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PRESIDENT'S MESSAGE Stephen Ludwig_ MD Powered By Docstoc
					Volume 42                                                  Number 2                                         Fall/Winter 2002

                                                  PRESIDENT’S MESSAGE
                                                    Stephen Ludwig, MD
                           General Pediatric Subspecialty          development, and critical care. Some might also include
                               Oxymoron or Moron                   neonatology. In all of these fields there is a general ap-
                                                                   proach to a wide range of clinical conditions. They deal
                           Is this term an oxymoron or am I        with the whole child perhaps limited by age spectrum, acu-
                           simply a moron for using it? What       ity of illness, or time course of the child’s condition. They
                           does it mean? Why is it impor-          deal with a large spectrum of disease and disorder. But these
                           tant?                                   generalist specialties adhere to the same philosophical prin-
                                                                   ciples and values as generalism itself.
                           I find that I use the term in two
                           settings. The first is when I am        The second scenario that evokes the use of the term “gener-
                           advising students or residents          alist specialties” is when I describe what I consider the con-
about their potential career choices. I tell them that they        stituency of the Ambulatory Pediatric Association (APA).
should first think about whether they wish to be a generalist      The APA is an organization that represents the interest of
or a specialist. Do they want to take care of the whole child,     the generalist and generalist subspecialist. APA represents
their family, and their community, or do they want to take         physicians in practice, those who work in outpatient depart-
care of one of child’s organ systems? This is not to say that      ments and clinics. The Association also represents academic
some of our pediatric subspecialists are not caring people         generalists, researchers of all kinds, and teachers of general
and do not look beyond the child’s heart or kidneys or endo-       pediatrics. Our organization also represents emergency pe-
crine glands. But there is a matter of focus. There is a           diatricians, adolescent medicine physicians as well as child
matter of study and concentration. For the organ based             development and behavioral pediatricians. Some of these
subspecialties, their point of study is that organ or organ        general specialists have moved away from the APA and
system. Choosing a career in one of these traditional speci-       formed their own specialty societies but we still consider
alities does limit focus and allows for more intense concen-       them as part of our kin and welcome them to participate
tration.                                                           along with the APA in areas they choose.

As students or residents are deciding about specialization         Whether an oxymoron or just moronic thinking on my part,
and, if they find themselves “generalists,” then they still have   pediatric generalists and generalists specialties are all alive
many choices. The term “generalist” used to mean primary           and well. Together, they offer our membership and the stu-
care practice and that is still a common and noble pursuit         dents and residents who will follow us a variety of areas of
for many generalists. But in modern pediatrics, there are          exploration and many rewarding and fulfilling career choices.
also many other “generalist’s roles” including academic gen-
eralists, hospitalists, and members of the “generalist
subspecialties.” The “generalist subspecialties” include
pediatric emergency medicine, adolescent medicine, child
Volume 42                                                Number 2                                       Fall/Winter 2002

                                                                                      Table of Contents
   COMMUNICATIONS DIRECTOR’S REPORT                                 President’s Report                              1
          Ruth A. Etzel, MD, PhD                                    Communications Director’s Report                2
                                                                    Past President’s Report                         3
                                                                    Committee Reports
                       Each month we welcome new mem-
                                                                             Education                              4
                       bers to the Ambulatory Pediatric As-                  Public Policy                          4
                       sociation. There are a variety of ways                Membership and Regions                 5
                       to become active in the                               Research                               5
                       organization’s work. Here are three                   Secretary                              5
                       examples:                                             SIGs and Workshops                     6
                                                                    APA Nominations                                 6
1. When the APA receives new books for review, we send              Special Interest Groups
out a notice on our list-serve (APA-NET) requesting names                    Advocacy Training                      7
                                                                             Community-Based Physicians             7
of members who are interested in writing short book reviews
                                                                             Continuity                             7
for publication in the Newsletter. If you have not already
                                                                             Emergency Medicine                     8
responded, or if you are not on the list-serve, please let me                Environmental Health                   8
know if you are interested in reviewing books for APA. We                    Faculty Development                    8
also welcome unsolicited book reviews from the APA mem-                      Inpatient Medicine/Hospitalist         9
bers. We’re interested in publishing reviews of books you                    Medical Student Education              9
find illuminating that would be of interest to clinicians who                Newborn Nursery                        10
care for children. And by all means, if you have recently                    Pediatric Emergency Medicine Program
written or edited a book, please send me a review copy.                      Directors                              10
                                                                             School and Community Health            10
                                                                    Around the Regions
2. Become involved in a committee. See the list of APA
                                                                             Region I                               12
Committees on page 26 and send an e-mail to the commit-
                                                                             Region II                              12
tee chair if you would like to volunteer.                                    Region III                             12
                                                                             Region IV                              13
3. The APA has a number of special projects that would                       Region VII                             13
welcome your involvement. This Fall, a new initiative to                     Region VIII                            14
promote research integrity is getting started. If you are in-                Region IX & X                          14
terested in joining a working group to develop a code of            Special Reports
research ethics and/or a curriculum module on research eth-                  AHRQ                                   15
ics, please contact me.                                                      Bright Futures                         16
                                                                             CATCH Program                          16
                                                                             Conflict of Interest in Research       17
Contact information:
                                                                             Cornet                                 18
Ruth A. Etzel, M.D., Ph.D.                                                   Educational Guidelines                 19
Alaska Native Medical Center                                        2003 PAS Meeting Highlights                     20
4320 Diplomacy Drive                                                2003 PAS Meeting Schedule                       22
Suite 2630                                                          Book Review                                     23
Anchorage, AK 99508                                                 New Members                                     23
Phone: 907-729-3279                                                 APA Journal                                     23
FAX: 907-729-3265                                                   Announcements                                   24
E-mail RETZEL@EARTHLINK.NET                                         Leadership Roster                               26
                                                                    Membership Application                          27

            “Luck is the residue
            of design”
                       -Branch Rickey

Volume 42                                                  Number 2                                            Fall/Winter 2002

             PAST PRESIDENT’S REPORT                                  The National Institute of Child Health and Human Devel-
              James Seidel, MD, PhD, MPH                              opment (NICHD) has begun a loan forgiveness program that
                                                                      presently gives forgiveness of loans to 50 trainees. The new
                                                                      rules for this program do not require National Institutes of
                       The Pediatric Education Steering
                                                                      Health funding to get loan forgiveness. This is a program
                       Committee of the Federation of Pe-
                                                                      that most felt needed to be expanded.
                       diatric Organizations (FOPO) has be-
                       gun to work on the implementation of
                                                                      The APA stressed the need to maintain the three year core of
                       the Future of Pediatric Education II
                                                                      pediatric training. Training competent pediatricians will be
                       (FOPE II) implementation plan. The
                                                                      difficult to accomplish in less than three years with the new
                       committee, under the leadership of
                                                                      work-hour requirements. All specialists must be competent
                       Richard Behrman, began its ambitious
                                                                      pediatricians as well as experts in their areas of specializa-
                       task by first examining the training of
pediatric subspecialists. Fewer young people are entering
fellowship training. If their numbers do not increase we will
soon face a work-force shortage in the pediatric speciali-                  AMBULATORY PEDIATRIC ASSOCIATION
ties. This is already evident in some areas such as Nephrol-
ogy, Endocrinology, and Rheumatology.                                                   DEBATE
                                                                                    Sunday, May 4, 2003
 The factors responsible for this decrease in the pool of fel-                       6:00 pm – 7:00 pm
lows is multifactorial. One area that needs to be re-exam-              Washington State Convention and Trade Center
ined is the research requirement of the American Board of
Pediatrics (ABP). Presently there is a requirement for evi-            Resolved:
dence of meaningful participation in research. Both the defi-          Resident work hours regulation will have a negative
nition of what is meant by “meaningful” and the documen-               impact on pediatric medical education.
tation of this requirement has been difficult for the Ameri-
can Board of Pediatrics to confirm. In addition, the length            Moderator:
of fellowships, the funding of training programs, resident             Stephen Ludwig, Associate Physician in Chief for
salaries, and inflexibility of fellowship training in many             Medical Education, The Children’s Hospital of Phila-
institutions compound the recruitment problem. The com-                delphia
mittee concurs that research training is important for all fel-
lows, no matter what path they choose in the future, be it             Pro Resolution:
clinical practice, or traditional academic research. The docu-         Carol D. Berkowitz, Professor and Executive Vice
mentation of participation in the scholarly activity and be-           Chair, Department of Pediatrics, Harbor UCLA Medi-
coming competent in research methodology and critical                  cal Center
analysis may be more important than producing an abstract
or paper. A position statement is being drafted for approval           Lewis R. First, Professor and Chair, Department of Pe-
of FOPO.                                                               diatrics, University of Vermont

The Pediatric Education Steering Committee (PESC) spon-                Con Resolution:
sored the 3rd Subspecialty Forum at the fall meeting of the            Kenneth B. Roberts, Director, Pediatric Teaching Pro-
American Academy of Pediatric (AAP) in Boston. Organi-                 gram, Moses Cone Health System, Professor of Pedi-
zations and individuals offered opinions on how to improve             atrics, University of North Carolina.
the pediatric specialist work-force. All parities agreed that
research education was an important component of fellow-               Steven P. Shelov, Professor and Chair, Department of
ship training. The representative of the Residents’ Section            Pediatrics, Vice President Infants and Children’s Hos-
of the AAP spoke to the barriers to fellowship training. These         pital of Brooklyn, Maimonides Medical Center
included: salaries, lack of flexibility of work schedules and
time frames for fellowship training and loan forgiveness.              This debate will be an hour of “edu-tainment,” in-
The gender-gap in fellowship training was also raised by a             tended to raise some important issues but all in the
number of speakers and the need to recruit more woman                  spirit of fun.
and minorities into academic pediatrics.

Volume 42                                                     Number 2                                                Fall/Winter 2002

                                           COMMITTEE REPORTS
                        EDUCATION                                                   to “increase the quality and quantity of properly stud-
                Michelle S. Barratt, MD, MPH                                        ied and labeled medications for infants, children, and
The Education Committee with the Faculty Development Spe-                      §    Signed on to a letter to the Chairman of the House
cial Interest Group (SIG) has proposed and received accep-                          Labor, Health and Human Services and Education
tance from the Board for an APA Faculty Development Pro-                            Appropriations Subcommittee to increase funding to
gram. Connie Baldwin deserves special thanks for her work                           the National Institute of Child Health and Human
in the process and writing of the proposal. Details are still be-                   Development that is commensurate with the 15% in-
ing worked out, but the purpose of the new program will be to                       crease to the NIH.
plan and implement a faculty development program that will                     §    Contacted the White House on behalf of the “Family
meet the continuing professional development needs of APA                           Opportunity Act” (S.321/H. R.600) that will provide
members, so they can enhance their performance, increase their                      needed health coverage for children with severe dis-
job satisfaction, and advance in their careers. An important goal                   abilities. A bill with bi-partisan support, it will allow
is to increase the quality, status and visibility of physician edu-                 low-income families to buy into Medicaid coverage
cators in academia. The workshops would target various lev-                         on a sliding scale. Over 300 national organizations,
els of learners and in various educational domains so that par-                     including the APA, have endorsed this bill.
ticipants could enhance their skills.                                          §    Provided support for the Children’s Health Improve-
                                                                                    ment and Protection Act that is focused on prevent-
The Education Committee has collaborated with the Faculty                           ing a devastating cut in State Child Health Insurance
Development SIG to co-sponsor a workshop entitled Models                            Program (SCHIP) funds as a result of the Balanced
For Faculty Development: A Smorgasbord of Successful Pro-                           Budget Act of 1997.
grams on the morning of Sunday, May 4. See the Faculty De-
velopment SIG report for the call for submissions.                        Members making a difference: Jack Pascoe stated the case for
                                                                          funds to “increase and improve the health-care work force”
Diane Kittredge, Connie Baldwin and colleagues, continue to               under the federal budget in a letter to the editor in the Septem-
work on the APA Education Guidelines for Residency Train-                 ber 1, 2002 edition of the Dayton Daily News.
ing in General Pediatrics. See the special insert section for
their update.                                                             Looking Ahead: In planning for the 2003 Pediatric Academic
                                                                          Societies Plenary Session, the working title is The Changing
There is a committee subgroup working via e-mail discussion               Spectrum of Pediatric Specialty Care: Implications for Pedi-
on the review process for promising curriculum materials for              atric Generalists and Specialists. The session will be on Sun-
posting to the web.                                                       day, May 4 at 2:30 pm-4:30 pm. It will be moderated by Russ
                                                                          Chesney and feature three speakers: Jim Perrin, Julia
If you are interested in being on the Education Committee and             McMillan, and Bob Haslan.
do not receive e-mails from me, please e-mail                                           If you would like summaries of the above legislation, have news
                                                                          of interest to share, or would like to be included on the Public
                                                                          Policy and Advocacy e-mail list, drop me a line at
               Lolita McDavid, MD, MPA

