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Chair’s report: ACOG leadership in the 21st century

Dr. J. Martin TuckerJ. Martin Tucker, MD

The ACOG Executive Board recently reviewed the report of the Presidential Initiative on Leadership in the 21st Century. This initiative, established in 2012 by then-ACOG President James T. Breeden, MD, assessed how to develop the next generation of ACOG leaders.

While we wait for the final recommendations from this initiative, I think it’s pertinent to review the many opportunities that already exist for members to become involved in ACOG activities and to become leaders.

Fellows and Junior Fellows often ask, how do I get involved? My answer is, if you are an ACOG member, if you pay your annual dues, if you read the Green Journal, Practice Bulletins, or Committee Opinions, or hand out ACOG patient education information in your office—you are involved.

The real question is how one becomes more involved. First and foremost, go to meetings. Meet your colleagues and your section, district, and national leaders and share information and ideas. There are ample opportunities to attend meetings throughout the year. The Alabama and Mississippi Annual Section Meeting is in Sandestin, FL, in May, and the Arkansas, Kansas, Missouri, and Oklahoma Annual Section Meeting is in Ridgedale, MO, (near Branson) in June. The Annual Clinical Meeting is in Chicago in April. And, don’t miss the Annual District Meeting in Indianapolis in October. This combined meeting with District V promises to be a great event.

Beyond meetings, District VII offers many opportunities for more involvement. There are funded opportunities to attend the Congressional Leadership Conference in Washington, DC, Hays Fellowships to attend the Robert C. Cefalo Leadership Institute in Chapel Hill, NC, and Hollis Fellowships to attend the Annual District Meeting each year. 

Next year, District VII will choose a McCain Fellow to spend two weeks in Washington, DC, working with the ACOG Government Relations and Outreach department. You will receive more information about the application process for the McCain Fellowship in the coming months. I encourage you to contact me or your section leadership if you have an interest in one or more of these opportunities for 2015 and beyond.

Each year, the incoming ACOG president makes appointments to the numerous national ACOG standing committees. The simple application process can be completed through the ACOG website. The process starts in June with an application deadline of August 1. Committee work is an excellent way to become more involved in ACOG.

In District VII, each section has its own governance. Depending on the section, there may be opportunities to serve on a section committee, as a regional representative within the section or as a legislative liaison. Section activities often require less travel, but can, nevertheless, be very rewarding.

Of course, section- and district-elected leadership positions are open to any Fellow in good standing who lives within the geographic boundaries of District VII. We are now entering the 2015 election cycle. District VII and the Mississippi, Arkansas, and Tennessee Sections will elect their officers during this cycle. You will receive a call for candidates via email in the coming weeks. The deadline for candidacy application is June 2. 

Some folks say, I really want to become more involved, but I really don’t have the time. The simple solution is to become involved through financial support. Consider becoming a member of Ob-GynPAC, ACOG’s federal political action committee. Ob-GynPAC supports many women’s health issues at the state and federal levels.

Don’t like politics? Then support ACOG development efforts through annual giving, planned giving, or endowment opportunities. Better yet, make a gift to the District VII endowment fund—the Pete and Weesie Hollis Educational Endowment Fund, which supports Junior Fellow educational activities within the district.

Stay involved. Get more involved. Become an ACOG leader in the 21st century. I look forward to hearing from you. 



2014 Annual District Meeting: Join us in Indianapolis

Dr. Grant R. CoxGrant R. Cox, MD, District VII secretary and program chair

“How are you rated, and who’s keeping track?” These questions will be two of many answered at the upcoming Annual District Meeting.

The meeting will be held with District V, October 10–12, in Indianapolis. The city is family friendly, featuring the nation’s largest children’s museum, the Indianapolis Motor Speedway (home of the Indianapolis 500), and multiple museums and sporting events. The meeting will start on Friday afternoon, to allow for Friday morning travel, and will conclude on Sunday. The schedule has been designed with families and free time in mind. The meeting will take place at the JW Marriott, which was chosen to facilitate walking to most downtown and family attractions. 

