American Society of Aerospace Medicine Specialists Meeting
Thursday, May 17, 2012
Salon A, Atlanta Hilton Hotel
President, Dr. Hernando Ortega, conducted this meeting. Vice President Dr. Joseph McKeon assumes the duties of President at the end of the meeting.
Call to Order at 0705.
Members in attendance: approximately 60 people at 0708
STANDARD AGENDA ITEMS:
1. Board of Governors Meeting Review and discussion
a. AsMA Council discussion items:
i. MOC efforts are proceeding rapidly. We must continue work to formalize and sustain MOC processes.
ii. AsMA undergoing improvements to home office and computer systems.
Database improving and web presence is a major focus item.
b. Organizational Maturity we are continuing to realize our charter. Dr. Ortega reiterated our three-fold purpose: 1) Service to our specialty of Aerospace Medicine, 2) Advocacy for members and 3) Outreach to all those training to support Aerospace Medicine (especially our residents).
c. Proposed MOC Part IV e-process under development by ad hoc committee
2. Secretarys Report: Dr. Van Camp. See Atch 1 (INFO)
a. Minutes from 2011 meeting were approved by a majority vote of those present. 2011 meeting minutes sent to ASAMS Officers and all membership, finalized and signed; ready for approval
b. Current ASAMS mailing address is the AsMA home office address. Home office has forwarded ASAMS mail to Dr. Ortega regularly.
c. Arrangements made for RAM bowl event. ASAMS spent $1611.51 on food for the event and arranged a cash bar.
d. MOC Issues: Part II seems more streamlined and is tracked by ABPM website and AsMA. Dr. Northrup and our Ad Hoc MOC committee are working process and sustainment details.
e. Updated Officer Listing still looking for historical information to complete this listing. (See Atch 2 Officer listing) Missing information is as follows:
i. Any BOG members for 2001-2 year
ii. VP 2002-2003
iii. Any BOG members for 2004-5 year
iv. Any BOG members for 2005-6 year
v. Any BOG members for 2006-7 year
vi. BOG members confirmation for 2008-9
f. Sincere appreciation to Dr. Ortega for standing in last year and accomplishing the secretary function while I was deployed.
3. Election of new Officers: Open positions include VP/President-elect, Secretary, and one Board of Governors (BOG) member. Nominations from both the Nominations Committee and from the meeting
floor. (See 5.a.iv) Ballots distributed. Election conducted. (see 7.a. for results) (INFO)
4. Treasurers Report: Dr. Chung Siedlecki (and Dr. William Tarver): We are in good financial shape at present. We are now beginning to deposit the funds from our MOC Part IV efforts. Balance prior to the meeting was approximately $9,491.25. We have reimbursed $1611.51 on the Post RAM Bowl reception. Additionally, we have approximately $19.00 of copying materials costs for this meeting and $99.50 for web site maintenance. Approximately $3,000 was collected for dues. After the meeting, the balance is $12,370.75. (See treasurers report, Atch 3) The Society is fiscally solvent. (INFO)
5. Committee Reports:
a. Standing Committees
i. Constitution and By-Laws (Dr. Jim Laub): There were no issues with the Societys By-Laws this year. Dr. Laub reported that AsMA had improved the Policy and Procedures Manual. (INFO) Members still want to explore electronic voting possibilities. We will watch to see what impacts the AsMA website upgrade has for this potential. Committee will look into what CBL changes might be needed to enable this. Additionally, the ethics discussions suggested the possible formation of a specific ethics committee (see 6.c). CBL will work with Drs. Pollan and Parmet on this issue. (OPEN, Dr. Laub)
ii. Membership (Dr. Ortega): See membership report, Atch 4. There are approximately 300 total members with 172 active, 17 associate, 30 student, and 30 new applicants. Member benefits include job notifications, and the opportunity strengthen the specialty to the benefit of all participants in the aerospace operations including passengers, aircrew
and the medical practitioners charged with promoting their health. (INFO)
iii. Aerospace Medicine Practice Standards and Competencies (Dr. Van Syoc): Dr. Van Syoc reported.