It’s fall and the leaves aren’t the only things changing. The
APA’s Public Policy and Advocacy Committee has been busy
on behalf of children and child health. With the budget pro-
                                                                                   Discontent is the first step in
cess underway, over the past three months the APA Public Policy                    the progress of a man or a
and Advocacy Committee has:                                                        nation.
     §    Worked for the enactment of legislation that will
          codify the 1998 Pediatric Rule that requires the FDA

Volume 42                                                   Number 2                                               Fall/Winter 2002

             MEMBERSHIP AND REGIONS                                                      SECRETARY’S REPORT
               Tina L. Cheng, MD, MPH                                                       Paul Young, MD

Fall is membership recruitment time with new fellows, resi-             The APA leadership and the Pediatric Academic Societies (PAS)
dents and faculty. Please encourage your colleagues to join!            program committee are excited about the 2003 PAS meeting in
                                                                        Seattle. Details of the invited science program can be found on
APA Membership continues to hold steady at about 1800. Each             the meeting website at, and I urge you
year we rely on new applications for membership as there are            to look it over. I am confident you will find many sessions of
always some members who drop from the organization. Unfor-              interest to you.
tunately, the number of members discontinuing APA member-
ship has increased slightly. We conducted a survey of these             In addition to the meeting dates of May 3-6, 2003, you should
members to understand the reasons for discontinued member-              note the dates for abstract submission. For those well orga-
ship. Many responded that they didn’t know that their mem-              nized folks who have completed their work, abstracts can be
bership had lapsed and the remainder stated that increased fi-          submitted as early as October 14 with a deadline for submis-
nancial pressures contributed to their discontinuing member-            sion of December 6. Submissions will be electronic. For some
ship. We are working on improving communication with mem-               helpful guidance in preparing your abstract, check out the ones
bers on membership status and are continuing to explore ways            that were accepted last year. These can be found on the website.
to increase the value of APA membership. We are also explor-
ing ways to collaborate with other organizations with overlap-          There will be some important changes regarding workshops.
ping interests. We welcome your thoughts. Thanks for your               The previous designation of “educational seminars” has been
efforts on behalf of our organization. Remember the benefits            abandoned. Traditionally “workshops” have been selected
of APA membership:                                                      through a peer review process and educational seminars have
                                                                        been invited by a sub-committee of the program committee.
-involvement in a great annual meeting                                  This mechanism is still in place but both sessions are called
-subscription to Ambulatory Pediatrics-now indexed in Index             “workshops.” More importantly, there will be no pre-registra-
Medicus and CINAHL                                                      tion for these sessions! All sessions will be on a first come
-the APA Newsletter with up-to-date information on the latest           first served basis. In past years, many people have signed up
in health care delivery, teaching, and research in general pedi-        for a workshop, then not attended. Others have been unable to
atrics                                                                  obtain their first, second or even third choices because the ses-
-discounted copies of APA guidelines and manuals                        sions have been “full.” Then on the day of the workshop, empty
-participation in regional activities and Special Interest Groups       seats are available.
-participation in APA-NET
-access to the Members-only part of the APA web page and                Leaders of the sessions will decide the appropriate number for
online text of Ambulatory Pediatrics                                    their workshop and, based on this, room size and number of
                                                                        seats will be allotted. Once the room is full, the door will be
Membership applications are found on the APA web site http:/            shut and no one else will be admitted. Obviously early arrivers
/, and at the back of Ambulatory Pe-            will benefit and late comers will suffer. We hope that only
diatrics, the official journal of the APA.                              those who intend to stay for the entire session will take one of
                                                                        the places.
Regions continue to be strong. See “Around the Regions” for
further information.                                                    This represents a major change and is clearly an experiment;
                                                                        the executive committee (of which I am a member) will be
               RESEARCH COMMITTEE                                       eager for your feedback!
            Kathy Kaufer Christoffel, MD, MPH
                                                                        As many of you know, I have been an understudy to David
We are currently organizing the Young Investigators Grant study         Stevenson, the program committee chair for the 2003 meeting,
section, reviewing research award nominees, and digesting the           and will be the program committee chair for the meetings in
workshop on faculty training. The committee workshop in May             2004 and 2005. As a result, I will be stepping down as your
will be on research ethics. This workshop, Conflict of Interest         secretary to assume this important duty. We are fortunate that
in Pediatric Research, will be held on Tuesday, May 6 at 8:45           Marilyn Dumont-Driscoll has agreed to fill out the remain-
am - 11:45 am. A new chair of the Research Committee will be            der of my term and will serve on the executive committee of
selected in the coming elections. The candidates for Research           the PAS along with the secretary-treasurers of the APS, SPR
Committee Chair are Lisa Simpson and Peter Szilagyi.                    and the AAP’s representative. As far as I know, this is the first
                                                                        time an academic generalist has been the program committee

Volume 42                                                    Number 2                                               Fall/Winter 2002

chair, and it will be an exciting challenge for me to meet the           We look forward to seeing you this coming May in the beauti-
needs and desires of the varied and diverse constituency of the          ful city of Seattle. This site really excites the nature lover in
academic pediatric societies. I am eager to have your sugges-            each of us and hopefully each of you is planning to attend PAS
tions as to ways we can make the meeting better—more infor-              this year! The program has many wonderful presentations
mative and more enjoyable. Let me know!                                  scheduled and the opportunities to renew old friendships while
                                                                         forging new alliances are unsurpassed! Please don’t miss out
                                                                         on this terrific meeting!
               WORKSHOPS AND SIGS
            Marilyn Dumont-Driscoll, PhD, MD

Open seating for workshops!!!!!!!!!! For the past several years
we have been aware of many members’ frustration with “closed”                        NOMINATING COMMITTEE
workshops. Ironically this was coupled with the workshop lead-                        Kenneth Roberts, MD, Chair
ers’ frustrations that often despite “filled” registration, there
were many unoccupied seats as some registrants failed to at-               The APA Nominating Committee, consisting of Jeff
tend. This year we have decided to pilot a different approach
that hopefully won’t create too many new problems. The en-
                                                                           Devries, Rebecca Kirkland, Judy Shaw and Ben
tire registration process and tickets for workshops will be elimi-         Siegel, has selected the following slate:
nated. Seating will be on a “first come, first served” basis. As
the meeting rooms do have a maximum seating capacity due to                       Two (2) Nominees for President-Elect
fire safety requirements, it will be necessary to close sessions                            Charles Oberg
when that number is reached. Your early arrival at sessions                                  Daniel Coury
will enhance your likelihood of successful attendance. Please
let us know at the meeting how this new system works.
                                                                            Two (2) Nominees for each of the two positions
Over the past several months the PAS Planning Committee has                         that will become vacant on the
been “creatively” working on the May 2003 Seattle meeting.                                Board of Directors
We were very pleased to see again the large number of work-
shops that were submitted for consideration. Many APA mem-                                   Research Committee
bers devoted innumerable hours to the review and selection of                                   Peter Szilagyi
workshops. Not only were there three times as many submis-                                      Lisa Simpson
sions as slots available for presentation, but as you can well
anticipate, the overall quality of the abstracts also was superb!
Taking into account past workshop reviews, member attendance                                   Workshops/SIGS
and a balanced program incredibly challenged the entire ac-                                    Connie Baldwin
ceptance and scheduling process.                                                                Janet Serwint

The workshops and SIGs are scheduled throughout the meet-                       Four (4) Nominees for Two Positions on
ing and often conflict with the invited science, platform ses-                        the Nominating Committee
sions and each other. I did receive some specific requests re-
garding scheduling and there is an attempt to equitably assign
                                                                                           Joseph Lopreiato
the SIGs based on previous years’ assignments. Please con-                                   Daniel Rauch
tinue to give us all your suggestions.                                                     Diane Langkamp
                                                                                           Elisa Alter Zenni
The SIG Chairs are submitting information on membership
rosters, yearly program agenda and projects. We hope that each
SIG group is networking throughout the course of the year via                          Please vote when your ballot
listserve or webpage. Don’t forget that these are available to
each SIG. Your favorite SIGs may need your help to enhance
                                                                                           arrives in the mail!
their value by contributions on topics of interest or member
news updates! We all need more than just our annual May
convening to refresh our zest and enthusiasm throughout the
academic year!

Volume 42                                                     Number 2                                             Fall/Winter 2002

                            SPECIAL INTEREST GROUPS (SIGS)
                  ADVOCACY TRAINING                                      A preview of the draft Compendium was presented at the AAP
                     David Keller, MD                                    National Conference and Exhibition (NCE) in Boston in Octo-
                   Murray Katcher, MD                                    ber 2002. Please contact Wendy Nelson for additional infor-
                                                                         mation (wnelson @
It’s been a quiet summer in Lake Wobegone but the Advocacy
Training SIG continues to strive to develop and assess the ef-           The Fall issue of our Newsletter was distributed electronically
fectiveness of the new curricula in “Community Pediatrics”               via APA-Net and also to the members of the Section of Com-
that are springing up around the country. It is hard to make             munity Pediatrics of the AAP. If you would like either an elec-
sense of it all, but that is exactly what Murray Katcher has             tronic or hard copy please contact me (emanuel.doyne
been doing, in collaboration with the present and past SIG lead- or 513-636-8043).
ers and his colleagues at the University of Wisconsin. Using
the Delphi technique, Murray is trying to develop a consensus            Nominations will begin to be accepted in December for our 2nd
among experts in child advocacy regarding the core knowl-                National Pediatric Community Teaching Award, won by Larry
edge, skill and attitudinal objectives that comprise an advo-            Nazarian of Rochester this past May. This award is sponsored
cacy elective. Many of the “Delphi” participants were recruited          by Mead Johnson Nutritionals and will be presented at the PAS
from the SIG after Murray’s description of the project last year.        meeting in Seattle in May, 2003. Details will be available
Stay tuned for further developments.                                     through APA-Net in the near future.

We would love to hear from our SIG members, regarding the                Our program for the 2003 PAS meeting is still gestating. Any
focus for next year’s annual meeting. For the last two years,            suggestions or recommendations would be appreciated. A few
we have provided a forum for residents to display their advo-            suggestions have included the billing and malpractice issues in
cacy projects and for presentation of some of the new curricula          community-based teaching. Dave Bromberg has been com-
that have been developed. What should we do this year? Let               municating with some of our Northwest U.S. colleagues about
us know: the planning for Seattle begins soon. Contact David             presenting a workshop about some of their community-based
Keller at, or Murray Katcher at                        programs for residents and/or medical students.
                                                                                               John Olsson, MD
              Emmanuel Doyne, MD                                         Our SIG is growing and expanding in scope of activities, un-
               David Bromberg, MD                                        der the direction of John Olsson. We are working on commu-
                                                                         nications issues. The continuity list serve (apa-
Our SIG has been involved with a number of projects through-    has over 200 members and pro-
out the past six months which mainly have revolved around                vides an opportunity to share and discuss issues specific to
our increasing relationship with the American Academy of                 continuity clinic. You can join by contacting Susan Feigelman
Pediatrics (AAP), specifically the AAP SIG for Resident Edu-             ( Becky Collins is working
cation and Training, chaired by Stan Fisch of Harlingen, TX.             on better utilizing the Continuity SIG page on the APA web
The momentum continues towards developing materials for a                site. We hope to have this up by the spring.
“Compendium of Resources” for the community-based pedia-
trician/mentor. Sub-committees are currently dealing with the            The Task Force had another hard-working weekend, this time
following areas: a “Starter Kit” discussing how to get started           in Portland, Maine. We will devote a large portion of the Se-
and the pitfalls involved in community-based teaching; devel-            attle spring meeting to the ACGME work hours issue and RRC
oping thematic programs in the areas of urban health, school             requirements. Please come with ideas and solutions.
health, child care settings etc.; evaluation tools; faculty devel-
opment resources; academic shareware etc. There are many                 CORNET, the continuity research network has received fund-
opportunities in this project to merge the talents of the APA            ing to develop an infrastructure. We are looking for regional
and its committees especially Education and Faculty Develop-             research coordinators. The coordinators will recruit other pro-
ment with the community resources of the AAP.                            grams and obtain ideas for projects. Contact Marilyn Dumont-

Volume 42                                                    Number 2                                               Fall/Winter 2002

Driscoll (, Janet Serwint                                         ENVIRONMENTAL HEALTH
(jserwint@jhmi) or Susan Feigelman (                                Ben Gitterman, MD
for inquiries. We have completed the NAMCS/PRINS study                                     James Roberts, MD
surveying continuity patient characteristics and visit charac-
teristics. Data should be available soon. Paul Darden is inter-          The Pediatric Environmental Health Special Interest Group is
ested in looking at definitions of continuity, so he may be so-          looking forward to another excellent meeting at the Pediatric
liciting assistance for a new project. We will be discussing             Academic Societies meeting in Seattle on May 5 at 8:45 am.
CORNET issues in Seattle.                                                We anticipate another multi-faceted session and are pleased to
                                                                         announce that our keynote speaker will be Michael Weitzman.
There are lots of activities going on in our SIG. We hope to             We hope to sustain the momentum of increasing attendance
see many of you at the spring meetings.                                  annually at our sessions.