The scientific program will feature a number of interesting lectures. ACOG Treasurer Scott D. Hayworth, MD, president and chief executive officer of Mount Kisco Medical Group in New York, will tell us how we are being rated by patients, employers, and peers. Cornelius O. “Skip” Granai III, MD, director of women’s oncology at Women & Infants Hospital of Rhode Island, will discuss controversies in ob-gyn with a presentation titled “Snakes, Bugs, and Us.”

The Dan Thorton Lecture will be given by Gary D.V. Hankins, MD, chair and professor of ob-gyn at the University of Texas Medical Branch in Galveston, on neonatal encephalopathy. Dr. Hankins will also offer a lecture on 10 clinical diamonds for preventing maternal death. Anthony L. Shanks, MD, assistant professor of maternal-fetal medicine at Washington University in St. Louis, will cover medical apps in ob-gyn, as we all love our phones.

Our own Nirupama K. DeSilva, MD, Oklahoma Section chair, will discuss abnormal bleeding in adolescents. Ted L. Anderson, MD, PhD, immediate past District VII chair, will participate in a debate on vaginal and robotic hysterectomies. James N. Martin Jr, MD, past ACOG president and past District VII chair, will be part of a team of speakers on new preeclampsia guidelines. Sunday will be devoted to implementation of ICD-10 diagnosis codes, featuring J. Martin Tucker, MD, District VII chair.

Save the dates now for what is sure to be an unforgettable meeting! I hope to see you there.



Junior Fellow news

Dr. Sara C. WoodSara C. Wood, MD, District VII Junior Fellow chair

Finally, it appears spring is here, which means the Annual Clinical Meeting is just around the corner! Two new Junior Fellow programs will be held on Sunday, April 27. A seminar by American Board of Obstetrics and Gynecology leaders will be followed by an afternoon dedicated to discussions on life after residency, or transitioning from training to practice. If you are in residency, a fellowship, or have yet to pass your oral boards, please come to these programs for valuable information.

I hope many of you will be able to attend the ACM. It’s always an educational, fun meeting. If you’re available, please stop by our District VII gathering and meet Fellows and Junior Fellows from across our district. The time and place will be available in the ACM final program.

District VII leadership continues to plan and prepare for the upcoming academic year and our joint Annual District Meeting with District V in October. We have several events planned, including a leadership course for Junior Fellows, a residency fair for medical students, and a community service project that will “exercise” all our skills—a fun run! The meeting is a great place to share your resident and fellow research projects. I recommend submitting your research for a presentation. More information will be available on the District VII website soon.

One of the greatest efforts from the Junior Fellow leadership this year will be to strengthen and connect Fellow and Junior Fellows across the district through social media. Kayla R. Fontenot, MD, District VII Junior Fellow vice chair, has been posting quite a bit on the District VII Facebook page. Please “like” the page now if you haven’t yet already. Future plans for the page include posts about residency programs and ACOG leaders in our district. We hope to engage members and inspire everyone to become more active in ACOG. 

ACOG offers more opportunities to members than I can describe in this article. Many of you are aware of the educational papers, meetings, and other benefits we receive. However, I would say the greatest gifts ACOG has provided me are the mentors I have in our district and the advice they’ve given me. District VII Fellows are committed to the engagement and opinions of Junior Fellows and continue to embrace the ideas and opportunities we brainstorm. It is through their encouragement that each of us is able to grow as a leader, physician, educator, and surgeon. 

Today, go find your mentors, and thank them. Let them know how they have impacted your career, your goals, and your desire to be a women’s health care advocate. As you move from residency or fellowship, look to your district or section leaders, and seek out new mentors. No matter what our subspecialties are, we are all united as ACOG members and ob-gyns.



