including the National Association of County and City Health Officials (NACCHO) national conference in Dearborn, Michigan this spring, and the National Commission on Correctional Health Care (NCCHC) conference in Ft. Lauderdale this fall.

The American Public Health Association (APHA) conference in Chicago this November will likewise provide an excellent opportunity to unfurl the AAPHP banner, raise awareness among both our public health and physician colleagues, and recruit new members. A meeting of the AAPHP held in conjunction with the conference will include a luncheon speaker as well as a panel discussion on current public health prevention and intervention topics. In addition, there will be a general membership meeting where your feedback will be both encouraged and valuable as we endeavor to move forward. I look forward to seeing all of you there.

Finally, while these professional gatherings provide good opportunities to promote AAPHP and our agenda, nothing is perhaps as effective for recruiting new membership as the interpersonal one-to-one meetings and conversations that all of us have every day in our personal and professional lives. We all want to take advantage of these situations, to find out what the professionals sitting across the table at lunch know about public health, what they think about the future of community health, and telling them why bringing their expertise to AAPHP will be valuable to them and the communities they represent.

We have made a good start, now it is time to truly reach out, to open our doors, and to demonstrate that our commitment to medicine and to public health will benefit all.

Joel Nitzkin MD, , MPH, DPA, FACPM Co-Chair Tobacco Control Task Force

During the past six months, Court challenges to the Master Settlement Agreement (MSA) have been processed in a number of states (Pennsylvania, New York, New Jersey, California, and others). Many of these were intended to modify the MSA between the 46 states which did not pursue individual lawsuits, and the tobacco industry. Such suits have been resolved or eliminated in most, but not all of the states, with no modifications being made in the Master Settlement Agreement.

As you may recall, the MSA provides about half the dollars on a per-capita basis than the four states which settled their own law suits, and imposes restrictions on lawsuits by others and on tobacco-related health education which are not present in the Wisconsin and Florida individual settlements. The total to be paid out over the next 25 years is $246 billion dollars, with $40 billion to Wisconsin, Texas, Mississippi and Florida, the four states with individual settlements, and $206 billion to the rest.

No money is to flow to any MSA state until all current and pending lawsuits against the MSA are settled in enough states to account for 80% of the US population. At time of this writing (October 5), enough states to reach 79% of “finality” have settled.

While some states will provide significant funding for tobacco control activities, most will not. Much of the funding in most states will go for healthcare services and research. Some see this as a positive development. Others point out that this will assure the silence of those receiving substantial cash infusions from the MSA.

While a financial windfall for the states, our interpretation has been that, in almost all states, the MSA has been of no value, and may perhaps be a significant setback for public health. Detailed discussions on this point have been presented in past issues of the AAPHP bulletin.

While all this has been going on, the tobacco industry has not missed an opportunity to strengthen their position, and their ability to continue their efforts to recruit teenagers into the ranks of smokers by presenting cigarettes as “forbidden fruit” and symbols of  sexual and social success.

In many, if not most states, the industry is rapidly moving to have the major provisions of the MSA written into state law.  While the Attorneys General do not have the authority to prohibit other “releasing parties” from suing the tobacco industry, state legislatures do have such authority, and are likely to do so, to assure the continuing flow of tobacco moneys into their coffers.

The tobacco industry has continued to pursue legislation at the federal level, to restrict the ability of potential litigants to form class action suits, and, if such are formed, to require that they be moved from state court to federal court, where they are sure to be delayed for years, and will have much less chance of success.

On yet another front, there is ample evidence that the tobacco industry has been vigorous in expanding “gray market” production and sale of tobacco

products. This is intended to evade state restrictions and taxes, and to sell cigarettes in each of the states that will not be counted toward their official “market share” for purposes of calculating the annual payment due each of the states.  “Grey market” cigarettes are cigarettes which have been legally produced for sale abroad, then diverted for sale here.

AAPHP has tried to stay abreast of all of these developments, and, where feasible, support action and make statements at the federal level to try to curb at least some of the most egregious actions of the tobacco industry.

The one major item of good news is the Clinton administration decision to pursue civil litigation against the tobacco companies.

Joel L. Nitzkin, MD, MPH,  DPA, FACPM Chair, Job Market Task Force

The past six months has been rather frustrating on the job market front.  Having established, on the basis of our work on this issue during the past

three years, that public health and preventive medicine credentials are of little value in the current job market, and that more often than not, public health leadership positions are going to either non-physicians or physicians without public health and preventive medicine training. While the value of preventive medicine is being increasingly recognized in the private sector, the importance of preventive medicine credentials in securing these jobs has not increased.

We had developed an action plan which required securing staff for an advocacy program oriented toward potential employers. To date we have not succeeded in securing such funding. This item and this plan were presented to the Public Health Leadership Forum, in July, and unanimously endorsed by that group. Unfortunately, no follow-up action is anticipated.  We have been invited to submit the results of the research we did on this issue to the American Journal of Preventive Medicine for publication. This it should be submitted within the next month. 