                                                                         Since our May 2002 SIG meeting, we have slowly begun the
                EMERGENCY MEDICINE                                       process of looking to fund an update and major overhaul of a
                  Halim M. Hennes, MD                                    faculty teaching manual to teach Pediatric Environmental
                                                                         Health that was developed and initially revised by the Children’s
The last newsletter, mistakenly, had Richard Ruddy’s Pediat-             Environmental Health Network– a Train the Trainers manual.
ric Emergency Medicine (PEM) program directors report in                 This project would be developed through a collaboration of
place of our SIG report. When the error was detected, we posted          the Children’s Environmental Health Network and the Ambu-
our report on the APA web site and I hope you had a chance to            latory Pediatric Association. Don’t miss the 6-hour Pediatric
read it. This will be my last year as the SIG chair and interested       Environmental Health mini course on Saturday, May 3 at 8:30
members are welcome to submit their names ASAP. Ballots                  am-3:00 pm in Seattle at the PAS meeting.
for the new chair election will be mailed this winter. Please
call or e-mail me (Office: 414-266-2629, e-mail:                                        FACULTY DEVELOPMENT if you are interested in volunteering.                             Latha Chandran, MD, MPH
                                                                                         Charlene Gaebler-Uhing, MD
The PEM SIG was established in 1991 to provide an avenue
for discussion and research presentation related to the care of          I would like to welcome Latha Chandran as my new fellow
acutely ill and injured children. Ellen Crain was the first chair,       SIG Co-leader and thank Ron Marino for three great years of
and founder, of the group from 1991- 1994. The second chair              SIG co-leadership. The summer was a busy one personally for
was Mark Baker, 1995-2000 and Halim Hennes is the cur-                   myself with my recent relocation to the Medical College of
rent chair.                                                              Wisconsin and for the SIG. During the spring meeting, the
                                                                         SIG members decided that they would like to facilitate the de-
We currently have 160 members in our group and a members                 velopment of a curriculum of rotating workshops at the PAS
only listserv hosted at Brown university PED-EM-                         meetings to address the faculty development needs of the APA
L@LISTSERV.BROWN.EDU. The list is usually used for SIG/                  membership. Multiple break-out sessions were conducted at
APA related announcement, membership updates, or discus-                 the SIG meeting to generate ideas for such a curriculum, and
sions of PEM related issues. APA members interested in join-             Constance Baldwin volunteered to summarize and create a
ing the list can forward their request to Dale Steele at                 written proposal from the ideas generated at the meeting. This
Dale_Steele@brown.EDU. Over the past 11 years we had some                summer she completed the proposal and Michelle Barratt for-
excellent discussions and debates on various clinical and ad-            warded it to the APA Board for consideration in the APA’s Long
ministrative issues in pediatric emergency medicine. The meet-           Range Plan. The proposal was received by the Board with en-
ing is usually held on Saturday morning from 8:00 -11:00am.              thusiasm, and an announcement of the program will be made
                                                                         at the 2003 PAS meeting. We would like to thank Constance
Our spring 2003 meeting is already planned and we will have              for all her thoughtful and hard work on this project and Michelle
some excellent presentations and hopefully an interesting de-            for taking our ideas forward to the Board.
bate. Dale Steele will lead the panel discussion on the cons and
pros of the ever-controversial topic of oral versus intravenous          In addition to generating the curriculum proposal, the Faculty
re-hydration. The administrative topic is reducing errors in the         Development SIG and the Education Committee are working
pediatric emergency department and our own expert Steven                 on a collaborative workshop for May 2003, entitled “Models
Selbst has agreed to lead the discussion. Hope you can attend            for Faculty Development: A Smorgasbord of Successful Pro-
and participate in the debate.                                           grams.” Please note the Call for Submissions, below.

                                                                         In keeping with our SIG motto “Share the Wheel” we invite

Volume 42                                                  Number 2                                              Fall/Winter 2002

any one who is interested in Faculty Development to join our                   INPATIENT MEDICINE/HOSPITALIST
listserv by contacting                                   Patricia Lye, MD
                                                                                        Daniel Rauch, MD
We also want to remind our current members that the listserv is
a great way to have rapid access to others interested in faculty       We are happy to report that we are much farther along in devel-
development issues.                                                    oping a PRIS (Pediatric Research in the Inpatient Setting) net-
                                                                       work. Chris Landrigan has agreed to chair the steering com-
CALL FOR SUBMISSIONS:                                                  mittee with representation from this SIG, the National Asso-
Faculty Development Models For APA Workshop, May 2003                  ciation of Inpatient Physicians (NAIP), and the AAP. The com-
Due Date: December 9, 2002                                             mittee is now working on by-laws and is starting to consider
                                                                       project ideas. Many thanks to those individuals who signed up
The APA’s Education Committee and Faculty Development SIG              to participate. Over 50 institutions are represented and we are
are jointly planning a workshop at the Seattle PAS meeting             always accepting new enrollees (please contact Dan Rauch).
entitled Models For Faculty Development: A Smorgasbord of              We are now focusing on next year’s meeting. Please follow
Successful Programs. The workshop has been planned to help             the SIG listserve for a call for workshops. We will also discuss
launch a new APA-organized faculty development curriculum,             curricula for a hospitalist fellowship, educational opportuni-
which is an outgrowth of the National Pediatric Faculty Devel-         ties unique to the inpatient setting, and academic promotion.
opment Scholars project. Workshop organizers include
Constance Baldwin, Mimi Bar-on, Michelle Barratt, Sarah
Croskell, Charlie Gaebler, Lindsey Lane, and Virginia                             MEDICAL STUDENT EDUCATION
Niebuhr.                                                                                 Steve Miller, MD

The workshop has been accepted for presentation on the morn-           We continue to be the home for medical student education, and
ing of Sunday, May 4, and will feature 10-15 faculty develop-          as such, foster activities that support outstanding education at
ment models, to be selected by the workshop leaders after a            all levels (including patient education) and support our mem-
review of submitted proposals. Presenters will describe pro-           bers – and all pediatricians – with the task of always growing
grams or activities that help pediatric faculty members enhance        in our core mission as teachers.
their skills as educators. The models will be varied, from
mentored individual activities, to workshops or conferences,           We have four areas of concentration to serve this mission.
to full-scale courses. Podium and poster presentations will be
included, and computer demonstrations will be facilitated. Each        First, this year we will make a supreme effort to collaborate
model will be analyzed by the group with respect to demon-             with other SIGs to reinforce the central role education plays in
strated outcomes, resources required, and barriers encountered.        all aspects of outstanding patient care, training and science.
The workshop will combine platform presentations, posters,             We are exploring concrete collaboration with the Advocacy,
and interactive discussions, to allow participants to pool cre-        resident, Hospitalist/Inpatient, and Pediatric Program Direc-
ative ideas and curricular materials, strengthen their profes-         tors SIGs. We invite others as well. We would like to explore
sional networks, and consider ways to implement faculty de-            the area of professionalism and humanism in its concrete rela-
velopment at their own institutions.                                   tionship to training and patient care. Please e-mail me asap
                                                                       with ideas for collaboration for this year’s program.
To submit a proposal, send a completed submission form (with
1-2 page description of your faculty development program) to           Second, we continue to focus on developing and sharing tools
the address below. The submission form will be distributed on          for real time, bedside evaluation of basic competencies. These
the APA-NET listserve. You may also e-mail Constance                   include evaluating histories (communication skills), physical
Baldwin to obtain a submission form. Electronic submissions            examinations (being worked on in a small work group that in-
are strongly encouraged!                                               cludes Sherylin Smith and Terrance Murphy among others),
                                                                       and professionalism. We will continue this work this year.
Constance D. Baldwin, Ph.D.
Professor of Pediatrics and Family Medicine                            Third, we will focus on disseminating the concrete benefits of
Associate, Office of Educational Development                           focusing on professionalism and humanism. We will share the
University of Texas Medical Branch, Rt. 0344                           Physician Charter – an internal medicine document, for its rel-
301 University Blvd.                                                   evance to our practice.
Galveston TX 77555-0344
Phone: 409-772-3245 Fax: 409-772-4599                                  Finally, we will continue to be the source of information on
E-mail:                                              important developments in medical student education and im-

Volume 42                                                  Number 2                                                Fall/Winter 2002

portant opportunities for growth of the members.                        presentation, which we can forward to all members through e-
                                                                        mail if you have not already received it. The goal is to have
We will be setting new agendas this year – preliminary new              more emergency departments submit data and then to write
issues include, technology, novel teaching approaches and               this up for publication in the coming year. The second part of
documenting the cost and impact of education as scholarly,              the meeting was a presentation / discussion on Mentoring. The
clinical and academic work.                                             discussion described ways to improve mentoring of junior fac-
                                                                        ulty with a significant amount of discussion around opportuni-
Below is a brief summary of last year’s SIG program. Special            ties to improve mentoring for women faculty. There were sev-
thanks to Bill Raszka, Lindsay Lane, Sherylin Smith and Scott           eral handouts and references. One interesting reference is an
Jones.                                                                  Institute of Medicine (IOM) publication downloadable from
                                                               Ideas and goals
Summary of 2002 SIG Meeting                                             for the spring 2003 meeting should be forwarded to
Title: Competency Based Evaluation: Using the Tools and        That would include topics or even
Searching for Collaboration                                             having us do a joint SIG meeting with another group to focus
                                                                        on an area of interest.
The meeting focused on testing real time evaluation and feed-
back tools for medical students and residents. Over 100 people
participated, including many senior educators and many first                    SCHOOL AND COMMUNITY HEALTH
time attendees (about 15% of the group). As usual, the ad-                              Linda Grant, MD
vancement of our attendees was a primary goal – and having                             Mona Mansour, MD
so many experienced people – interacting with new members                             Nazrat Mirza, ScD, MD
– was a critical outcome of the meeting. We were also pleased
to see an international presence, with attendees from New               At the May meeting, we conducted a survey of the Pediatric
Zealand and Lebanon.                                                    residency directors to gain input on what is happening in train-
                                                                        ing programs with respect to community and school health.
                                                                        The intent of the survey was to identify areas of interest, need
                  NEWBORN NURSERY                                       or concern on which the School and Community Health SIG
                    Linda Meloy, MD                                     could focus its efforts. This was not intended to be a scientific
                                                                        exercise for publication. It was also understood that the resi-
We continue to answer newborn nursery questions through our             dency directors might not know the details of programs they
e-mail system. Any questions concerning practices in newborn            were being asked to describe. Nonetheless, forty-two programs
nurseries to which APA members would like an answer can be              responded, providing a detailed overview of school health in
sent to                                           medical education. The following represents a summary of
                                                                        the findings, for although the survey was set-up to provide num-
Latha Chandran is compiling data on teaching and needs as-              bers and percentages, the true value is in the descriptive com-
sessments for the attendees of our meeting this past spring. We         ments that most programs added to qualify their answers.
hope that the data will help us meet the needs of our members
and provide vision for future meetings. We have established             Most programs (32/42) have a community and school health
groups to study the new group B strep guidelines, teaching,             component in their program; however the depth and breadth of
hyperbilirubinemia, and hypoglycemia. John Olsson, Latha                the programs varied widely. It became clear that the funda-
Chandran, and Linda Meloy are working on the new compe-                 mental definition of what constitutes “school” or “community”
tency based curriculum for the Newborn Nursery for the APA.             is not universally embraced. Many programs considered school
                                                                        to be synonymous with community, while others viewed the
                                                                        two as distinctly different. The intensity or frequency of an
        PEDIATRIC EMERGENCY MEDICINE                                    experience also varied greatly, from electives to mandates, from
             PROGRAM DIRECTORS                                          occasional lectures to 3 year longitudinal experiences.
                Richard Ruddy, MD
                                                                        Fifteen programs reported a separate community block rota-
The SIG meeting was held on the last day of the PAS meeting.            tion, 10 of which included school health as part of that rota-
Conflicts with other workshops and travel back home limited             tion. Advocacy rotations were also another place for commu-
attendance. We will work hard to change that for the next meet-         nity or school health experiences and often were used inter-
ing! Kathy Shaw presented the data she had received from                changeably with community. Other than a community rota-
Pediatric Emergency Directors characterizing their emergency            tion, the next most common venue for school health was dur-
department in the first half of the meeting. It was an excellent        ing an Adolescent Rotation and within that context, school-