Young physician report

Dr. Stacey L. HolmanStacey L. Holman, MD, District VII young physician

I have been unlucky in my travels so far this year. I wasn't able to attend the Interim District Advisory Council Meeting in Memphis, TN, due to cancelled flights out of New Orleans. The priorities of young physicians remain how to find representation to fill leadership positions and how to establish renewed interest in ACOG. We also need to develop a network for improving communication among physicians during this time in our careers.

I will be attending the Annual Clinical Meeting in Chicago in April and hope to learn some new insights at the young physician meeting. Please consider attending the 10th Annual Young Physician Breakfast Forum at the ACM. Highlights from last year’s forum are on the young physician website.

I appreciate the district’s continued support of young physicians. I will have more information to share at the Annual District Meeting in Indianapolis in October.



National leader challenges District VII to reduce teen pregnancies

Forrest Alton
Forrest Alton

Forrest Alton, MSPH, chief executive officer of the South Carolina Campaign to Prevent Teen Pregnancy (SC Campaign), reported recent data on teen pregnancy at the Interim District Advisory Council Meeting in Memphis, TN, in February. According to Mr. Alton, six of the 10 states with the highest teen birth rates in the US are states in District VII.

In his role at SC Campaign, Mr. Alton leads the efforts of a nationally-recognized team to transform South Carolina by investing in young people. He is a national leader in issues of adolescent sexual health and teen pregnancy prevention.

Grant R. Cox, MD, District VII secretary and program chair, recently spoke with Mr. Alton about teen pregnancy prevention, including the critical role ACOG members play.

We heard a balance of two messages in your presentation at the Interim District Advisory Council Meeting. The US has made great progress in the prevention of teen pregnancies, but we still have a lot of work left to do. How can both be true?
On the national level, we’ve seen a decrease in the teen birth rate of more than half (54%) in the last 20 years. This decline is one of our nation’s greatest public health success stories, yet nobody is talking about it. Certainly, one of the reasons nobody is talking about it centers around the fact that the US still has one of the highest rates of teen birth in the industrialized world—and several states are lagging behind the progress we have seen nationally.

The news in District VII isn’t as positive as in other parts of the country. To this end, having conversations like the one we had at your interim meeting—bringing awareness to the issue, discussing solutions, and acting on those discussions—is critically important.

What are some solutions relative to the ACOG community?
Teen pregnancy is a complex issue that requires complex solutions. With that said, it’s obvious that physicians play a critical role in prevention. That role may include working to improve the teen-friendliness of their clinics or practices, ensuring affordable access to contraception (especially long-acting reversible contraception), and/or helping to improve conversations between teen patients and their parents. Physicians should be more involved in their communities, stepping outside of their practice walls and being consistent voices about the importance of providing medically-accurate, age-appropriate information on the topics of teen pregnancy and adolescent health. 

You stated in your presentation that there are long-term and widespread implications of teen pregnancy to the life course of teens into adulthood and also to society at large. Can you elaborate?
When children have children, we know that the life course of at least two generations is impacted. If we are serious as a nation about increasing graduation rates, decreasing poverty, improving health outcomes, and strengthening families, then we have to be more willing to discuss the issues of adolescent sexual health and pregnancy prevention.



District VII lobbies Congress on ob-gyn issues

Dr. Dana G. StoneDana G. Stone, MD, District VII legislative chair

Thank you to all the District VII members who attended the Congressional Leadership Conference (CLC), March 2–4, in Washington, DC. The meeting grows every year with new and returning members eager to learn about current ACOG legislative priorities. This year’s theme, “Spotlight on the Center,” gave members from each section in the district a chance to hear from moderate legislators in both parties.

In addition to general advocacy training, attendees learned about ACOG’s specific legislative goals for the year:  

  1. Medical liability reform that gives physicians protection from lawsuits when they follow medical guidelines
  2. A permanent repeal and replacement of the flawed sustainable growth rate formula for physician payment under Medicare
  3. An increase in residency slots to address the developing physician shortage
  4. Inclusion of ob-gyns in the Medicaid payment increase for primary care providers

Members from each section met with their representatives and senators to urge them to support these issues.

