News
Category I
New definitions of CME have been adopted by the AMA. These changes are the first since 1993 and are the result of converging regulatory forces on CME. The Category I designation is currently used by 48 of 50 states for licensure. JCAHO is using Category I designation as a measure of quality. Board re-certification for most specialties stipulate to a given number of Category I hours for admission to the Board and liability carriers are looking to Category I designation as a measure of continued competency.One can argue the validity of placing such emphasis on Category I designation. However, this convergence of authorities necessitated the AMA revisiting both the definition of CME and the methodology of designating activities as Category I.
The AMA has now placed under trademark protection the phrase "AMA PRA Category I Credit�". The symbol will be placed on CME offering for physicians to understand clearly that a certain standard has been met.
Several new delivery formats have been approved. ACMEC will begin to design a system for Point of Care learning as defined under the revised guidelines. This format when implemented will allow physicians up to � a credit for research directly related to patient management. The process is evolving and no specific system is in place however the potential of offer Category I is a major enhancement. We'll keep you informed as this new system unfolds.
CME Hours by Method
(Primedia Research, Medical Meetings, February 2006)
- Out of Town Meetings 37%
- Local Meetings 26%
- Online 6%
- Audio/Video Tapes 6%
- CD ROM's 3%
- Journals 15%
- Audio Conferences 1%
- Other 6%
What's Ahead
Idaho Academy of Physician Assistants, April 6-8, 2006
Idaho Academy of Family Physicians, May 18-20, 2006
Idaho Medical Association Meeting, July 14-16, 2006
Burkholder Lectureship in Oncology, April 19, 2006
Idaho Epilepsy Conference, June 16-17, 2006
Anderson Center - Wednesday, 8:00 a.m.
Mercy Medical Center - Wednesday, 12:30 p.m. - Winter Room
Centennial Room - Friday, 8:00 a.m.
CHEERS (Children's Hospital Education Enrichment Review)
MEMBERSHIP: The following members were approved:
Upcoming Events:
April 2006
May 2006
Extracts of the Saw palmetto berry are used by over 2 million men in the United States to treat symptoms of benign prostatic hyperplasia. Alpha blockade medications and five alpha reductase inhibitors to reduce the size of the prostate are also in widespread use. These medical therapies have reduced the number of surgeries required to treat this very common condition. Previous studies have different preparations of the saw palmetto berry have suggested benefit in BPH. A recent double blind trial by Bent and colleagues assigned 225 men over the age of 49 with BPH to a one year treatment of saw palmetto extract or a placebo. Their primary end points which were based on scores of the American Urologic Association's symptom index and the maximal urinary flow rates found that the saw palmetto did not improve symptoms or objective measures of BPH more than did the placebo. The incidence of side effects was similar in the two groups. An accompanying editorial by DiPaola argues that since herbs and dietary supplements are not under the FDA's watch it is the responsibility of physicians to inform their patients about the inherent risks and unproven benefits of most of these therapies. He argues that these herbal remedies ought to meet the same rigorous scientific evidence as all medications before one can recommend them. This trial was also funded by grants from the National Institutes of Health and the National Center for Complimentary and Alternative Medicine. Their advisory committee helped select the product to be studied. (N Engl J Med 2006 February; 354: 557-66)
The National Surgical Infection Prevention Project is aimed to reduced mortality and morbidities from surgical site infections. Bratzler etal recently published guidelines concerning this. These infections develop in 2-5% of patients undergoing clean extra-abdominal surgeries and after nearly 20% of patients who undergo intra-abdominal procedures. Physicians need to pay attention to these guidelines. The panel recommends that the antibiotic be administered as near at possible to the time of incision. Infusion of the first dose should be in sixty minutes or less before the incision with the exception of the fluroquinolones and vancomycin which should be initiated 120 minutes before incision. If a tourniquet is required such as in a total knee arthroplasty the infusion should be concluded before the tourniquet is inflated. There is no added benefit for multi-dose prophylaxis or prophylaxis given after the wound is closed. Whenever possible a single agent is recommended with the choice based on the type of surgery. The author's stress that these recommendations must be individualized for each situation and will change over time as bacterial resistance changes. The control of hyperglycemia and aggressive fluid resuscitation also reduces the rate of surgical site infection. (American Family Physicians 2005 November; 72: 2098-2100)
John J. Mohr, M.D.
St. Luke's Regional Medical Center - Wednesday 8am, Anderson Center
Mercy Medical Center - Wednesday 12:30pm
VA Medical Center - Thursday 8am, AW Horsley Learning Ctr.