Volume 42                                                  Number 2                                                  Fall/Winter 2002

based health centers were most often mentioned. Twenty seven                 NEW ETHICS SPECIAL INTEREST GROUP
programs stated that IEP, IDEA and 504 information was ad-
dressed in the Child Development programs often with rein-              Anyone interested in forming a special interest group in ethics,
forcement during continuity clinic. Only three programs did             please contact Christine McHenry at 513-636-4506 or
not address these issues, although several others voiced reser- The preliminary objectives of
vations about how well the area was covered. Twenty-one pro-            the SIG are to:
grams claimed a school observation experience.
                                                                        1. share how our programs are addressing the RRC require-
The most unified response was on the section concerning knowl-             ments and fellowship training requirements for ethics in-
edgeable faculty. Most programs (34/42) admitted to having                 struction;
faculty who were knowledgeable in school health, the work-              2. discuss how our programs are fulfilling the requirement
ings of the local school district, special education issues, and           for instruction in research integrity;
health education programs of their local districts. Even pro-           3. keep abreast of new issues in the field of health care eth-
grams without identified experiences in community and school               ics;
health did have the faculty capacity.                                   4. keep informed of new requirements for education;
                                                                        5. explore what our organizations are doing in terms of orga-
Connections with the school districts elicited more cut and dry            nizational/social ethics.
responses. Twenty-seven programs have a formal connection
with the school system, 15 do not. That connection could be a           If there is sufficient interest, we will have our first meeting this
the operating of School-based health centers or a faculty mem-          spring in Seattle. I look forward to hearing from you.
ber who is also a district school board member, It could also
mean a formal memorandum of agreement. Only half of the
programs (21/42) stated they are able to do research in the
schools. Only 10 schools reported that their school district had
the equivalent of an institutional review board. This question
also elicited more “don’t knows” than any other question. Half
the programs also felt that there were roadblocks with working
with school districts ranging from lack of time in the residency
program to school’s fear of outside interference.                              “You gain strength, courage and
Finally, in an effort to determine the depth of knowledge about
                                                                               confidence by every experience
school health-a question was asked about the residency                         in which you really stop to look
director’s knowledge of the CDC model of comprehensive                         fear in the face...
school health. This model highlights 8 components that a school
must have in place to ensure optimum child wellness. Twenty-
three program directors were not aware of the model, 13 were                   You must do the thing which you
somewhat aware and two were very familiar. This obviously                      think you cannot do.”
does not address whether there were other faculty in the pro-
gram who are more involved with the details of school health.
                                                                                                  - Eleanor Roosevelt
From this information, the School and Community Health SIG
will plan its strategy for the next few years. It is clear that
there is great variability in the concepts of school and commu-
nity health activities. As this SIG seeks to link with the AAP
equivalent interest groups (CATCH initiatives, School and
Community committees) we will be looking to highlight ex-
emplary practices and to tease out the elements that make for a
successful program. We hope to have a website before the next
meeting and to use this as a common base for discussions of
community and school health.

The School and Community Health co-chairs would also like
to express our gratitude to the residency program directors who
graciously shared their time and expertise.

Volume 42                                                  Number 2                                               Fall/Winter 2002

                                       AROUND THE REGIONS

                                                                        an optional workshop in the afternoon. Please begin thinking
                                                                        about submitting your abstract presentations. The deadline will
                                                                        be the same as for the national meeting (December 6), but the
                                                                        abstracts need to be submitted separately to us. Please let us
                                                                        know if you have any suggestions regarding workshops.

                                                                        Region III
                                                                        Maryellen Gusic, MD
                                                                        Vicki Meguid, MD
Region I                                                                The annual meeting of Region III was held in Rochester, New
David Keller, MD                                                        York, on October 4th. Medical students, residents, fellows,                                                       nurse practitioners, and faculty gathered to discuss and learn
Ronald Samuels, MD, MPH                                                 more about the care of children with special health care needs.                                          Faculty for the conference represented many of the institutions
                                                                        in our region. Maryellen Gusic welcomed participants by in-
Our planning process for the New England Regional Meeting               troducing the components of a medical home and the statistics
continues. In order to assure that all parts of the district are        of children with special health care needs. She presented cur-
represented, we are soliciting “local APA advocates” to en-             rent research about access to care, disparities in care, and the
courage attendance and participation in the conference, date            relationship between continuity of care and the quality of care
and location still to be announced.                                     provided and utilization of emergency services and hospital-
                                                                        ization. Greg Liptak, a nationally recognized expert on this
So far, Bill Adams and Paul Geltman have volunteered to                 topic, demonstrated the tools available to evaluate one’s prac-
represent Boston University, Tony Alario will encourage the             tice to determine ways in which one can better provide coordi-
folks down at Brown and Ed Bailey will try to get participa-            nated, integrated and family and community centered care. He
tion from the folks on the North Shore. We are hoping to hear           demonstrated use of the “Medical Home Index” and other qual-
from the rest soon, so that we can put this conference together         ity improvement indices to improve primary care provision for
for some time this winter.                                              children with special needs. Neinke Dosa previewed some
                                                                        innovative tools that use information technology to improve
Be well, keep in touch and make sure to get those abstracts in          functional and clinical outcomes for these children. She shared
when the request comes out.                                             a web-based approach to the diagnosis and management of acute
                                                                        illness in children with chronic conditions. She also introduced
Region II                                                               an electronic “medical record” that will promote information
                                                                        sharing between parents and care providers. Frances Glascoe
J. Lindsey Lane, BM, Bch                                                helped us to understand how we can collaborate with parents                                                      to screen for developmental and behavioral concerns. She dem-
Karen S. Edwards, MD, MPH                                               onstrated the use of several questionnaires to identify children                                                  at risk and in need of additional testing. She reminded us of
                                                                        the importance of early intervention and repeated screening
Plans are being made for our annual regional meeting. Save              over time. Participants worked in small groups to apply and
the date: Friday, March 7, 2003. The meeting will be held in            interpret these resources in the evaluation of a child whose
the Clark Conference Room at NY Presbyterian Hospital in                parent had identified concerns. Another small group consid-
New York City. Tentatively, the morning session will consist            ered the transition to adult care and independence for teens
of a keynote speech and abstract and poster presentations, with

Volume 42                                                    Number 2                                               Fall/Winter 2002

with chronic conditions. Moira Szilagyi and Vicki Meguid
facilitated the discussion of the issues involved in providing
                                                                          Region VII
continuous and comprehensive care for children in the foster              Stephen Weimer, MD, Past Co-chair
care system. Participants were encouraged to become mem-        
bers of the APA and to attend the national meeting in May. We             Ronald Baldwin, MD, 1st Co-chair
will be holding elections for a new co-chair for our region this
fall. Vicki Meguid will be completing her term as co-chair and            Tina Haynes, MD, 2nd (Incoming) Co-chair
will “hand over the reins” in Seattle in May. Please look for   
your ballot in your electronic or office mailboxes.
                                                                          Hello to all Region VII members from your co-chairs. Here
                                                                          are the latest Region VII happenings.
Region IV
Ben Gitterman, MD                                                         To begin with, your regional APA meeting will again be a part                                                         of the Southern Regional Meetings (SRM) in New Orleans,
Janet Serwint, MD                                                         February 20-22, 2003. This conference is co-hosted by Re-                                                         gion VIII and several other southern professional medical so-
                                                                          cieties. To be sure, the SRM is a great opportunity for stu-
Here’s hoping you have had a good summer and a beautiful                  dents, residents, fellows, and faculty to submit abstracts for
fall.                                                                     presentation, attend informative workshops, and commiserate
                                                                          with colleagues. SRM meeting information can be found at:
Region IV, thanks to the hard work of Helen Ragazzi and Gail    ; and you can register for the meeting at:
Cohen, is looking forward to its annual regional meeting over    We look forward to seeing you there!
the Martin Luther King week-end, in Richmond, Va. It re-
mains a relaxed, but highly productive session that consistently          Secondly, the APA national meeting will be held during Pedi-
receives kudos from 40-50 attendees annually. In addition, it             atric Academic Societies (PAS) Annual Meeting in Seattle, May
has served as a great family weekend for families and kids,               3-6, 2003. Information on the PAS meeting can be obtained at
since it is a 3 day weekend for most of us.                      Abstracts can submitted for presenta-
                                                                          tion on-line at this site beginning in October 2002, with the
We hope that you have already received a “call for presenta-              deadline being December 6, 2002. Please consider attending
tions” for the regional meeting. This is an excellent opportu-            this stimulating national meeting.
nity to share your work, pilot a new idea, receive supportive
feedback, or share your experience in a platform or workshop              Next, watch your mail soon for the APA election ballot. As
session about an important clinical subject or health delivery/           you know, Region VII co-chairs are elected for a 3 year term,
policy issue that could be relevant to us all. Helen at                   with states alternating each year. This year Texas is eligible and Gail at will be                  for the 2003 co-chair elections, so look for several Texans on
sending out an announcement soon and can be contacted via e-              the fall APA ballot. Please vote; these are the people who will
mail for further information about submissions.                           lead the APA regionally and nationally into the future!

Our regional research project award is an exciting way to work            Lastly, your regional newsletter, TOAL Tales, has experienced
collaboratively on an idea that may have been percolating for             some technical difficulties in getting up on the web. Your co-
awhile in your list of “things I want to be doing.” A little seed         chairs will let you know when this mission is completed.
money, as this award provides, is a great way to get started.
The only major requirement is that the project involves col-              Have a nice fall!
laboration/participation between two or more institutions within
our region.         Please contact Ben Gitterman at or Janet Serwint at
for additional information if you are not already informed about                     Next Newsletter Deadline
this great opportunity.                                                                              vvv

Finally, please let the region know if your e-mail (or your “snail                        February 10, 2003
mail”) address has changed. Contact Barry Solomon at Please do this even if you have already
informed the APA national office.