The Ob-GynPAC party at the historic Daughters of the American Revolution National Headquarters gave everyone a chance to relax and raise funds for ACOG’s federal political action committee. The PAC is bipartisan and effective at helping elect friends of medicine to Congress. Last election cycle, the PAC raised more than $1 million, which gave ACOG a great deal of recognition on Capitol Hill. The PAC is well on its way to reaching the $1 million goal again.

All ACOG members and spouses can contribute to the PAC and relay information about candidates who deserve its support. Contact me if you have questions about the PAC or would like to contribute. (You will not be favored or disadvantaged by reason of the amount of your contribution or a decision not to contribute. Contributions from foreign nationals are not permitted.)

J. Martin Tucker, MD, District VII chair, has challenged each section to send at least four ACOG members to the CLC next year. The district and sections help sponsor some attendees, though all members are welcome to attend. Next year’s CLC will be held March 8­–10. Let me know if you have an interest in attending. You will find it a fascinating way to learn about ACOG’s policies. Members are often surprised at how much they enjoy meeting with members of Congress. Let’s rise to the challenge and have each section send four new or returning members to the CLC next year.



District Advisory Council welcomes new Kansas and Missouri Section chairs

Dr. Kathryn E. Sawchak
Dr. Kathryn E.
Sawchak

The District VII Advisory Council is composed of representatives from each of its nine sections. Every year, two to three sections rotate new members onto the council. Each section representative has a three-year term. This rotation provides continual renewal with new members while maintaining history with more senior members. The council is led by four district officers who also have three-year terms. The district encourages all ACOG members to get involved with their sections and consider one of the many available local leadership roles.

Kathryn E. “Kassie” Sawchak, MD, is the new Kansas Section chair and representative on the District Advisory Council. She is in private practice in Hutchinson, KS. Her practice includes management of an office and an outpatient surgery center. Thus, she understands the range of issues affecting office and institutional practice, as well as the current challenges of the business of medicine. In addition to her busy practice responsibilities, Dr. Sawchak is a wife and mother who finds time to train for and run half marathons. As Kansas Section chair, Dr. Sawchak hopes to engage more ob-gyns in the Kansas Section.

Dr. Octavio R. Chirino
Dr. Octavio R.
Chirino

Octavio R. “Tavo” Chirino, MD, is the new Missouri Section chair and representative on the District Advisory Council. He has been in private practice since 1977 and also chairs the department of ob-gyn at Mercy St. Louis, where he is committed to the development of new and innovative women’s services. As an active outdoor enthusiast, Dr. Chirino often rides bicycles with his wife on trails in the St. Louis area. During his tenure, Dr. Chirino hopes to involve many physicians in the legislative process in Missouri.

Drs. Sawchak and Chirino encourage the physicians of their sections to join them at the combined Arkansas, Kansas, Missouri, and Oklahoma Section Meeting at Big Cedar Lodge near Branson, MO, June 13–14.




District VII Donald F. Richardson Memorial Prize Paper Award winner

Dr. Nelson C. Echebiri
Dr. Nelson C.
Echebiri

Nelson C. Echebiri, MD, a recent ob-gyn resident at the University of Oklahoma in Tulsa, is one of two Junior Fellow winners of the 2013–14 Donald F. Richardson Memorial Prize Paper Award. He will present his paper titled “Placental Alpha-Microglobulin-1 and Combined Traditional Diagnostic Test: A Cost-Benefit Analysis” at the Annual Clinical Meeting in Chicago in April. His co-authors are M. Maya McDoom, PhD, MPH; Jessica Pullen, MD; and Nora M Doyle, MD, MPH.

