Weekly Updates: June 3, 2013

By admin3

From the Director

It's June! Lots of things happening in the next few weeks, so please look at Updates and also any email blasts that come from the med res office.  This week, we have Lauren Dincher's birthday (happy birthday Lauren!), JARs and SARs starting their last rotations of the year, RESIDENT RESEARCH NIGHT on Tuesday at 5:30 pm in the Searle Center, Mallika Dhawan and others presenting their documentary films on Wednesday at 6 PM at the Center for Documentary Studies, 1317 W Pettigrew Street, Nicole Greyshock's chief talk at Grand Rounds on Friday , the ACLT Graduation Dinner on Friday night and the SAR Dinner on Saturday night.  So, mark your calendars! Kudos this week go to Aaron Mitchell and Nancy Lentz for helping out their fellow residents who were gen med night JARs, to Armando Bedoya, Marianna Papademitriou, Tim Mercer, Ryan Nipp, Ryan Schulties and Jason Webb for helping with our last "How To Be A JAR" session and to George Cheely for a spectacular chief's grand rounds. Extra kudos this week to the following recipients of the APPLESEED AWARD, given by the medical students to residents who excel in teaching on the wards.  Thank you so much for your excellent work! Appleseed Award Recipients:  Hal Boutte, Matt Chung, Hassan Dakik, Alexander Fanaroff, Kedar Kirtane, Phil Lehman, Yvonne Mowery, Laura Musselwhite, Kevin Parrot, Lauren Prats Porras, Venu Reddy, Matt Summers, Iris Vance, John Wagener, Scott Westphal .  PLEASE ALSO TAKE TIME TO DO YOUR "SELF_EVALUATION" in Medhub.  Many of you have completed this and your advisors look forward to discussing it with you. Pubmed from the program this week goes to our residents who will be presenting at the upcoming resident research day

Wei (Denise) Duan-Porter, MD;  Autoimmune disorders in patients with B-cell chronic lymphocytic leukemia

Ann Marie Navar-Boggan, MD, Ph.D;  Effect of a Peer Assessment and Feedback Intervention on Blood Pressure Control in the Ambulatory Setting

Jason Rose, MD;  Blood Gene Expression Profiling Reveals An Association Between Viral Infection, Platelet Function, and Acute Myocardial Infarction

Looking forward to seeing you all on the wards and at the many events this week!

And not to be missed - kudos to Phil Lehman and Jon Menachem for reminding us about Seersucker Tuesday, and also to Xavier Preud'homme for his impeccable style.  Go out and get your stripes…Seersucker Tuesday recurs every week from now till September" Aimee [box]

What Did I Read This Week

(submitted by Suzanne Woods, MD  )

Perspectives of Physicians and Nurse Practitioners on Primary Care Practice

The New England Journal of Medicine, May 16,2013:  368; 20 p130-137

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Why did I read this article: As a combined medicine-pediatrics primary care provider I recognize the need for more trainees to enter into the practice of primary care as we truly have a shortage of such providers.  As a residency program director, I think it is critically important to offer trainees a great experience in outpatient primary care during residency to expand their knowledge of a career in this area.128708_suzanne_woods_prd Summary:   The National Survey of Primary Care Nurse Practitioners and Physicians was conducted from Nov 2011 to April 2012 and yielded data from almost 1000 providers (almost 50/50 between the two groups).  This was prompted by the proposals current being discussed to expand the supply and scope of practice of NP’s to address the increased demand for primary care physicians. Results revealed that:
  • Physicians reported working longer hours, seeing more patients and earning higher incomes compared to nurse practitioners.
  • 80.9% of NP’s surveyed worked in a practice with an MD but only 41.4% of MD’s work in a practice that employs NP’s.
  • NP’s feel they should be able to lead medical homes, have hospital admitting privileges, and be paid equally for the same clinical services as physicians. Physicians disagree with these attitudes/thoughts by NP’s.
  • When asked “do you agree with the statement that physicians provide a higher-quality examination and consultation than do nurse practitioners during the same type of primary care visit”  physicians agreed 66.1% and NP’s disagreed 75.3%. Far from being in agreement!
  • Turns out that the respondents attitudes differed significantly on every measure of policies and practices related to the scope of practice.  It is clear that the training, credentialing, and professional education culture of the preparation for the respective two career paths are different.
Take home points:
  • The proposal to expand the primary care workforce and scope of practice by employing more NP’s is controversial.
  • MD’s and NP’s do not agree about their respective roles in the delivery of primary care.
  • There are very polarized views on this topic and unclear if this study will help or “further inflame the rhetoric that has been offered by some leaders of the two professions”.
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From the Chief Residents

Grand Rounds

Date                  Chief Resident Grand Rounds May 31             Nicole Greyshock, MD

Noon Conference

Date Topic Lecturer Vendor
6/3 Stead Society   Noon Conference 2002, 8253, 8262,4275, 2270 The Pita Pit
6/4 Townhall Chiefs Sushi
6/5 IM-ED   Combined Conference: medical challenges of space James Logan Saladelia
6/6 Acute   phase reactants; how to intepret in select rheum diseases Sam Dalvi Moe's
6/7 Chair's   Conference Chiefs Chic-fil-A