Volume 42                                                      Number 2                                              Fall/Winter 2002

Region VIII                                                                 joint meeting between our regions and the Western Associa-
                                                                            tion of Pediatric Program Directors.
Elisa Zenni, MD                                                     Karen Buchi has graciously agreed to replace Stan Michels
Joe Gigante, MD                                                             as Region IX co-chair. Karen represents the University of Utah                                        Department of Pediatrics. We are glad to welcome her aboard!
Bill Basco, MD

Greetings from Region VIII! We are in the midst of planning                                            tttt
our annual regional meeting, in conjunction with Region VII
and other southern societies. It will be held in New Orleans,                                 REGION LISTING
February 20 – 22, 2003 at the Hyatt Regency Hotel. The over-
all theme of the meeting will be “Obesity.” This is a great                                         Region I
opportunity for you and your trainees to present work in a col-                Connecticut, Maine, Massachusetts, New Hampshire,
legial atmosphere, while enjoying the wonderful New Orleans                         Rhode Island, Vermont, Newfoundland,
cuisine and jazz music! There are many ways to get involved,                                  Nova Scotia, Quebec
from presenting at a poster or plenary session or leading a work-
shop, to reviewing abstracts or moderating a session. You should                                  Region II
have already received a registration form and call for abstracts                New Jersey, New York City, Philadelphia, Delaware
in the mail. Please contact Bill Basco if you need further in-                                     Region III
formation.                                                                           Upstate New York, Western Pennsylvania,
                                                                                              West Virginia, Ontario
We are always interested in hearing suggestions on improving
communication within our region and helping members to be-                                          Region IV
come more involved. Look for ballots for regional and na-                    District of Columbia, Maryland, North Carolina, Virginia
tional elections soon, and please vote. We hope to see you in                                          Region V
New Orleans in February!                                                                  Illinois, Indiana, Michigan, Ohio
                                                                                                   Region VI
Regions IX & X                                                                     Iowa, Kansas, Minnesota, Missouri, Nebraska,
Region IX Co-chairs                                                                  North Dakota, South Dakota, Wisconsin,
Stanton Michels, MD                                                                         Manitoba, Saskatchewan                                                                               Region VII
Tom Ball, MD                                                                           Arkansas, Louisiana, Oklahoma, Texas
Region X Co-chairs                                                                                 Region VIII
Cindy Ferrell, MD                                                                Alabama, Florida, Georgia, Kentucky, Mississippi,                                                                     South Carolina, Tennessee, Puerto Rico
Richard Pan                                                                                        Region IX                                                               Arizona, Hawaii, Nevada, New Mexico,
                                                                                             Southern California, Utah
The Region IX and X annual conference will be held at the La
Playa Hotel in Carmel on February 1-2, 2003. There had been                                         Region X
talk about moving the meeting to different sites throughout the               Alaska, Colorado, Idaho, Montana, Northern California,
region and this talk is still going on. We decided to keep it in             Oregon, Washington, Wyoming, Alberta, British Columbia
Carmel this year and discuss the issue further there. We ask
that those coming to the meeting please bring ideas of places
that might be possible to hold a regional meeting in your area.
We hope to alternate between a Region IX site and a Region X
site from year to year. Registration for this year’s meeting is
due on January 10, 2003. If you did not receive a copy of the
meeting registration form, please contact one of your region
chairs to obtain one. It should be a great time as this is the first

Volume 42                                                  Number 2                                                Fall/Winter 2002

                                               SPECIAL REPORTS
                                          HEALTH SERVICES RESEARCH IN THE
                                              NATIONAL CHILDREN’S STUDY
                                       William Lawrence, MD and Denise Dougherty, PhD

One hundred thousand is a number of considerable magnitude.             seeing the NCS will be the NICHD Director in conjunction
It is the combined capacity of Yankee Stadium, Fenway Park              with the Federal Consortium and a collection of agencies of which
and then some. It is the population of a Berkeley, California, a        AHRQ is one.
Gary, Indiana, or a Cambridge, Massachusetts.
                                                                        Much of the activity to date has been occurring at the working
Now imagine 100,000 children. Imagine following their health            group level. Over the past two years, the working groups (each
and development over two decades, and you have one of the               comprised of federal employees and leading non-federal ex-
most ambitious studies ever proposed, the National Children’s           perts) have been identifying priority areas of research on child-
Study (NCS). And consider this: if you were to meet 10 dif-             hood health and development while also developing a diverse
ferent children from the NCS cohort per day, it would take              set of hypotheses to be tested. The NCSAC has reviewed all
more than 20 years to meet them all!                                    workgroup hypotheses and will be providing comments to in-
                                                                        dividual working groups during Fall 2002 and to a National
Working with the lead federal agencies supporting the plan-             Assembly to be held on December 15-18, 2002.
ning phase of this study (the National Institute of Child Health
and Human Development (NICHD), the National Institute of                AHRQ staff has played, and continues to play, key roles in the
Environmental Sciences (NIEHS), the Centers for Disease                 planning, structure, and agenda of the NCS. Peter Gergen,
Control and Prevention (CDC), and the US Environmental Pro-             MD, an epidemiologist and primary care physician, co-chairs
tection Agency (EPA), the Agency for Healthcare Research and            the Study Design Working Group, which is assisting with overall
Quality (AHRQ) is helping to lay the groundwork for the NCS;            design issues and advising on hypothesis prioritization. Will-
a study that proposes to track 100,000 children over 20 years           iam Lawrence, MD, serves as federal co-chair of the Health
(from before birth to age 21) and assess environmental factors          Services Working Group (HSWG), a working group for which
on their health and development. Though NCS’s charge is to              the Agency advocated. Denise Dougherty serves as AHRQ’s
examine the “physical, chemical, biological and psychosocial            representative on the Federal Consortium, which advises the
influences” on children’s health, the study’s magnitude and             Director of NICHD on policy issues regarding the study. In
longitudinal nature provide unique opportunities for health ser-        addition, the NCS is currently funding several pilot studies;
vices research and improving children’s health care. Clearly,           AHRQ’s Practice-based Research Network Resource Center
any study that looks at the influences on children’s health and         is the site for an NCS-funded pilot study of the capacity of
developmental outcomes should at least measure health care’s            primary care practices to collect NCS data.
role in preventing and ameliorating those influences. This ar-
ticle summarizes the history, status, and structure of the NCS;         The NCS Health Services Working Group
provides a look at the emerging health services research hy-
potheses; and notes ways for APA members to become more                 AHRQ, along with the NCS program office, is helping to sup-
involved.                                                               port several activities to develop a children’s health services
                                                                        research agenda for the NCS, including activities of the HSWG.
NCS Origins and Early Planning Activities                               Co-chairing the HSWG with Dr. Lawrence is Neal Halfon,
                                                                        Director of the Center for Healthier Children, Families, and
The NCS is rooted in the work of the Presidential Task Force            Communities at UCLA. Taking a broad view of the scope of
on Environmental Health Risks and Safety Risks to Children              child health, Lawrence, Halfon and the multidisciplinary group
( Recogniz-             of health services researchers that comprise the HSWG cre-
ing that many questions about such risks remained unanswered,           ated subcommittees representing six general areas of health
the task force issued a set of recommendations which ultimately         services.
led to passage of The Children’s Health Act of 2000 (PL 106-
310) which authorized planning and conduct for the NCS. Over-           At a July 2002 meeting cosponsored by AHRQ and the NCS,

Volume 42                                                    Number 2                                                Fall/Winter 2002

HSWG members and an additional group of health services                   of this initiative, Bright Futures: Guidelines for Health Super-
researchers developed two general hypotheses framed within                vision of Infants, Children, and Adolescents was developed to
the overarching goals of the study. The first hypothesis is that          provide comprehensive health supervision guidelines, includ-
quality health care services for children can act to mediate the          ing recommendations on immunizations, routine health screen-
genetic and environmental influences on health and develop-               ing, and anticipatory guidance.
mental trajectories over a child’s lifespan and through several
mechanisms. HSWG’s second general hypothesis is that qual-                The first grant, the Bright Futures Education Center, focuses
ity health care services can reduce disparities in health and             on revising the Bright Futures guidelines; improving aware-
developmental outcomes resulting from social, economic, psy-              ness of the importance of preventive services among health
chological, and physical environmental disparities.                       care professionals, public/private partners, communities, and
                                                                          families; and developing materials to assist in implementation
Moving Forward                                                            of the guidelines. This program is housed in the AAP Depart-
                                                                          ment of Committees and Sections and the Department of Prac-
Though Congress has not yet committed to funding the Na-                  tice and Research. The second grant, the Bright Futures: Pedi-
tional Children’s Study in its entirety, the value of such a study        atric Implementation Project (PIP), is located in the AAP De-
to our knowledge about what works and what doesn’t in                     partment of Community Pediatrics. The purpose of the project
children’s health care has generated excitement and energy                is to examine barriers to pediatric provider implementation of
among child health services researchers, many of whom have                Bright Futures guidelines and to develop new strategies to im-
volunteered time and resources to helping design the study.               prove implementation of the guidelines. The 2 AAP programs
Neal Halfon, in particular, has generated a high level of enthu-          will work closely together. Joint project activities will include
siasm among health services researchers. AHRQ recognizes                  the development of a new web site and newsletter. Judith Shaw
and appreciates his extensive efforts to incorporate health ser-          represents the Ambulatory Pediatric Association on the Bright
vices research into the NCS, and is grateful to NICHD’s Peter             Futures Project Advisory Committees which provide guidance
Scheidt, Director of the NCS Program Office, for encouraging              to the grants.
the working group to develop a health services research agenda
for the study.                                                            For more information on Bright Futures Education Center ac-
                                                                          tivities, please contact Darcy Steinberg, MPH, Director, Bright
To date, many members of the APA have worked through the                  Futures Education Center, at 847-434-7935, or by e-mail at
HSWG to help develop a draft conceptual framework and study      For questions regarding the Bright Fu-
health services hypotheses for the NCS. Other APA members                 tures: Pediatric Implementation Project, please contact Linda
can get involved by signing up for a list serv to receive news            B. Paul, MPH, manager, Bright Futures: PIP at 847-434-7787
on important NCS events and meetings through the study web                or by e-mail at
site at, and the e-mail address
at Those interested in providing input spe-
cific to the Health Services Working Group can contact Will-                               CATCH PROGRAM
iam Lawrence at                                                   Funding Opportunities for Residents

You are welcome to attend the National Children’s Study Work-             A national program of the American Academy of Pediatrics
ing groups and Study Assembly, on December 16-18, 2002 at                 (AAP), Community Access to Child Health’s (CATCH) mis-
the Baltimore Marriott Waterfront in Baltimore, MD.                       sion is to improve access to health care and other needed ser-
                                                                          vices by supporting pediatricians and communities who are
                                                                          involved in community-based efforts for children. The CATCH
            BRIGHT FUTURES AT THE AAP                                     Program provides pediatricians with training, technical assis-
                                                                          tance, peer support, networking opportunities and funding op-
The American Academy of Pediatrics (AAP) is pleased to an-                portunities. Included are two excellent, high-profile funding
nounce that it recently was awarded 2 cooperative agreements              programs tailored specifically to Pediatric Residents and the
from the Maternal and Child Health Bureau (MCHB), Health                  challenges they face when learning and entering the field of
Resources and Services Administration (HRSA), to promote                  community pediatrics. The Resident CATCH Planning Funds
the use of Bright Futures among pediatric health providers and            program and the Rome-CATCH Visiting Professorship program
the public. Bright Futures, initiated by the MCHB over a de-              are direct responses to the needs of resident pediatricians. These
cade ago, is a philosophy and approach that is dedicated to the           programs are a response to three major pediatric issues.
principle that every child deserves to be healthy, and that opti-
mal health involves a trusting relationship between the health            1. Community Pediatrics and Advocacy training is now
professional, the child, the family, and the community. As part              mandated by the Residency Review Committee (RRC)

Volume 42                                                    Number 2                                                  Fall/Winter 2002

   with many training programs requiring residents to com-                tion in hepatitis B preventive health education, vaccination and
   plete a community/advocacy project.                                    activities.
2. An increasing number of residents have expressed an
   interest in planning community-based child health ini-                 In Greenville, SC, John P. Batson has extended his resident
   tiatives.                                                              CATCH grant program, “Fueled for Life,” a program designed
3. A key finding from the Johns Hopkins University evalu-                 to identify and intervene with children at risk for morbidity
   ation of the CATCH Program concluded that exposure                     associated with increased weight. Dr. Baston was able to iden-
   to issues of community child health and direct experi-                 tify colleagues, businesses and athletic trainers who voluntar-
   ence in advocacy early on in a resident’s education are                ily contributed their time and efforts to his community-based
   pivotal in promoting a pediatrician’s commitment and                   program.
   activity in this area.
                                                                          These are two examples of how CATCH can become a spring-
Resident CATCH Planning Funds grants are awarded annu-                    board to both and increase in community health care and the
ally on a competitive basis to pediatric residents who submit             professional development of residents as they being their ca-
proposals to plan community-based programs to increase ac-                reers in health care.
cess to health care for children. Grants up to $3,000 are awarded
for innovative planning activities. Since 2000, 48 grants have                  CONFLICT OF INTEREST IN RESEARCH:
been awarded.                                                                         WHOSE CONFLICT IS IT?
                                                                                       Christine L. McHenry, MD
The Rome-CATCH Visiting Professorships in Community
Pediatrics Program is named for Leonard P. Rome, MD, a                    A lot has been said recently about financial conflict of interest
pediatrician and tireless child health advocate, who dedicated            in clinical research including its influence on the type and qual-
his life to improving children’s health. For nearly ten years now,        ity of research produced and the safety of the research partici-
the visiting professorship program has promoted not only ad-              pant. The catalyst that brought these issues prominently to the
vocacy for children but also the promotion of the field of com-           forefront was the death of Jessie Gelsinger. Jessie was a young
munity pediatrics. Accredited pediatric residency programs as             man who was a participant in a gene therapy study in which
well as AAP Chapters, pediatric associations and medical                  the principal investigator and the institution had substantial fi-
schools are welcome to apply.                                             nancial interests. Questions were raised about the reporting of
                                                                          adverse events during the animal phase of the study, changing
Information about these resident-focused programs can be found            inclusion criteria without proper review, and the informed con-
on the AP’s CATCH web site at                   sent process, among others. This tragic case recently was high-
factshet.htm. or by e-mailing the CATCH program at                        lighted on NBC’s Dateline. As a result of this case and others, You can also write to us at: CATCH Planning                guidelines for avoiding and managing financial conflict of in-
Funds, Division of Community-based Initiatives, American                  terest have been published by various academic organizations.
Academy of Pediatrics, 141 Northwest Point Blvd, Elk Grove                For example, the Association of American Medical Colleges
Village, IL 60007, phone: 800-433-9016.                                   (AAMC) has stated that any financial interest in human sub-
                                                                          ject research is potentially problematic, should come under close
Residents                                                                 scrutiny, and should be done only if there are compelling rea-
Resident pediatricians have a special opportunity to become a             sons to do so. It also recommended the establishment of a Con-
part of the CATCH Program using their ideas and interests                 flict of Interest Committee to approve the involvement of an
within their community. Resident CATCH Planning Funds                     individual with a conflict, to manage the conflict, and to over-
grants are awarded annually on a competitive basis to pediatric           see the research.
residents who submit proposals to plan community-based pro-
grams to increase access to health care for children. Grants up           When it comes to industry relationships with academic institu-
to $3,000 are awarded for innovative planning activities. Since           tions or individual scientists the potential for conflicts of inter-
2000, 48 grants have been awarded.                                        est beyond financial abound. An investigator, for example,
                                                                          may have funding from a company but also may be a member
In 2002, the CATCH Program has two residents who deserve                  of that company’s advisory board or speaker’s bureau. Condi-
special recognition from the CATCH program for their projects.            tions for funding an investigator’s proposal may include the
Wenny Jean of Boston, Mass. has completed her resident grant              right of the company to approve all manuscripts before sub-
“Boston Asian American Pacific Islander Hepatitis B Preven-               mission for publication, to delay publication, or to not publish
tion Program.” Her program helped to develop strategies to                negative data. These industry ties can bias research in terms of
eliminate disparities and increase Asian Americans’ participa-            what research in undertaken and what results are reported and