Dr. Echebiri was drawn to his research subject after an experience with a patient who ruptured membranes at 32 weeks’ gestation. This particular patient had negative traditional testing of vaginal pooling, ferning of fluid, and ultrasound evaluation of amniotic fluid. However, Placental Alpha-Microglobulin-1 (PAMG-1) was positive. This finding led Dr. Echebiri to study PAMG-1 in comparison to traditional testing. The findings of this study were particularly surprising as PAMG-1 was discovered to be the best first test used over traditional testing.

Dr. Echebiri matriculated to America from Nigeria in 2002. He received his undergraduate education at Lincoln University in Jefferson City, MO, and completed his medical degree and Master of Business Administration from the University of Kentucky in Lexington. He currently resides in Buffalo, NY, with his wife, Dr. McDoom, where he is completing an ob-gyn residency at the University of Buffalo. Dr. McDoom has a joint post-doctoral position between the Social Science Research Center at Mississippi State University and the department of global health and population at Harvard School of Public Health.



GirlSmarts website celebrates two-year anniversary

GirlSmartsGirlSmarts is a website for adolescents to explore their health behaviors. The site averages 10,000 to 15,000 visits per month, which is a tremendous increase from when it began two years ago, reports Nirupama K. DeSilva, MD, Oklahoma Section chair. Overall, 189,500 people have viewed the site. Approximately 93% of visitors are new, and they come from 13 countries.

According to Dr. DeSilva, the frontal cortex of the teenage brain—the part that understands consequences of behaviors—is underdeveloped. GirlSmarts allows teens to access high-risk situations in a web-based format, prior to potentially experiencing these situations in real life. The site gives teens time to formulate their actions and decrease risk-taking behavior. Further, the question portion of the site offers teens accurate answers to commonly asked questions.

Dr. DeSilva was the primary developer of the site with web designer GiantSky. A grant from District VII helped with the initial and current funding. A mobile app is currently in development and is expected to launch in late spring or early summer. 



Section reports

ArkansasArkansas
Stephen F. Lefler, MD, section chair

Arkansas Section leaders have been busy planning and attending meetings. William “Sam” Greenfield, MD, section vice chair, and Ashita Gehlot, MD, section Junior Fellow chair, represented Arkansas at the Congressional Leadership Conference, in Washington, DC, in March. I attended the Interim District Advisory Council Meeting in Memphis, TN, in February.

Dr. Greenfield and I have been working with Kathryn E. Sawchak, MD, Kansas Section chair, Octavio R. Chirino, MD, Missouri Section chair, and Nirupama K. DeSilva, MD, Oklahoma Section chair, on plans for our combined Annual Section Meeting at Big Cedar Lodge near Branson, MO. The meeting will be held June 13–14, and we expect it be another great event. I hope many of our members can attend.

 

KansasKansas
Kathryn E. Sawchak, MD, section chair

For the next three years, I will be serving as section chair, and Melissa Hague, MD, will be serving as section vice chair. Our goals during this time are to promote more involvement from Fellows statewide and to facilitate growth and leadership among Junior Fellows. Your thoughts and ideas are welcome. Feel free to contact us with your ideas or concerns.

Dr. Hague and I attended the Interim District Advisory Council Meeting in Memphis, TN, in February. Topics such as elective deliveries prior to 39 weeks’ gestation, upcoming challenges with ICD-10 implementation, and differences among states regarding tort reform were discussed.

The March of Dimes and Kansas Department of Health and Environment are working to reduce overall preterm births rates in Kansas. The Kansas Perinatal Quality Collaborative will work to develop a plan to enforce a hard stop on elective deliveries prior to 39 weeks’ gestation. The concern regarding ICD-10 implementation is payment delays, which could significantly impact medical practices.

The $250,000 cap on non-economic damages in Kansas was recently challenged. The Kansas Supreme Court upheld the cap. The court’s ruling signaled two necessary actions for those wanting to preserve the cap and its protection. The first action is to increase the amount of the cap. The second action is to participate in purchasing professional liability insurance from the Kansas Health Care Stabilization Fund as a defined health care provider.