Submitted by John Poundstone MD MPH

Cash Flow report Jan. 1, 1999 to Sep. 1, 1999

Inflows

membership dues                                                 $3,353

Prev. 99 registrations                                           $700

Rebate                                                                    $578.58

Smith-Kline grant                                                 $600

Interest                                                                  $188.04

Miscellaneous incl. regis. paid in cash             $506

 

Total inflows                                                         $5,925.62

 

Outflows

R. Davis campaign                                               $1,000

NACCHO exhibit                                                  $550

Job survey                                                            $75.36

Legal fee (PA filing)                                             $55

Mail box                                                                 $212

Prev. 99 meeting expense                                    $2,136.50

Memb. dues (ACPM & ATPM)                        $730

Publ. expense + sec’y expense                          $1,171.28

Web page                                                              $787.70

 

Total outflows                                                       $6,717.84

 

Difference                                                             -$792.22

Total in bank accounts                                       $24,101.62

(Note from Secretary $2665.00 of 1999 dues was actually submitted at the end of 1998 and is not recognized on this cash flow report)

 

Virginia Dato MD MPH

COMMUNICATION

                We continue to improve our ability for communication. As of October 11, we have email addresses for 129 members.  AAPPH News is now being sent out by email whenever 3 to 4 items of interest accumulate.  Items for inclusion should be sent to aaphp@iname.com.

As a result of these quick news letters we are able to provide input into a variety of timely issues and attend a variety of conferences such as an end of life conference and a quality assurance conference. (Note: due to budget constraints, we can not support the expenses of most of these conferences. However, often there are members located near the conference or who have positions that can support the travel expenses.) We now have an ethics committee because a number of members expressed interest in being our ethics liaison to the AMA.  Kevin Sherrin MD has agreed to chair this new committee.  

For those members who do not have email, especially those who are retired and are on fixed income, may I suggest trying one of the free internet email services.  You can go to your local library and sign up with a service such as http://www.yahoo.com or http://www.iname.com.  Your email will then be waiting for you when you next to the library or other public access location.

The bulletin continues to be sent out 3 to 4 times a year.  This mailing and the previous mailing were processed by a company called http://www.eletter.com.  The use of this service permits us to take advantage of lower mailing rates since all addresses go through a verification process and are bar coded before mailing. The company destroys each mailing list as soon as the mailing is sent out.  As your secretary I am overjoyed because I just have to upload the files from my computer and eletter.com does the rest at a very reasonable price.

MEMBERSHIP

- As of October 7^th, 1999, we had 200 members who have PAID their 1999 dues (Note two of these members paid twice and I have credited them for year 2000 dues).  Of this number 188 were continuing members and 12 were new members

We had 64 members that paid in 1998 (or late 1997) but had not renewed for 1999 as of October 7, 1999.  They will be dropped on Dec. 31, 1999. I suspect that some are non-AMA members who joined when dues was $13.00.  The jump from $13.00 to $75.00 is significant.  See below for who paid what 1999 dues (paid in late  1998 or in 1999) . Note how few people paid the $75.00 rate.

Dues that the 1999 members paid:

 8 - unknown dues or paid an irregular amount (some missing information from the transition from the AMA)

46 paid $20.00 dues for residents/retired

83 paid $23.00 (dues that was paid for AMA members before 12/31/98)

35 paid $33.00 (AMA member dues paid after 12/31/98)

23 paid $65.00 ( non AMA active before 12/31/98)

  6 paid $75.00 ( non AMA active after 12/31/98)

The mean fee was therefore $30.00

 

Total revenue $6018 from dues

 

Note: AMA match for AMA members 129*$42.00  would be $5418

Of active members 81% reported being AMA members via the dues they sent in.

For those who have not received AAPHP News by email here are some recent items: (Both items were originally from AMA letters to our organization.)

Item 1:  The AMA is looking for up-and coming physician leaders to participate in the AMA - 2000 AMA/Glaxo Wellcome Emerging Leaders Development Program: NLDC .  Fifty physicians will be selected to participate in the conference March 25, 2000.  For additional information check the web page at: http://www.ama-assn.org/meetings/public/nldc2000/glax.htm

Item 2 The American Medical Accreditation Program, AMAP, requests our input as they  further implement their quality improvement activities, the Clinical Process and Patient Outcomes components of AMAP.  General information about this program is at http://www.ama-assn.org/amap.   They will be issuing a nationwide call for physician performance measurement systems that meet established Criteria for AMAP-compatible Physician Performance Measurement Systems.  In addition they are identifying performance measurement sets that systems will be required to adopt in order to become or remain AMAP-compatible.  This activity will promote standardization in physician-level performance measurement.  THEY ARE NOW CALLING FOR COMMENT ON THE DRAFT AMAP ADULT DIABETES MEASUREMENT SET. The primary purpose of the Measurement Set is to encourage improved patient care by ensuring physicians receive standardized, useful information about how they manage adult patients with Type 1 and Type 2 diabetes compared with established clinical recommendations and with their relevant peers.   They would like comments by October 29, 1999. The draft set is supposed to be available at the web site above, however it was not when I looked.  Therefore any one interested in reviewing these measurements may have to contact Karen Kmetik, PhD at 312-464-4221 or karen_kmetik@ama-assn.org for a copy of the document.  