Volume 42                                                    Number 2                                                 Fall/Winter 2002

As obvious as financial and other industry-related conflicts of                     CORNET: The APA Continuity SIG
interest may be, there are other conflicts that tend not to get as             Primary Care Practice-based Research Network
much press. In the academic world there are constant pres-
sures for the academician to obtain grants and to publish in              CORNET, the Continuity Research Network is alive and thriv-
peer reviewed journals in order to advance. This constant pres-           ing! This is an outgrowth of the APA Continuity SIG mem-
sure may force some to “cut corners” in their research or to              bers’ longstanding interest in developing collaborative projects.
falsify or fabricate data. Not only does the individual have a            While the SIG has been instrumental in fostering many aspects
lot to gain (or lose, as the case may be), but the organization           of faculty development, many individuals felt it was time to
has a vested interest in being “the first” to discover or “the            move forward with a research network. We are grateful to have
only” center to do a pioneering technique. It is the ethical in-          received the endorsement of the APA in its development thus
tegrity of each individual researcher and the ethical foundation          allowing us to benefit from its administration and communica-
of the organization that safeguards the integrity of the scien-           tion system. Our special thanks to Marge Degnon, Executive
tific enterprise.                                                         Director, for her assistance and advice with the project. We
                                                                          also are indebted to the support we have received from the
In addition to the conflicts of interest highlighted above, there         Pediatric Research in Office Setting (PROS) network, espe-
is an everyday conflict we all face as health care professionals.         cially regarding advice in the development of the infrastruc-
This is what I call “the ethics of free.” We have been exposed            ture.
to this conflict since the first days in medical school. You know,
the free pens or reflex hammer, free lunch at a teaching confer-          The CORNET mission is to establish a self-sustaining collabo-
ence, or the black leather bag with your name on it (does any-            rative research network among pediatric continuity clinic prac-
one use their black bag anymore?!) And what about textbooks               titioners so as to produce high quality research in primary care
or reimbursement for conference fees or trips to resort areas all         to improve the health care of minority and underserved chil-
expenses paid? Obviously these marketing techniques have                  dren. Our research goals are threefold: 1) to study the health
paid off for companies over the years or the companies would              and health care issues of minority and underserved populations;
have stopped this practice long ago. Why does this practice of            2) to investigate health care disparities; and 3a) to study resi-
gift giving work? It does so because it sets up, consciously or           dent education, 3b) to compare practice behaviors between resi-
unconsciously, a feeling of obligation on the part of the re-             dents in their continuity practices with pediatricians in their
ceiver towards the giver. And therein lies the potential for con-         practice settings and 3c) to increase resident exposure and in-
flict of interest. The American Medical Association published             volvement in primary care research.
guidelines addressing the issue of gifts from industry 10 years
ago. These guidelines, for the most part, have been ignored.              We currently have 28 institutions that have enrolled in COR-
Now PhARMA, a group of major pharmaceutical companies,                    NET. Our goals are to continue recruitment of practice sites
has drawn up similar guidelines, and as of July 2002, these               with concentration on recruitment from underrepresented re-
companies voluntarily have agreed to abide by them. For my                gions, expand our recruitment to community continuity sites at
medical center this means no more free backpacks for the in-              each institution, solicit ideas for future research projects, work
coming residents, no summer picnic (sponsored by one of the               on the development of the research and obtain ongoing exter-
formula companies) for faculty, fellows, residents and their              nal funding. Recent notification of start-up funding from AHRQ
families, and no more baseball tickets, to name a few of the              will enable us to move forward with infrastructure expansion
items and events. All I can say is that it’s about time!!!!!              including web-based data entry and statistical support.

This year the 2003 Research Committee workshop will focus                 We look forward to collaborating with many of you in future
on conflict of interest in pediatric research. This workshop will         projects.
be held on the morning of Tuesday, May 6. Many of the above
research-related issues will be explored, and hopefully we will           Project Director: Janet R. Serwint, Johns Hopkins University
have time to discuss the more subtle, but real conflicts we face          Communication Director: Susan Feigelman, University of
every day. As always, there will be plenty of opportunities to            Maryland Recruitment Director: Marilyn Dumont- Driscoll,
network with colleagues on these and other very important as-             University of Florida
pects of academic life. Hope to see you there!

Volume 42                                                   Number 2                                            Fall/Winter 2002

        APA EDUCATIONAL GUIDELINES FOR                                       Chair of Advisory Board)
         RESIDENCY TRAINING IN GENERAL                                   ·   American Academy of Pediatrics (Robert Perelman)
                      PEDIATRICS                                         ·   American Board of Pediatrics (Gail McGuinness)
        Revision Project: Fall 2002 Progress Report                      ·   American Board of Medical Specialties “Quad” to
                                                                             Define Competencies in Pediatrics (Carol Carraccio,
With funding from the Macy Foundation, the APA is revising                   Gilbert Liu, Gail McGuinness)
its Educational Guidelines for Residency Training in General             ·   Association of Medical School Pediatric Department
Pediatrics, first published in 1996. The revised Guidelines will             Chairs (Elizabeth McAnarney)
address the new Accreditation Council for Graduate Medical               ·   Association of Pediatric Program Directors (Carol
Education (ACGME) competencies and curriculum require-                       Carraccio)
ments, as well as recent advances in the science and practice of         ·   Council on Medical Student Education in Pediatrics
pediatrics. Moreover, the document will be mounted on the                    (Richard Sarkin)
web as a live database, so users can search and sort the goals           ·   Federation of Pediatric Organizations (Carol Carraccio,
and objectives and download information in a variety of user-                Kenneth Roberts)
defined formats.                                                         ·   Pediatric Education Steering Committee (Richard
The revision project is rapidly progressing on a very demand-            ·   Residency Review Committee (Carol Carraccio,
ing timeline. On August 1, the Revision Project Team received                Gilbert Liu, Gail McGuinness)
revised drafts of sections of the document from eight section            ·   Society for Adolescent Medicine (Trina Anglin)
editors, who were helped by dozens of contributors (general-             ·   Society for Developmental and Behavioral Pediatrics
ists and specialists) to update their section. In September, the             (Martin Stein)
team completed a massive review and editing process, in order
to circulate a composite draft for further content review to gen-
eralists, specialists, and organizations involved in various as-
pects of pediatric education. A meeting with representatives of
these organizations, who compose the Educational Guidelines
Advisory Board, will take place in early November. In Decem-
ber, the APA will begin loading the document into a database.
Goals and objectives will be coded by ACGME competency,
rotation, keywords on hot topics, and assigned fields for teach-                           REMINDER
ing and evaluation methods, to enable users to obtain the infor-
mation most suitable for their educational program.                                    Please contact the
A beta test of the Educational Guidelines website will be initi-                          APA National
ated at the Association of Pediatric Program Directors (APPD)                             Office if your
and PAS meetings in May 2003. The Project Team will give
workshops and demonstrations at both meetings. A set of com-
                                                                                       e-mail address has
puters will be set up at the PAS meeting in the APA Focus                                   changed.
Lounge, to allow individuals to explore the website and pro-                            This is extremely
vide feedback on the formats of user-defined output documents.
The beta test will proceed online from May - December 2003,                               important for
with new functions added to the website for testing during this                         keeping the APA
period. The final website will be prepared for formal launch-
ing in May 2004.                                                                       listserves current.
Project Team: Diane Kittredge, Constance Baldwin, Mimi
Bar-on, Patricia Beach, Franklin Trimm
Consultants: Kenneth Roberts, Carol Carraccio, Liz Wilson
Section Editors: Mary Ottolini, Angelo Giardino, John
Frohna, Michelle Barratt, Lynn Garfunkel, Robert En-
glander, Christopher Smith, Stephen Ludwig, Tina Master
Advisory Board:
· Ambulatory Pediatric Association (Kenneth Roberts,

Volume 42                                          Number 2                                    Fall/Winter 2002

                               Pediatric Academic Societies
                                     Annual Meeting
                                                May 3-6, 2003
                                 Washington State Convention and Trade Center
                                                  Seattle, WA

Plan now on joining over 4,500 of your colleagues in Seattle to support our common mission of discovery, excel-
lence in care, and dissemination of new knowledge. We are arranging an extraordinary 2003 program that reflects
the breadth of pediatric research with topical and timely presentations and exchanges that will keep the scientist
and practitioner interested in children’s health occupied from start to finish. In addition, numerous educational
opportunities can be found through the panoply of educational seminars, workshops and special interest groups.
Original research remains the core value of the meeting and submission of your best research is encouraged.
More information about abstract submissions, the program and the outstanding faculty participating this year will
be available on the PAS website at soon. We look forward to seeing you!