1). There are 52 clinical practice guidelines (CPGs) that were originally sponsored by the education committee of the AsMA and assumed by the Aerospace Medicine Practice Standards Competencies Committee of ASAMS. The plan is to allow access to these from the AsMA web site. These guidelines are being used internationally and across civilian and military branches. There is interest in publishing or at least referencing these CPGs in the Journal of Aerospace Medicine and other journals in Aerospace medicine. There is a continued need for involvement of the members in maintaining the scientific accuracy and currency of the current CPGs and developing new CPGs.
iv. Nominating Committee presented by Dr. Jerry Owen: Pre-meeting nominations for VP, Secretary and BOG member. Nominations for VP were Dr. William J. Tarver and Dr. Mark E. Mavity. Nomination for secretary was Dr. Diane C Ritter. Nomination for BOG included Dr. Jason Cromar, Dr. John Crowley, Dr. James DeVoll, and Dr. Walter Matthews. Results reported in 7.a. (INFO)
b. Special Committees
i. Publications Committee: Presented by Dr. Dave Rhodes. The main effort is to get our CPGs into the peer reviewed literature. This effort however, ties into the ethics discussions in Sec 6.c and the Aerospace Medicine Practice Standards and Competencies in Sec 5.a.iii.
ii. Certification Maintenance. Presented by Dr. Susan Northrup: MOC part II is holding steady. Again this year you only have to turn in the front sheet of the MOC packet. ABPM and AsMA both track MOC and CME information for members on their respective websites. Some members still see the cost of the MOC Part II at AsMA as too high. (INFO) MOC Part IV is currently on the ASAMS website at a member cost of $295 ($395 for non-members). The current process is completely through Dr. Northrup. We have actually completed over 15 applications. All state licensure boards are moving towards full acceptance of MOC, as is the AOA. We have an ad hoc committee that is putting together a committee-based process incorporating electronic means. We should begin to see some progress with the AsMA website upgrades slated for the fall. (See section 6.b.ii)
iii. Space Medicine: Presented by Dr. William Tarver. See attached report.
Three CPGs have been developed; Vitamin D, Renal Calculi Prevention and Space Sickness Management. Clinical opportunities in space medicine are being posted on AMSTRA. The commercial space flight and suborbital flight industries have multiple companies developing programs and systems. The FAA Space Center of Excellence is harnessing the expertise of nine core universities and promoting safety in human space flight. (INFO, Atch 5)
iv. Website: Presented by Dr. Salazar: AsMA is finally upgrading their web services and databases. We continue to work to move the ASAMS website onto the AsMA servers. We will work to incorporate dues collections with AsMA as allowed. There is a need for member assistance into WEB development and applications. (INFO)
6. OLD BUSINESS:
Assorted old business items: In preparation for 2012 meeting, Drs. Ortega/Van Camp conducted a thorough review of past minutes for open items that need to be
a. Milestones and timelines for ASAMS officers & committee chairs discussed development of a continuity tool for volunteers in order to insure smooth transition and function of the organization from year to year. (Ortega, Secretary) (Open-2008) Drs. Young and Johnson will attempt to develop a CONOP for ASAMS critical activities by Fall 2010. Dr. Young reported that a template CONOP is in work and now needs input from the committee chairs and officers. Draft shown at meeting. Will email MS Excel file out to all officers for review this summer. See Atch 6 Manual of Operations. Officers will work on this draft to finalize for future. (Remains OPEN, 2012, Dr. Young, Officers)
b. MOC Related Items:
i. MOTION: Maintenance of Certification Committee investigate ASAMS paying (or subsidizing) MOC credits in ASEM, and further that they investigate alternative MOC delivery methods for possible ASAMS sponsorship (including web based). See 6.b.ii & 6.b.iii (CLOSED: Dr. Northrup)