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Maestro - How to Make it Work For You

(submited by Clay Musser, MD and Brian Griffith, MD)

[/box] The go live date is 3 weeks away, and the number of training sessions that everyone has participated in is almost mind boggling.  So, what's left to do? The implementation team will be presenting a series of "hot topics" at the front end of noon conference starting this week.  Please make every effort to attend. Maestro Noon Conference Presentations
  • June 6th – Treatment Team & System Lists
  • June 7th – Rounding/Handoff Reports
  • June 10th – Medication Reconcilation
  • June 14th – Insulin Orders/Ordersets
  • June 19th – Core Notes / Smartphrases
  • June 20th – Core Ordersets
  • June 21st - Cutover/Go-LIVE
The team would also like to extend an open invitation to everyone to consider participating in one of 4 GenMed Specialty Labs that Clay and Brian will be doing for the hospitalists.  If you would like to know more and inquire about space for attending, please email Brian directly.  The date/time for these sessions are below.  Each will be in the Eye Center Mobile Classroom.
  • June 5th 4-5:30pm
  • June 7th 5-6:30pm
  • June 17th 5-6:30pm
  • June 18th 4-5:30pm
And finally, the Personalization Labs also are offer a great opportunity for you to fine tune your skills.  You can find a date/time that will work for you by using the following link? https://intranet.dm.duke.edu/sites/medicine.duke.edumedicine.duke.eduMaestroCare/SitePages/Articles/May13_Wave4_PersonalizationLabs.aspx [divider]

From the Residency Office

TSMA (work done inside Duke for extra compensation)

The program fully supports Duke’s policies regarding moonlighting as delineated in the Trainee Manual and Benefit Guide found on the GME website.  At no time may the hours allocated for TSMA activities negatively impact training or violate duty hour policies.  Residents who would like to be considered for Temporary Special Medical Activity (TSMA) in Oncology, Emergency Medicine, or Student Health  must meet the following: 1. Program level – either JAR or SAR 2. Successful completion of rotations on MICU and Gen Med 3. Be in good standing and without any active corrective action 4. Provide written support from their advisor supporting the trainee’s request. The advisor may send an email to the attention of the Program Director, copy to the Program Coordinator, confirming their approval (to be completed prior to initiating the online TSMA form). 5. Initiate the online TSMA form found on MedHub. On notification of approval by GME, the trainee may contact the service Director and request approval to participate in the TSMA service. Please Note: TSMA is approved only for each academic year. If you are currently participating in TSMA and plan to continue after July 1, you will need to resubmit the required forms for approval.   Men in Pink

Addition to Our Families (submitted by Phillip Lehman and Brett Goodwin)

One more picture to share with everyone - and as for me, seeing two of our residents in "pink" is priceless Enjoy!!!!

SAR Board Review Schedule

Only two more sessions remaining.  The reviews are being held in the MedRes Library, Duke North, 8th Floor. Please contact Megan Diehl or Jeff Clarke if you would like to attend.
Date Topic Faculty
5-Jun Dermatology/Rheumatology Dr. Criscione
11-Jun Mixed Bag (Medical ethics, Palliative Medicine, Psych) Dr. Zaas, Chiefs

CRQS Community

Reminder - the VA Chief Resident Quality and Patient Safety presentations are happening this week - June 4th and 5th. Ryan Schuleits (Improving Care for Veterans Presenting with Chest Pain) will be presenting on June 4th @ 15:20. Sessions will be held in the 8th floor conference room of the VA Medical Center.  The following link provides the full schedule of presentations: CRQS- 2013 Schedule of end of year presentations

How to Achieve Fluid and Environmental Balance

This heading might not be medically accurate, but we think the outcome is - to help safeguard our environment while maintaining adequate levels of hydration.   You might recall that severals weeks ago we reported that the program goes through over 18,000 bottles a year, and water dispensers started appearing in the Med Res and ACR office, as well as a new coffee machine with more options. Gnome H2OWe really feel committed to making a change, and as of this week will discontinue buying cases of bottled water.  We also have been exploring options that can help with the transition.  Check out the picture of Mr. Gnome, who you will see is sampling his favorite beverage from a water pouch - refillable, reuseable, collapses to fit in a pocket, comes with a carabineer to hang from "whatever", and even includes a spot for your name.  So, if you like the idea and want to have a "container of water" at hand - for meetings, lunch, what ever - the first batch will be available to distribute to residents starting this week.  Just stop by the office and ask.  If we go through the first order, which we really expect might be the case, we will get more to have on hand.

Contact Information/Opportunities

Northern Maine IM Hospitalist Columbia Presbyterian Medical Center

Upcoming Dates and Events

  • June 4:  Resident Research Conference, Searle Center
  • June 7:  Chief Grand Rounds - Nicole Greyshock, MD
  • June 8:  SAR Dinner, Hope Valley Country Club
  • June 14:  Chief Grand Rounds - Jason Webb, MD
  • June 21:  Chief Grand Rounds - Jeffrey Clarke, MD

Useful links

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