                                         Program Highlights
State of the Art Plenary                                      Topic Symposia
    • Advances in Neonatal Nutrition                             • Animal Models of Human Cardiac Disease
    • Evaluation/Challenges to Academic                          • Birth Defects in Developing Countries
        Health Centers                                           • Bone Health
    • Fetal Origins of Adult Disease                             • Developmental Neurogenetics
    • Herpes Viruses                                             • Genetic Basis of Complex Disease
    • Immunodeficiency Syndromes                                 • Genetic Basis of Gastrointestinal Disease
    • Sepsis                                                     • Health Care/Foster Care
    • Sex and the Pediatrician                                   • “Home From War”–Follow Up Post Hemato-
    • The Changing Faces of Pediatrics: Clinical Care,               poietic Stem Cell Transplant
        Training and Research                                    • Intrauterine Environment on Neonatal
Mini Courses                                                         Outcomes
   • Cancer and Adolescence                                      • Lung Water
   • Genetics in Primary Care/Molecular Biology                  • New Genetics of Acute Leukemia
   • Handheld Computers                                          • Newborn Screening
   • Lipid Disorders                                             • Nutrient Signaling
   • Office Management of Spasticity                             • Outcomes/Translational Research
   • Pediatric Environmental Health                              • Pediatrics and Public Health
   • Pediatric Rare Tumors                                       • Reperfusion Injury Mechanisms
   • Substance Abuse – Current Issues                            • Smallpox
   • Update on Psychopharmacology in Children:                   • Solid Organ Transplantation
      Adolescents                                                • STDs – Current Issues
                                                                 • Vaccines
Hot Topics
   • Health Disparities
   • Hot Topics in Adolescent Medicine
   • Hot Topics in General Pediatrics
   • Neonatal Hot Topics

Volume 42                                           Number 2                                       Fall/Winter 2002

                                        Educational Workshops
Over 110 workshops will be presented focusing on practical topics of concern for trainees and
junior scholars and on medical education, research, clinical issues, health services delivery and
advocacy. Offerings for 2003 can be found on the PAS meeting website at


Receipt Deadline: Friday, December 6, 2002 Submit Online at URL:

         PAS Program Office * 3400 Research Forest Drive, Suite B 7 * The Woodlands, TX 77381
               Phone: 281-419-0052 * Fax: 281-419-0082 * E-mail:

                          POSTER SESSION ON CURRENT GENERAL
                               TRAINING, RESIDENCY AND

            This poster session will:
            1) Highlight the uniqueness of these grant activities as well as their contributions in shap-
            ing graduate medical education for the nation;

             2) Provide a forum for project directors of HRSA funded grants to discuss their activi-
            ties, challenges and innovations directly with other project directors and colleagues inter-
            ested in medical education, with the possibility for replication in other programs;

            3) Provide an opportunity for initiating networks and collaborative activities with other
            grantees and participants at the annual meeting and;

             4) Provide an opportunity for HRSA to showcase measurable outcomes from residency,
            faculty development, predoctoral and academic units in primary care grant activities to
            the pediatric community. Abstract deadline is February 15. Contact Amy Pulupa at the
            APA Office for further details at

Volume 42                                                           Number 2                                                    Fall/Winter 2002

                                 2003 Pediatric Academic Societies Annual Meeting
                                               May 3-6 ~ Seattle, WA

       SATURDAY, MAY 3                         SUNDAY, MAY 4                          MONDAY, MAY 5                         TUESDAY, MAY 6
8:30am (&9:30am) – 11:30am                     7:00am – 8:00am                        7:00am – 8:00am                       8:00am – 10:00am
 Educational Workshops (*) &             Meet the Investigator Breakfast            APA Regional Breakfasts                  Topic Symposia &
 APA Special Interest Groups                                                                                               Subspecialties/Themes
                                              7:30am – 9:00am                         8:00am – 10:00am                (Original Science Abstract Programs)
     8:30am – 11:30noon                   APA Past Officers Breakfast                  Topic Symposia &
        Mini Courses                                                                 Subspecialties/Themes                  8:45am – 11:45am
                                              8:00am – 10:00am                 (Original Science Abstract Programs)      Educational Workshops &
                                               Topic Symposia &                                                         APA Special Interest Groups
                                             Subspecialties/Themes                   9:00am – 12:00noon
                                        (Original Science Abstract Program)        Educational Workshops &                   10:15am – 1l:15am
                                                                                  APA Special Interest Groups          State of the Art Plenary Session
                                        8:00am – 10:00am OR 11:00am
                                          Educational Workshops (*) &                 10:15am – 12:15pm
                                          APA Special Interest Groups                Subspecialties/Themes
                                                                               (Original Science Abstract Programs)
                                              10:15am - 11:45pm
                                          APS Plenary/Howland Award                 10:15am – 12:00noon
                                          & (11:15am) St. Geme Award               SPR Presidential Plenary,
                                                                                  Awards & E. Mead Johnson
                                              11:45am - 1:45pm                         Award Lectures
                                              Poster Session II &
                                            HRSA Workshop Posters

                                               1:45pm – 2:30pm                        12:00noon – 1:30pm                 12:00noon – 1:30pm
                                                  Lunch Break                           APA Luncheons                      Poster Session IV
                                              APS Business Meeting
                                                                                      12:15pm - 1:00pm
                                                                                     SPR Business Meeting

 12:00noon (&1:00pm) – 3:00pm                 2:00pm – 5:00pm                        1:00pm – 2:45pm                         1:45pm – 3:45pm
          Mini Courses                    Educational Workshops (*) &             March of Dimes Prize in                       Hot Topics
  Educational Workshops (*) &             APA Special Interest Groups          Developmental Biology Lectures                Topic Symposia &
   APA Special Interest Groups                                                                                             Subspecialties/Themes
                                               2:30pm – 4:00pm                       1:45pm – 5:00pm                  (Original Science Abstract Programs)
        3:15pm - 5:15pm                 State of the Art Plenary Sessions         APA Presidential Plenary &                          and
        Topic Symposia &                        *PPC - 2 Hours*                      Armstrong Lecture                     Educational Workshops
 (Original Science Abstract Programs)          4:15pm – 6:15pm                        3:00pm – 5:00pm
      Educational Workshops                    Topic Symposia &                       Topic Symposia &
                                             Subspecialties/Themes                  Subspecialties/Themes
         3:15pm - 5:15pm                (Original Science Abstract Programs)   (Original Science Abstract Programs)
         APA Committees
                                              5:00pm – 6:00pm                         5:00pm – 6:45pm
        5:15pm - 7:15pm                     APA Business Meeting &               Exhibits & Poster Session III
        Poster Session I, &                        Awards
        Opening Reception                                                                Evening
                                                6:00pm - 7:00pm                  APA Board/Awardees Dinner
        7:15pm - 8:30pm                            APA Debate
    PAS Presidential Reception                                                            Evening
                                                 Evening                       Open for Departmental Activities
            Evening                      APS Member/Howland Dinner
 Open for Deparmental Activities

     Exhibits Open 4pm-7:30pm                Exhibits Open 11am-3pm               Exhibits Open 2:45pm-6:45pm                  Exhibits Closed

Volume 42                                                    Number 2                                       Fall/Winter 2002

                      BOOK REVIEW                                                   Welcome New Members !

                    Fast Food Nation                                      Chavi Agarwal                 Angela LaRosa
           The Dark Side of the American Meal                             Ingrid Allard                 Mary Alice Lee
                    By Eric Schlosser                                     David Amin                    John P. F. Lopez
             HarperPerennial, 2001. 384 pages.                            Jennifer Anders               John C. Luk
           Reviewed by Kathi Kemper, MD, MPH                              Galia Austin-Leon             Keith Mann
Do you eat? Does anyone in your family eat? Do your patients              Jennifer Bass                 Michael Miescier
eat? If the answer to any of these questions is “yes,” you must           Allison Beitel                Kristin Millin
read Fast Food Nation. After you read it, talk with your col-             Joan Bregstein                Rakesh Mistry
leagues, your family and your patients about it. So many of us            Richard Lee Bucciarelli       Takao Nagai
eat quickly, fitting our meals in between our racing obligations,         J. Auxford Burks              Nancy Payne
deadlines and errands. We seldom stop to think about what                 Heather Butler                Dana Erikson Ramirez
goes into that meal, what happens to those who grow, process,             Marina Catallozzi             Rebecca Ryder
distribute and sell the food or the greater costs to our society          Alison Chantal Caviness       Roytesa Savage
and environment associated with our food choices. Reading                 Karen Corrigan                Lisa Scharff
this book makes you think about all those issues; it is thought           Lauren Daly                   Kimberly Schwartz
provoking; it raises questions, and that is the mark of a good            Craig DeWolfe                 Philip Siefken
education. It makes you think more deeply and consider the                Amy Drendel                   Anushua Sinha
causes and consequences of each day’s actions and each life’s             Eric W. Fleegler              Alyson Smith
work. The writing is clear, cogent, and compelling without being          Thomas George                 Julie Spangler
“preachy”. It’s an easy read, but not easy to digest. Here’s an           Gwen Glew                     Nancy Spector
example of one of the many facts presented, “This year, Ameri-            Marney Gundlach               Jeffrey Sperring
cans will spend more money on fast food than on higher edu-               Donna Halloran                Natasha Sriraman
cation.” Is that true? If it is, what does that mean? What should         Srikant Iyer                  Susanne Tanski
I do about it? Lest you be overwhelmed with huge social and               Makoto Kamada                 Judith Taylor-Fishwick
political problems beyond your reach, Schlosser offers you a              Catherine Karr                Christina Ullrich
clear and simple section, “What to do.” If you take care of               Abeer Khayat                  Kimberly Uyeda
children, know a teacher, a principal or a parent, read this book.        Mona Shah Kulkarni            Laura Voigt
Who knows, it may provide the spark for the next APA Public               Walter Lambert                Sophia Yen
Policy statement or it just might change your life.

                                                  AMBULATORY PEDIATRICS
                                                  NEW EDITORIAL WEBSITE
                                                      James Perrin, MD

Ambulatory Pediatrics, the official journal of the APA, continues to thrive and grow. Recent special issues include ones on
children’s oral health and on health services research and pediatric emergency medicine. The journal receives steadily increasing
numbers of manuscripts on diverse topics, with a special emphasis on pediatric education and child health services research and

Members receive the journal as a membership benefit and can also access the electronic version easily through the journal website
( or through the APA website.

We are delighted to let you know that Ambulatory Pediatrics has entered into an arrangement for web-based manuscript submis-
sion and review with Allen Press. The system is up and operational now, so you can submit your manuscripts now through the
website, Many APA members have helped the journal as reviewers and as authors, and almost all of the
reviewers are now included in the person database of the journal on the web. So, you can check if you’re there – and update the
files as well!! We’re particularly interested in knowing your areas of interest and expertise. As of January 1, 2003, we will
encourage submission of essentially all manuscripts to the journal by the new method. The new website also allows reviewers to
download manuscripts from the web and to send their reviews directly to the journal through the website.

Volume 42                                                         Number 2                                                    Fall/Winter 2002


JUNIOR FACULTY MEMBER                                                          402, Las Vegas, NV 89102. Applications received by January 31, 2003
Carolinas Medical Center                                                       will be given full consideration. AA/EOE.
Charlotte, North Carolina
The Department of Pediatrics at Carolinas Medical Center is seeking
a junior faculty member to join a collegial general pediatric faculty                                         tttt
with a primary commitment to teaching. Responsibilities include                DIVISION CHIEF
supervision of residents and students in a full range of inpatient and         University of North Carolina
outpatient settings. Some flexibility in time commitment (75% to               Chapel Hill, North Carolina
full time) is available. Fellowship training or academic experience is         The University of North Carolina at Chapel Hill is seeking an experi-
preferred. Preference will be given to candidates with special inter-          enced general academic Pediatrician to serve as Chief of the Division
est or expertise in the management of common behavior problems.                of Community Pediatrics. The Division is the largest in our depart-
                                                                               ment with major clinical, research and educational responsibilities.
The Carolinas HealthCare System ( is               The Division has a long tradition of excellence in research (clinical,
a large, vertically integrated system of acute and chronic care facili-        health services, educational, epidemiological and quality improve-
ties and physician practices in North and South Carolina. The Sys-             ment). The Division staffs the general inpatient service, the newborn
tem includes a full service Children’s Hospital within a hospital,             nursery, the residents’ continuity clinic and the Pediatric Emergency
multispecialty teaching clinics, and an off-campus adolescent health           Department. We are looking for an individual to provide innovation
center. Its flagship institution is Carolinas Medical Center, a 777-bed        and leadership to these critical missions. Send CV and inquiries to:
academic medical center that is home to 10 residency programs. The             Albert Collier, MD, Chief, Division of Infectious Diseases, UNC-
pediatric residency program has 7 residents at each level. Residents           CH, CB# 7220, Chapel Hill, NC 27599-7220. UNC is an equal op-
from family medicine and emergency medicine also rotate on the gen-            portunity/ADA employer.
eral pediatric teaching services.