The Kansas Medical Society has proposed to increase the cap incrementally over an eight-year period to $350,000. This action would cause an increase in insurance premiums over this period. Currently, the average liability policy for $1 million/$3 million coverage in Kansas is approximately $36,350.

Our Annual Section Meeting will be held with the Arkansas, Missouri, and Oklahoma sections at Big Cedar Lodge near Branson, MO, June 13–14. All our Kansas colleagues are invited to join us for a fabulous conference and to get involved in the meeting’s planning.

We look forward to interactions with more of our members. Together we can make a difference!

 

LouisianaLouisiana
William D. Binder, MD, section chair

Money drives everything, and we live in a time of tight money for health care. In Louisiana, Gov. Bobby Jindal has cut hundreds of millions of dollars from higher education and health care. Poor perinatal outcomes are a huge expense for our state, and state government officials don’t think they’re getting their money’s worth.

In the last year, I’ve been to meetings sponsored by the National Governors Association, Louisiana Department of Health and Hospitals and Institute of Healthcare Improvement, Capital Area Human Services District, and March of Dimes. I have acted on behalf of Woman’s Hospital in Baton Rouge to improve outcomes in our service area.

Few ob-gyns attend these meetings or are even aware they take place. I’ve learned a few things from these meetings. First, Louisiana is almost dead last in every perinatal measure. The March of Dimes again gave Louisiana a failing grade for prematurity. Though, our rate of 15.3% was a slight improvement over the previous rate of 15.6%.

Second, I now really appreciate the difference between the practicing ob-gyn view of the world and the public health view of the world. It is helping one person at a time vs. helping millions at a time. I always thought I was doing a good enough job until I started seeing the numbers.

As an individual ob-gyn, I never saw elective inductions as a problem. We now know that a hard stop on elective deliveries prior to 39 weeks’ gestation has improved outcomes, reduced unexpected admissions to neonatal intensive care units by 20%, and saved the health care system millions of dollars.

There will not be change without measurement. And to continue to improve, we have to decide where we want to end up, what changes can help us get there, and most importantly, what to measure to ensure that our changes are an improvement.

The Louisiana Section will have new officers take over at the Annual District Meeting in October. We will welcome Kathleen T. Sullivan, MD, as section chair, Marshall S. St. Amant, MD, as section vice chair, and Robin B. Bone, MD, as section secretary-treasurer.

Gary M. Agena, MD, was our only representative at the Congressional Leadership Conference, in Washington, DC, in March. The conference was held at the same time as Mardi Gras, so it was difficult finding anyone available to go. The Louisiana Annual Section Meeting was held on March 22 in New Orleans, with J. Martin Tucker, MD, District VII chair, and James N. Martin Jr, MD, past ACOG president and past District VII chair, as speakers.

 

MississippiMississippi
Wayne A. Slocum, MD, section chair

The Mississippi Section is eagerly awaiting its Annual Section Meeting with the Alabama Section in lovely, sun-drenched Sandestin, FL, May 8–11. The program includes preeminent speakers in our specialty, as well as past and present ACOG leaders. We plan to honor Helen B. Barnes, MD, as a legend in ob-gyn for the state of Mississippi. There should be plenty of time for social activities as well, so please come on down and see us on the beach. We’ll do our best to make sure you’re glad you came.

 

MissouriMissouri
Octavio R. Chirino, MD, section chair

The Missouri Section welcomed new officers at the 2013 Annual District Meeting in September. I assumed the role of chair and am looking forward to a productive, educational three years on the Section Advisory Council. The new section vice chair is Peter B. Greenspan, DO, and the new section secretary-treasurer is Ravi S. Johar, MD.

The Section Advisory Council has met twice via teleconference since September and discussed a variety of issues affecting the state. We recently ratified an update of the section policies and procedures. Section leaders are busy planning for our Annual Section Meeting with the Arkansas, Kansas, and Oklahoma sections. The meeting will be held at the beautiful Big Cedar Lodge near Branson, MO, June 13–14. This joint effort has been successful for us all and enables a more efficient use of our combined resources.