ii. A motion (2009) was made that ASAMS allow the use of up to $2000 to help AsMA Education and Training Committee move to an electronic version of MOC. Dr. Silberman reported that State Boards are pushing DO MOC. The American Board of Medical Specialties or ABMS MOC process is as follows: MOC Part I -Professional Standing: Medical specialists must hold a valid, unrestricted medical license in at least one state or jurisdiction in the United States, its territories or Canada. (Licensure by a State). MOC Part II-Lifelong Learning and Self-Assessment: Physicians participate in educational and self-assessment programs that meet specialty-specific standards that are set by their member board. MOC Part III-Cognitive Expertise: They demonstrate, through formalized examination, that they have the fundamental, practice-related and practice environment-related knowledge to provide quality care in their specialty. (The test in AsMA every 10 years by ABPM.) MOC Part IV-Practice Performance Assessment: Essentially a Quality component. Part IV MOC can be done by any ABPM specialty for any specialty. Beta test was completed in March. Current charge for evaluating Part IV applications/projects is $295 for ASAMS/AsMA members and $395 for non-ASAMS/AsMA members. An ad hoc committee has been formed to streamline the process and incorporate electronic means as possible. Members include Drs. Young, Ritter, Storms, Woodson and Duvall. Progress is in work. Additionally, AsMA is working to upgrade its web presence and electronic member services. 2012 action delayed in anticipation of AsMA website upgrades in the Fall. (OPEN, Ad Hoc Committee)
iii. A motion (2009) was made to formally ask AsMA to work to house the web forms and data required for distribution of Aerospace Medicine (AsM) MOC Part IV (front end) while ASAMS develops a process for review, validation, certification, and reporting of MOC Part IV to ABPM (back end). The motion was further amended to contain a press ahead clause, stating if AsMA was unable or unwilling to help, then ASAMS press ahead with fielding by years end. MOC part 4 has completed beta testing. ASAMS is co-developing with AsMA a process to oversee MOC part IV certification in line with ACOEM and ACPM. An ad hoc committee has been formed to streamline the process and incorporate electronic means as possible. Members include Drs. Young, Ritter, Storms, Woodson and Duvall. Ties in with above 2 items. Beta testing is complete. Process currently in place. Electronic process development is dependent on AsMA website upgrade which is in progress. (OPEN, Ad Hoc Committee and Dr. Northrup)
c. Proposal: ASAMS membership and officers need a concerted effort to define the role and function of ASAMS in AsMA. What is main product of ASAMS? What is the definition of AsM specialist? Ethics issues? Goals and objectives? AsM program development. Dr. Ortega reemphasized that this society was formed to provide professional standards and oversight to the practice of AsM (Ortega 2009). Much discussion followed. Dr. Parmet related 3 cases of State Licensure Boards mischaracterizing AMEs as AsM specialists in lawsuits. His experience cries out for us to develop ethical standards, medicolegal certification, licensure issues, etc. Who talks to State Licensure Boards for our specialty? This was part of the original vision of this organization. It is not simply a forum for another meeting but THE organization that represents our chosen medical specialty. A motion (2009) was made that we develop a formal process to review professional conduct of practitioners of AsM. Discussion suggested that ethical standards be modeled off of other medical organizations. Some felt that the Aerospace Medicine Practice Standards and Certification Committee take this on. Currently Dr. Van Syoc has been focused on the CPG process. It was further suggested that the definition of an AsM specialist be considered by this group. The definition motion passed. Drs. Parmet and Pollan will work this issue and report back next year. 2010: Discussed the submitted guidelines. Dr. Parmet requested feedback on these standards and described several examples of questions of authorities, credibility, standards and practice of our specialty. Should these standards apply to anyone who practices AsM or only to our members? Legal cases and some State Boards of Licensure have used FAA course graduates (i.e., AMEs) as expert witnesses on standards of practice in AsM. The discussion then turned to a committee to work on this issue. This led into discussions of ASAMS committee structure overall to remedy this and oversee practice standards and competencies.
2011: A draft of Ethical Guidelines for ASAMS was discussed. An updated version will be submitted to all the membership via email. Dr. Parmet proposed that we charter a committee of the most recent 5 past presidents as our Ethics Committee. 2012: Much work was done on the Ethics Statement. Thanks to Drs. Ireland, Parmet, Pollan, and Ritter for their work. 2012: The guideline improved over the year and was handed out at the meeting. MOTION: To adopt the ethical guidelines (as presented in Atch 7) for ASAMS practitioners. Motion PASSED.