Charlotte, North Carolina is a vibrant, growing city with an excellent                                        tttt
quality of life. We enjoy a variety of cultural and recreational oppor-
tunities throughout four distinct seasons. Lakes, mountains, and the           FACULTY, GENERAL PEDIATRICS CHILD ADVOCACY
Grand Strand beaches are nearby.                                               Baystate Medical Center
                                                                               Western Campus of Tufts University School of Medicine
Please direct inquiries to:                                                    Springfield, Massachusetts
Laura Noonan, MD, Department of Pediatrics, Carolinas Medical                  The Division of General Pediatrics at Baystate Medical Center is seek-
Center, P.O. Box 32861, Charlotte, NC 28232. Telephone: 704-355-               ing a full time faculty member. The ideal candidate will be energetic,
3156                                                                           innovative, and interested in medical education and clinical practice
                                                                               in an academic setting. We are particularly interested in individuals
                               tttt                                            experienced in evaluation of child abuse and neglect. An interest in
                                                                               caring for ethnically diverse population of children and adolescents,
ADOLESCENT MEDICINE (PEDIATRICS)                                               as well as an interest in teaching is required. Fellowship training in
University of Nevada School of Medicine                                        General Pediatrics, demonstrated ability to do clinical research, and a
Las Vegas, Nevada                                                              working knowledge of medical Spanish are preferred but not required.
The University of Nevada School of Medicine, Las Vegas campus, is
seeking a pediatrician specializing in Adolescent Medicine at the As-          Baystate Medical Center, Baystate Health System’s flagship hospital
sistant/Associate Professor level. Candidates should be board certi-           and the Western Campus of Tufts University School of Medicine has
fied in Pediatrics, fellowship trained in Adolescent Medicine and              over 600 inpatient beds and residency programs in pediatrics, medi-
qualified for Nevada medical licensure and malpractice insurance               cine, med/peds, surgery, anesthesiology, radiology, OB/GYN, emer-
coverage. M.D. degree or equivalent. Responsibilities include par-             gency medicine, and pathology. Baystate Medical Center houses
ticipation in medical student education and resident supervision, in-          Baystate Medical Center Children’s Hospital and its Family Advo-
patient and outpatient clinical practice activities and collaboration          cacy Center (FAC). The FAC is the only hospital-based Children’s
with community. Interest in developing clinical research opportuni-            Advocacy Center in Massachusetts, and is a fully certified program
ties and outreach programs is desirable. For complete position an-             of the National Children’s Alliance. FAC staff conduct
nouncement see Interested candidates should sub-          multidisciplinary evaluations and has a strong therapy program with
mit a letter of application, an updated curriculum vitae, and names            a staff on on-site therapists.
and addresses of three references to: Bernard H. Feldman, MD, MPH,
Department of Pediatrics, UNSOM, 2040 W. Charleston Blvd., Suite               This position would fill the Medical Director’s position at the FAC

Volume 42                                                         Number 2                                                    Fall/Winter 2002

with shared responsibilities in the Division of General Pediatrics.  
                                                                               Baystate Health System is an Equal Opportunity Employer
Springfield is located in the beautiful Connecticut River valley in the
foothills of the Berkshires with convenient access to coastal New                                             tttt
England, Vermont and metropolitan Boston and New York.
                                                                               PRIMARY CARE/GENERAL PEDIATRICS
Interested applicants should submit a CV and cover letter to:                  Yale School of Medicine
Robert S. Gerstle, MD, Director, General Pediatrics, c/o Don Rain-             New Haven, Connecticut
water, Baystate Health System, 759 Chestnut Street, Suite S1578                We are recruiting an individual to teach and supervise residents in
Springfield, MA 01199. Telephone: 800-767-6612                                 our Primary Care Center and to function as a Resident Continuity
Fax: 413-794-5059 Email:                                 Group Team Leader. A career interest in Pediatric Ambulatory Edu-
Baystate Health System is an Equal Opportunity Employer                        cation is essential. This position is full time; 80% of the time will
This position does not qualify for a J-1 Visa Wavier                           focus on Resident supervision and teaching and 20% will focus on
                                                                               academic endeavors in Pediatric Ambulatory education. Fellowship
                               tttt                                            training in a discipline related to Primary Care/General Pediatrics is
                                                                               desirable. Faculty appointment will be as an Assistant Professor in
CHIEF, GENERAL PEDIATRICS                                                      the Section of General Pediatrics. Interested individual should con-
Baystate Medical Center Children’s Hospital                                    tact Paul McCarthy, M.D., Section of General Pediatrics, Department
Western Campus of Tufts University School of Medicine                          of Pediatrics, Yale University School of Medicine, P.O. Box 208064,
Springfield, Massachusetts                                                     New Haven, CT 06520. Yale is an Affirmative Action/Equal Oppor-
Baystate Medical Center Children’s Hospital is seeking a Chief of its          tunity Employer, Women and minorities are encouraged to apply.
Division of General Pediatrics, which includes 11.5 MD FTE’s and               Deadline is January 1, 2003.
multiple mid-level providers. The ideal candidate will have a strong
academic focus and qualify for an appointment at least as an Associ-                                          tttt
ate-Professor at Tufts University School of Medicine. The candidate
will have good organizational skills, be energetic, innovative, and be         ASSISTANT/ASSOCIATE PROFESSOR
interested in furthering the Division’s mission to provide medical             Saint Louis University School of Medicine
education, clinical programs (including impatient, newborn care, ado-          St. Louis, Missouri
lescent medicine, and community sites) and clinical research in an             The Division of General Academic Pediatrics in the Department of
academic setting. A desire to lead the care for an ethnically diverse          Pediatrics at Saint Louis University School of Medicine is seeking a
population of children and adolescents and to participate in medical           full-time faculty member at the assistant or associate professor level
student and resident education and clinical research is required. Fel-         to join the Division. Candidate must have training and/or experience
lowship training in General Pediatrics or subspecialty training and a          in Health Outcomes or Clinical Research. The successful candidate
working knowledge of medical Spanish are desirable. The division is            will have protected time to develop the outcomes/clinical research
heavily involved in resident education and supports a large continu-           mission of the division. The individual will share educational and
ity clinic practice. There are 25 pediatric and 32 combined medicine-          teaching responsibilities in the clinic and hospital setting with cur-
pediatric residents in our program. The demonstrated ability to men-           rent faculty.
tor faculty in clinical research is very desirable.
                                                                               Patient care activities are based at Cardinal Glennon Children’s Hos-
Baystate Medical Center is the Health System’s flagship hospital and           pital, a 165 bed free-standing hospital located immediately adjacent
the Western Campus of Tufts University School of Medicine. BMC                 to the St. Louis University Medical Center in midtown St. Louis. The
is a tertiary care hospital with over 600 beds and residency programs          medical staff includes 90 full time site-based Saint Louis University
in pediatrics, medicine, combined med/peds, surgery, anesthesiology,           School of Medicine faculty. Saint Louis University is a Catholic Je-
radiology, OB/GYN, emergency medicine, and pathology. Baystate                 suit institution dedicated to education, research and healthcare.
Medical Center houses the Baystate Medical Center Children’s Hos-
pital. Baystate Health System is one of New England’s largest inte-            Please forward curriculum vitae to Timothy J. Fete, M.D., M.P.H.,
grated healthcare delivery systems.                                            Director, Division of General Academic Pediatrics, Department of
                                                                               Pediatrics, Saint Louis University School of Medicine, 1465 South
Springfield is located in the beautiful Connecticut River valley in the        Grand Blvd, St. Louis, MO 63104-1095. Phone: 314-577-5643.
foothills of the Berkshires with convenient access to coastal New
England, Vermont and metropolitan Boston and New York. The area                Saint Louis University is an affirmative action, equal opportunity
also supports a rich network of academic institutions including the            employer, and encourages nominations of and applications of women
University of Massachusetts and Amherst, Smith, Hampshire and                  and minorities.
Mount Holyoke Colleges.

Interested applicants should submit a CV and cover letter to:
Edward O. Reiter, MD, Chairman, c/o Don Rainwater, Baystate Health
System, Inc. , 759 Chestnut Street, Suite S1578, Springfield, MA
01199. Telephone: 800-767-6612, Fax: 413-794-5059, Email:

Volume 42                                                           Number 2                                                    Fall/Winter 2002

                                                    APA 2002/2003 LEADERSHIP ROSTER
OFFICERS                                                                        International Health
President                                                                         Anna Mandalakas          
  Stephen Ludwig                                   Cynthia Howard           
President-Elect                                                                 Literacy Promotion in Primary Care
  Paul Darden                                          Robert Needlman          
Secretary                                                                         Perri Klass              
  Paul C. Young                                Managed Care
Treasurer                                                                         Alan B. Bernstein        
  David Jaffe                                     Medical Informatics
Communications Director                                                           Kevin B. Johnson         
  Ruth Etzel                                      Medical Student Education
Immediate Past President                                                          Steve Miller             
  James Seidel                                  Newborn Nursery
                                                                                  Linda Meloy              
BOARD MEMBERS                                                                   Nutrition
 Katherine Kaufer Christoffel           Sandy Hassink            
 Marilyn Dumont-Driscoll                          Pain
 Michelle Barratt                         Neil L. Schechter        
 Lolita McDavid                                Pediatric Emergency Medicine Program Directors
 Tina Lee Cheng                                         Richard Ruddy            
 Lance Rodewald                                      Pediatric Tobacco Issues
SPECIAL INTEREST GROUP CHAIRS                                                     Dana Best                
Advocacy Training                                                                  Deborah Moss            
  David Keller                                       Pediatric Telephone Care
  Murray Katcher                              Allison Kempe            
AIDS/HIV                                                                        Pediatrics for Family Practice Residents
  Nancy Hutton                                          David Turkewitz          
Child Abuse                                                                     Practice-based Research Network
   Cindy Christian                             Robert Siegel            
Complementary and Alternative Pediatrics                                        Race in Medicine
  Scott Faber                                      Anne Beal                
  Sharon Riesen                                    Ivor Horn                
Community Based Physicians                                                      School & Community Health
  Emanuel Doyne                       emanuel.doyne                    Linda Grant              
  David Bromberg                            Mona Mansour             
Continuity                                                                        Nazrat Mirza             
  John Olsson                                     Serving the Underserved
Culture, Ethnicity & Health Care                                                  Wendy Hobson             
  Glenn Flores                                      Peter Sherman            
  Lee M. Pachter                            Women in Medicine
  John I. Takayama                                   Carol Berkowitz          
Developmental-Behavioral Pediatrics
                                                                                STANDING COMMITTEES
  Daniel Lee Coury          
                                                                                 Education                          Michelle Barratt
Division Directors in General Pediatrics                                         Research                           Katherine Kaufer Christoffel
  Gary A. Emmett                                    Health Care Delivery               Lance Rodewald
Emergency Medicine                                                               Public Policy & Advocacy           Lolita McDavid
  Halim Hennes              
Environmental Health                                                            OPERATIONAL COMMITTEES
  James Roberts                                       Communications                     Ruth Etzel
  Ben Gitterman                                       Finance                            David Jaffe
Faculty Development                                                              Membership                         Tina Lee Cheng
  Charlene Gaebler-Uhing                              Regions                            Tina Lee Cheng
  Latha Chandran                          Nominating                         Kenneth Roberts
Health Services Research                                                         Liaisons                           Paul Darden
  Lawrence C. Kleinman                        SIG Coordinator                    Marilyn Dumont-Driscoll
 Injury Control                                                                  Workshop Coordinator               Marilyn Dumont-Driscoll
  Seth Scholer              
  Bob Sege                                          JOURNAL EDITOR
Inpatient Medicine/Hospitalist                                                   James M. Perrin          
  Daniel Rauch              
  Patricia Lye                                            NATIONAL OFFICE                     703-556-9222
                                                                                 Executive Director                 Marge Degnon
                                                                                 Executive Assistant                Amy Pulupa

Volume 42                                                       Number 2                                          Fall/Winter 2002

                                           APPLICATION FOR MEMBERSHIP

Name: _____________________________________________________ Degree(s): ______________
Telephone:_______________________________ FAX: ____________________________________
**Ethnicity: oWhite, Non-Hispanic oHispanic oAfrican-American oAsian oOther_______
Date of Birth: ____________________________ E-Mail: __________________________________
Mailing Address: ____________________________________________________________________
Medical Institution Affiliation: __________________________________________________________
Present Position: _____________________________________________________________________
Proposer: ___________________________________________________________________________
Seconder: __________________________________________________________________________
(Please include both the name and signature of your sponsors. BOTH must be current APA members.)
Teaching: ___________________________________________________________________________

Patient Care: ________________________________________________________________________

Patient Care Research: ________________________________________________________________
*You will be automatically added to the electronic network, APA-Net, unless you check the box below.
              Please do not add me to APA-Net.
** Your response is voluntary and will help the APA achieve its goal of promoting diversity.

APA Dues:                                                                  Send this application, signed by the proposer and
o In Training                $50.00                                        seconder, with curriculum vitae and dues payment
o Non-Physician              $100.00                                       in US dollars to:
o Physician                  $200.00
                                                                                             Membership Chair
Please make checks payable in US dollars to the Ambulatory
Pediatric Association
                                                                                       Ambulatory Pediatric Association
                                                                                       6728 Old McLean Village Drive
(Credit Card Payment Options: Master Card & Visa)                                            McLean, VA 22101
Print Cardholder Name:                                                                      Phone: 703-556-9222
Card Number:                                                                       
Expiration Date:                                                                   
Signature of Cardholder:
                                                                                     Applications are reviewed monthly.

         e Yo

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AMBULATORY PEDIATRIC ASSOCIATION                                       FIRST CLASS
6728 Old McLean Village Drive                                       U.S. Postage Paid
McLean, VA 22101                                                    McLean, VA 22101
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