Legislative efforts this year will focus on tort reform and reversing damage done by the Missouri Supreme Court in July 2012 when it declared medical non-economic liability award caps unconstitutional. We continue to work with a lobbyist group hired over the last few years to help us communicate with the Legislature. The group will work in tandem with the Missouri State Medical Association on this issue in 2014.

In addition, we will continue to push oversight legislation to have only adequately trained and licensed midwifery providers offering obstetric care to patients in Missouri. Other issues we will follow closely in the Legislature are Medicaid transformation, advanced practice registered nurse independent practice, and prescription drug monitoring.

Dr. Greenspan, Beth A. Rasmussen, MD, and Simon P. Patton, MD, District VII Junior Fellow secretary-treasurer, attended the Congressional Leadership Conference, in Washington, DC, in March to represent the section in national legislative efforts.

The Missouri Women’s Health Advocates Political Action Committee is seeking donations from Missouri ob-gyns to help move our legislative efforts forward. Because of the nationwide implications of tort reform efforts in Missouri, we have sought help from District VII as well. Missouri continues to work with state pediatricians to collaborate on issues of mutual interest.

 

OklahomaOklahoma
Nirupama K. DeSilva, MD, section chair

Lydia D. Nightingale, MD, section secretary-treasurer, Katherine C. Arnold, MD, section Junior Fellow vice chair, and I are working to improve health education in Oklahoma City and rural areas of our state. We’ve made several contacts regarding the introduction of sexual education into Oklahoma City schools. We’re also meeting with local organizations that house teen clinics within high-risk schools to obtain objective data demonstrative of the usefulness of the proposed health education. Lastly, the Oklahoma Institute for Child Advocacy in Oklahoma City plans to partner with the Oklahoma Section to teach medical students advocacy and to work on best practices for teen pregnancy prevention. 

Tulsa now has a sexual health education curriculum established in the majority of its schools. The Campaign to Prevent Teen Pregnancy was initiated in Tulsa in late 2013. Grant R. Cox, MD, District VII secretary and program chair, and I, on behalf of the Oklahoma Section, continue to be intimately involved in this campaign through speaking engagements with the community on this topic and assistance with the initiation of teen-friendly clinics.

The GirlSmarts website is growing on an international level and being increasingly used as a resource for teens in health education. We are working to overhaul the site to make it even more teen friendly and accessible. We also continue to add to the question-and-answer databank where teenage girls can get answers to common health questions. 

With the assistance of our lobbyist and the leadership of Mark C. Genesen, section vice chair, we are moving toward making legislative allies with representatives and senators within the Oklahoma government. We also are bracing ourselves for the current legislative session.

Our Annual Section Meeting will be held with the Arkansas, Kansas, and Missouri sections at Big Cedar Lodge near Branson, MO, June 13–14. I hope many of you can attend.

 

TennesseeTennessee
Christopher T. Welsch, MD, section chair

As you are well aware, there are many evolving dynamics in the practice of medicine, and we are all in this together for the benefit of our patients. A few items of note, specific to our state:

  • The cost of a $1 million/$3 million liability policy has decreased from previous years, mostly due to legislation that remains in place, despite challenges to similar laws in surrounding states
  • Caps on damages still exist. A $750,000 cap on non-economic damages ($1 million in catastrophic injury cases) was enacted in 2011 and became effective in 2012. The cap has not been challenged in appellate courts yet
  • There is a federally-administered health insurance exchange in Tennessee, and the state government has chosen not to participate in Medicaid expansion under the Affordable Care Act
  • There are no Medicaid medical home products in Tennessee at this time. Ob-gyns are not designated as primary care physicians in commercial medical home products. Moreover, ob-gyns are not designated as approved providers for preventive exams for female Medicare patients

Each section within ACOG has three officers—chair, vice chair, and secretary-treasurer, all of which are three-year positions. The next Tennessee officer rotation will occur in the fall of 2015. The deadline for submission of election materials is June 1, 2014. A call for candidates will be sent from the national office this spring. The Nominating Committee will meet in the fall of 2014, and chosen nominees will be notified subsequently. We welcome anyone who is interested in serving the members of our section to submit election materials. Please feel free to contact any of the current officers if you have questions about these positions.