OFFICERS

PRESIDENT

Douglas A. Mack, MD, MPH

Grand Rapids, MI

(616) 336-3020

(616) 336-3884 Fax

E-mail:  maupmack@iserv.net

VICE PRESIDENT

Mary Ellen Bradshaw, MD

Phoenix, AZ

(602) 528-3850

(602) 528-3840 Fax

E-mail:  mebmd@aol.com

PRESIDENT ELECT

Dave Cundiff, MD, MPH

Louisville, KY

(502) 456-6132

(502) 775-6195 Fax

E-mail: DCundiffMD@aol.com

SECRETARY

Virginia M. Dato, MD, MPH

(412) 422-9351

(630) 604-3256 Fax

E-mail:  vdato@aol.com

TREASURER

John Poundstone, MD, MPH

(606) 288-2486

(606) 288-2359 Fax

E-mail:  jpound@lex.infi.net

 

Note: The Board of Trustees includes all elected officers, editor of the Bulletin, the AMA delegate and the immediate past president.

BOARD OF TRUSTEES

Kathleen H. Acree MD, JD MPH

Sacramento, CA

 

C.M.G. Buttery MD

Urbana, VA

 

Erica Frank, MD, MPH

Atlanta, GA

 

R C. William Keck, MD, MPH

Akron, Ohio

 

Charles Konigsberg, MD, MPH

Alexandria, VA 

 

Rika Maeshiro, MD, MPH

Washington, DC

 

Alfio Rausa, MD, MPH

Greenwood, MS

 

Elizabeth Safran, MD, MPH

Atlanta, GA 

 

Marc A. Safran, MD

Atlanta, GA 

 

Marcel Salive, MD, MPH

Rockville, MD

 

 

PAST PRESIDENT

Joel L. Nitzkin, MD, DPA

New Orleans, LA

E-mail:  jln-md@mindspring.com

AMA Delegate

Jonathan B. Weisbuch, MD, MPH

E-mail: jbweisbuch@earthlink.net

AMA Alternate Delegate

Mary Ellen Bradshaw, MD

Young Physician AMA Delegate

Rika Maeshiro, MD, MPH

Young Physician AMA Alternate Delegate

Elizabeth Safran, MD, MPH

AMA Section Council Representatives

Erica Frank, MD, MPH

John Poundstone, MD, MPH

Web Master

C.M.G. Buttery MD

Ethics Chair

Kevin Sherrin MD

Co-Editor of Bulletin

Doug Mack, MD, MPH

Virginia Dato MD MPH

 

Address all correspondence to:

AAPHP

PMB#1720

P.O. Box 2430

Pensacola, Fl 32513-2430

Phone: 630-604-3256

Fax: 630-604-3256

Email: aaphp@iname.com

Web Page  http://www.aaphp.org

 

AAPHP's Fall Conference
Saturday,  November 6, 1999    8 AM to 5 PM  Hyatt Regency Hotel Columbus EF 151 E. Wacker Drive Chicago, Illinois
Gathering	Coffee	8 AM to 9 AM
General Membership Meeting	Highlights: Executive Committee Reports, AMA Delegation Report/ Medicine Public Health Initiative, Young Physicians  Report, Preventive Medicine Residency/ CCRC Update, Job Market Initiative Update, Tobacco Settlement Update	9 AM to 12 PM
Luncheon Speaker: Stephanie Zaza MD MPH	Topic: Application of Evidenced-Based Criteria to Community Health Education and Services. Dr. Zaza is Chief, Community Preventive Services Guide Development Activity, Centers for Disease Control and Prevention.	12 PM to 1 PM
Panel: Current Hot Topics for Public Health Physicians: Impact on Practice, Policy and Resources	·        Evaluating the Nation's Diabetes Control Efforts.  Mark Safran MD, Senior Medical Officer, Division of Diabetes Translation, Centers for Disease Control and Prevention ·        Tobacco-related Education: Do We Know What Works? Donna Grande, M.G.A., AMA ·        Evaluation of HIV and STD Outreach Programs, Ellen Sogolow Ph.D. , Health Scientist, Centers for Disease Control and Prevention ·        CPT Codes and the Practice of Public Health: Arvid K. Goyal  MD, AAPHP Representative to AMA CPT Advisory Committee Open Discussion	1 PM to 3 PM
Future Action Planning Session	AMA Resolutions Legislative Initiatives/Activities Other	3 PM  to  5 PM

It is not too late to attend. Email aaphp@iname.com or fax 630-604-3256 and then bring your check to the meeting.  Registration is $30.00 and includes lunch. Residents and students have the option of attending for free without lunch.