The ethical guidelines are adopted and now available for consultation. (CLOSED) There is still a portion of this that must be discussed process/committee to review member conduct as required. Will refer to CBL. (REFERRED TO BYLAWS CMTE, 2012, 5.a.1, Dr. Laub)
d. Nominations of deserving ASAMS members to AsMA Fellow A motion (2010) was made and passed to establish an ad hoc committee to review ASAMS current committee structure with an eye to formalizing the nominations to Fellow for ASAMS members. Dr. Merchant agreed to chair that committee with past ASAMS officers that he will recruit. Additionally, we must market our specialty to internal and external customers. Dr. Ortega collated the AsMA Fellows and Associate Fellows lists onto the ASAMS membership spreadsheet. This file has been sent to Drs. Merchant and Parmet for action this cycle. Process needs further formalization. (OPEN, 2012, Dr. Merchant, Parmet)
e. AMA representation as a specialty society, AsMA has a delegate seat in the AMA House of Delegates. AsMA is also one of the primary participants in the AMAs Specialty Service Society Section Council of Preventive Medicine. We have a delegation of 4 to this section council the delegate, alternate delegate and 2 other representatives. This delegation is currently delegate-Dr. Glenn Merchant; Alt Delegate-Dr. Ortega; Section council reps-Dr. Daniel Shoor. The second Section Council representative position is vacant. We need a cadre of specialists familiar with the AMA policy process to represent our specialty to the House of Medicine. Drs. Lowry and Westphall served as Section Council Representatives at the November 2011 interim AMA House of Delegates meeting. Interested physicians please contact any of the current delegation. (CLOSED, Drs. Merchant and Ortega)
f. Dr. Woodson brought up a recommendation that AsMA sponsor a panel on medical ethics at next years annual meeting that could count as the required ethics training that many State licensure boards require annually. Dr. Boudreau was present and will work with Dr. Woodson on this initiative. Discussion ensued on several fronts regarding CME, MOC, lifelong learning and Dreyfus model. ACCME is pushing towards more workshop oriented courses for differing levels of medical practice based on a Gap Analysis of membership. This issue is larger than ASAMS as it affects AsMAs annual meeting process. ASAMS must advocate for and lead the effort toward these improvements in specialty education and annual knowledge building and management. Additionally, our CPG efforts should be open to Gap Analysis also. The ASAMS medical ethics panel occurred Wednesday morning and was well attended. The further issue of MOC & lifelong learning will be addressed by AsMA Education and Training committee and followed closely by ASAMS. (CLOSED, Drs. Woodson, Boudreau)
g. Airline Medical Directors Working Group report compiled by Dr. DuBois for AsMA: Dr. Gordy Landsman brought forth this report as a springboard to raise an even larger issue. This report simply reflects the reality that our specialty of Aerospace Medicine is losing visibility, respect and market share. Currently the only visible advocacy for AsM is in government (DoD and FAA). But AsM was vital and significant throughout the middle of this century. And there are new and growing areas where AsM expertise is needed to enhance the performance of individuals operating in the aerospace medium. Many factors were identified as contributing to this effect: economics at major airlines, loss of focus in AsM, lack of a definition/acceptance of AsM specialist, perception that AsM does not include clinical medicine, rise in remotely piloted aircraft, government budget situation, and ongoing health care reform. Aerospace Medicine needs to promote its unique place in medicine and business. A motion was made and PASSED to establish an ad hoc committee to focus on this effort. The committee members include Drs. Cheryl Lowry, Gordy Landsman, Yvette DuBois, John Barstow, Jay Neubauer and Susan Northrup. They will report back in May 2012 on efforts that ASAMS should encourage in order to respond to the challenges above. Ran out of time to discuss in 2012. Will remain open for 2013. (OPEN, ad hoc committee Dr. Landsman, 2011)
7. NEW BUSINESS
a. Election results new officers for 2010-11 year (INFO - CLOSED)
i. President Dr. Joseph McKeon
ii. President Elect/VP Dr. Mark E Mavity, USAF
iii. Treasurer 2yr term Dr. Chung Siedlecki
iv. Secretary Dr. Diane C Ritter, USAF
v. BOG member Dr. Jay Neubauer and Dr. Keith Brandt and Dr. Walter
b. Dr. Hernando Ortega has been selected as a trustee of the American Board of Preventive Medicine, replacing Dr. Richard Jennings as he rotates off the ABPM. (INFO)
c. ACPE is looking for interested physicians who have experience in Executive leadership. The organization has a lot to offer ASAMS members. Please look at this organization and consider whether it is right for you. Contact Dr. Brent Klein for further information. (INFO)
d. Are the ABMS/ABPM requirements for MOC too onerous? (Dr. Vince Michaud) As I sat in the AsMA program committee meeting last month and heard the new requirements for CME and MOC, I began to wonder if at some point, the requirements to remain certified would require more hours than available to actually practice. Next I wondered if ASAMS should suggest to the ABPM that the requirements creep has become too burdensome? The situation reminded me of the situation that JCAHO morphed into over time leading to the new care facility certification entity AAAHC. I definitely dont have any solutions to this situation, however I think it might be useful for ASAMS to begin this discussion early rather than when the requirements start to negatively impact practice. (Ran out of time to discuss; will bring up in 2013. (OPEN)
e. Introduction of Dr. Joe McKeon as new ASAMS President
8. Meeting adjourned at 0815. Next meeting 1 6 May 2013, Chicago, I L (INFO)
//signed 26 Oct 2012//
Roscoe Van Camp, MD, MPH ASAMS Secretary 20 I 0-2012
1- ASAMS Secretary's Report
2- ASAMS Officer Hi story Listing (2012)
3- ASAMS Treasurer's Report
4- ASAMS Membership Report
5- ASAMS Space Medicine Committee Report
6- ASAMS Draft Manual of Operations
7- ASAMS Ethical l Guidelines and Expert Witness Position
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