The section is returning this year to a regionalized section meeting format, sponsoring programs throughout the state in conjunction with local ob-gyn societies. We recognize the constraints of professional life, limitations on time away from a busy practice, and absence of need for formalized continuing medical education given the American Board of Obstetrics and Gynecology Annual Board Certification process. We are formatting these meetings accordingly.

The first meeting this year was a dinner program in conjunction with the Memphis Ob-Gyn Society in February. It featured ACOG President Elect John C. Jennings, MD, Gerald F. Joseph Jr, MD, ACOG vice president of practice activities and past ACOG president, and J. Martin Tucker, MD, District VII chair, as speakers. The second meeting was held in April in Knoxville and welcomed Ted L. Anderson, MD, PhD, immediate past District VII chair, as a speaker.

Gov. Bill Haslam has chosen to pursue a model similar to the one currently in place in Arkansas to address costs associated with delivery of health care. This approach establishes specific “episodes of care” for which different stakeholders are designated as “quarterbacks” and are responsible for the overall cost of delivery of that service. The intended goal is to provide savings sharing, quality control and assessment, and eventually cost-overrun accountability. Interestingly, one of the first three episodes of care and its respective quarterback is perinatal care and ob-gyn.

We surmise that—out of more than 250 specified episodes of care—perinatal care was chosen because the government pays for more than 50% of deliveries statewide. The outcome of how this episode is defined and how the specific parameters are assessed has yet to be fully understood.

The Tennessee Initiative for Perinatal Quality Care is currently in the sustainment phase of its 39-week delivery project and is still enrolling sites for its project on optimizing antenatal steroid use. Work is ongoing on its breast-feeding initiative with hopes to develop another around managing and/or decreasing maternal hemorrhage. 

Bobby C. Howard, MD, Frank H. Boehm, MD, Giancarlo Mari, MD, and David Adair, MD, represent the section on the State Oversight Committee. Their annual meeting was in Nashville in February and featured Haywood L. Brown, MD, District IV chair, as a plenary speaker.

The section is committed to leadership training and facilitating interaction of our members with ACOG at the state, district, and national levels. To this end, the section will defer $100 of the cost of registration for any Tennessee Fellow or Junior Fellow interested in attending the Annual District Meeting in October.

The section will also support attendees to the Congressional Leadership Conference and Robert C. Cefalo Leadership Institute. These events are held each spring. Please contact any of your section officers by September 30 if you are interested in participating in 2015.

Are you a resident conducting clinical or lab research? Many opportunities exist to present your research on a local or district level, and the section has available funds to support these activities. Please have your program director contact a section officer for further information.

We appreciate the privilege of serving you. Please contact us at any time if we can be of assistance. I hope to see you at one of our section meetings or the ADM in October!



Calendar of events

2014

April
26–30
Annual Clinical Meeting
Chicago
Register today

May

8–11
Alabama and Mississippi Annual Section Meeting 
Hilton Sandestin
Sandestin, FL
Contacts: Harper Wood, 334-315-2668 or
harperwood@windstream.net;
Gail Seago, 601-954-0448 or
mssectionacog@gmail.com

22–25
ACOG Coding Workshop
Nashville, TN
Register today

June
13–14
Arkansas, Kansas, Missouri, and Oklahoma Annual Section Meeting
Big Cedar Lodge
Ridgedale, MO
Contact: Joetta Cunningham, 918-743-6184 or 
joetta@tcmsok.org

October

10–12
Annual District Meeting (with District V)
JW Marriott
Indianapolis
Contact: Emma Jellen, 202-863-2456 or 
ejellen@acog.org