St. Alphonsus Regional Medical Center - Friday 8am, Centennial Room
8 James Bowen, MD, Adjunct Associate Professor, Department of Rehabilitation; Associate Professor, Department of Neurology, University of Washington School of Medicine.
8 James Bowen, MD, Adjunct Associate Professor, Department of Rehabilitation; Associate Professor, Department of Neurology, University of Washington School of Medicine.
10 Alex Spyropoulos, MD, Clinical Associate Professor of Medicine University of New Mexico; Medical Director, Clinical Thrombosis Center, Lovelace Health Systems.
Tumor Boards
Mercy Medical Center - Tuesday, 12:00 noon
Saint Alphonsus Regional Medical Center - Thursday, 12:00 noon
Breast Care Panel-Saint Alphonsus RMC - Tuesday, 7:00 a.m.
St. Luke�s Regional Medical Center - Tuesday, 12:00 noon
Breast Tumor Board-St. Luke�s RMC - Thursday, 7:00 a.m.
MSTI Pediatric Tumor Board - 2nd & 4th Wednesday, 12:00 noon
Meridian Tumor Board - 1st & 3rd Thursday, 12:00 noon
1st, 2nd, 4th, Thursday, 8 a.m., Anderson Center - Ada -2
Provisional Membership:Jeffery Dzieckzowski, M.D.; Renee Bobrowski, M.D.; Sarah Hirsch, M.D.
April 15, ACMS Night at the Discovery Center (in conjunction with "Under Your Skin" display)
Jacob, age 92, and Rebecca, age 89, living in Florida are all excited about their decision to get married. They go for a stroll to discuss the wedding and on the way they a pass drug store. Jacob suggests they go in.
Jacob addresses the man behind the counter. "Are you the owner?"
The pharmacist answers, "Yes."
Jacob: "We're about to get married. Do you sell heart medication?"
Pharmacist: "Of course we do."
Jacob: "How about medicine for circulation?"
Pharmacist: "All kinds."
Jacob: Medicine for rheumatism and scoliosis?"
Pharmacist: "Definitely."
Jacob: "How about Viagra?"
Pharmacist: "Yes, a large variety that works."
Jacob: "What about vitamins, sleeping pills, Geritol, antidotes for Parkinson's ?
Pharmacist: "Absolutely."
Jacob: "You sell wheelchairs and walkers?"
Pharmacist: "All speeds and sizes."
Jacob: "We'd like to use this store as our Bridal Registry."
5 Flu Epidemic of 1918, David Lee, MD
12 Rehab for the Brain Injured Patient, Nancy Greenwald, MD
14 Childhood Immunizations, Maggie Cross, MD
19 Burkholder Lectures in Oncology
19 Guidelines for Management of Heart Failure, Scott Hiatt, MD (Mercy Medical Center)
21 Trends in Complex Spinal Surgery, Christian Zimmerman, MD, Bruce Andersen, MD
3 Robert LeBow, M.D. Lectureship, Uninsured in Idaho, Elizabeth Foster, MD
10 Metabolic Syndrome, Kenneth Wilhelm, MD (Mercy Medical Center)
24 Symptom Management at End of Life, Kevin Clifford, MD
31 Management of VTE in Medically Ill Patients, Robert Pendleton, MD
1 Hypertension Update, Don Morris, MD
8 MS Update, James Bowen, MD
15 ADHD, J. Timothy Leavell, MD
22 Topic TBA, Caitlin Gustafson, MD
29 Peanut Allergies, Michael Keiley, MD
1 Hypertension Update, Don Morris, MD
8 MS Update, James Bowen, MD
15 ADHD, J. Timothy Leavell, MD
22 What We Know About Avian Flu, Charles Reed, MD
29 Peanut Allergies, Michael Keiley, MD
2 Assessing for Dementia and Treatment Options, Kristine Theis, PA, Kitty Anderson, PharmD
9 Limits of Evidence Based Medicine, Mark Tonelli, MD
16 Autoimmune Thrombocytopenia Purpura, Terry Gernsheimer, MD
23 Update in Liver Transplantation, Anne Larson, MD
30 Barrett's Esophagus and Esophageal Cancer, Dr. Sandhu
3 Medical Residency, Military Combat and Other Sleep Deprived States, William Thompson, MD
10 Management of DVT, Alex Spyropoulos, MD
17 Peanut Allergies, Michael Keiley, MD
24 Diagnosis of Acute Retroviral Syndrome (HIV) in Idaho, Clay Roscoe, MD
31 Legislative Update, Bob Seehusen
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