Minutes of Board Meetings

Board Meeting:  April 12, 2007

Attendance: Abraham Hamaoui, MD, James Neuerdorf, MD, Dan Miller, MD, Bob Morrow, MD, Sudhir Vaidya, MD, Lori Weir, MD, Doug Hudson, MD, Sofia Din, MD (resident), Nancy Georgekutty, MD (resident)

Meeting was called to order at 8:20PM. 

The minutes of the previous meeting were reviewed and approved.

Second Annual BWAFP Neuro-Rehabilitation Seminar and Awards Dinner

Evaluations from the seminar held earlier this evening were generally positive and rate the presentations as fair to good.

Dr Sudhir Vaidya was commended for the organization and preparation of the program.  The lectures were very instructive.

Later, there was a discussion as to ways to improve attendance.  Improved support from the local residency directors would be helpful but no concrete suggestions as to how to achieve this were made.  Dr Lori Weir suggested to make phone calls to chapter members, and to make a personal contact.  Though some individuals have taken offense to this in the past it was decided to go ahead and try again.

Dr Morrow suggested that other topics or activities such as “Sam Parties” might have a broader base of appeal and have better attendance.  This idea was met with general support and it was decided to try to plan one of these sometime later in the summer or fall.

Electronic Medical Records

An update on academy and governmental efforts to institute systems of electronic medical records was discussed.  NYC has received a HEAL Grant to assist in developing a system in the 5 boroughs of New York City, but this will not include Yonkers or other areas of Westchester County.  Some grant money has been received by the State Academy, which will likely be used to help practices develop and install electronic records keeping systems.  There will likely be opportunities for individuals to become educators for these systems as well as to institute such systems in their practices at a reduced cost.  Other grants are also being sought to develop disease specific programs such as diabetes care/education/prompts/etc.  It was pointed out that one of the major obstacles to developing uniform systems of record keeping accessible to everyone stems from “competition” and the multiple systems which always develop in the US.

Call for Action:

Those individuals interested in becoming educators or obtaining more information about these programs should contact the NYSAFP.

Upcoming State Academy Meeting and Congress of Delegates

Anyone who plans to attend the meeting and would like to participate more actively in the Bronx-Westchester Chapter should contact Dr Abraham Hamaoui.  Dr Hamaoui is testing the waters to run for Vice-President of the NYSAFP and the support of Delegates at the Congress would be extremely helpful.

The meeting was adjourned at 9:00PM.

Respectfully submitted,

Doug Hudson, MD

BWAFP Meeting Chair : March 29.2007

The meeting was called to order and the business most urgent was to nominate the delegates to the 2007 Congress of Delegates to the NYSAFP and to have elections for Officers of the Board (in construction).

Board Meeting:  Tuesday, January, 11, 2005

Board Meeting Agenda:

1. ALSO Courses
2. Research Forum
3. Future Activities

Minutes
The meeting was called to order by Dr Deen. 
Present: Drs A. Hamaoui, D. Deen, E. Natal and M. Douglas. Excused: Drs Yudin and Neuedorf

The items of the agenda were opened and discussed in sequence. 
The minutes of the last meeting were reviewed and approved. The budget was approved.
ALSO courses: After much discussion the decision was made that the BWAFP will relinquish to the NYSAFP the organization of the ALSO provider courses as of 2006, as now the objectives of 1) bringing ALSO to the area; 2) improving the OB resources available to the programs; 3) developing a network of FP involved in OB; 4) development of local instructors and faculty advisors; 5) establish a tradition of sequential ALSO courses have been achieved. It is expected that the NYSAFP will continue to organize ALSO provider and instructor courses for the whole state and increase networking and knowledge base for maternal care. 
Research Forum: The discussion was opened and several members brought up the subject that of poor showing and need to improve the presentation skills and methodology of resident presentations in general. A point was raised to send a second request for the NYSAFP to return its Research Forum to the summer and not hold it in winter, in date so close to our local traditional Forum. Dr Hamaoui reported that the web journal concept, though approved has not proceeded in its development as no one has yet collaborated. A suggestion was made to initiate a registry of all resident projects in our area, to make available on the net and thus disseminate the resident work.
Research Teaching Day: The board decided to dedicate its effort in the next three to five years in developing a research course for the residency program in the model of the ALSO project and the Sports Med Teaching Day. Each program would have a liaison faculty for research and would send two participants to annual research teaching days. A further effort in developing local conjoined research projects would be made.
Seeing the lateness of the hour, and no further business to discuss, a motion to adjourn was called, seconded and the meeting ended.

Board Meeting:  Monday, March 21, 2005

Board Meeting Agenda:

1. Election of Delegates- COD June 2005
2. Website – How does it look like? Make it more interactive? Contributions from other officers and residents
3. Maternal Care- 6^th Ed. Deadline for turning material May 31^st
4. OB – Network ALSO.  Where do we go from now?
5. Budget – Approval of past accounts and new budget
6. Events – Planning for Sports Medicine, Sports Medicine Development Fellowship, Research Forum, Management Teaching & Leadership Forum, Web Journal
7. Other business – New FMIG meeting in Manhattan

Minutes
The meeting was called to order by Dr Hamaoui. 
The minutes of the last meeting were reviewed and approved. The budget was approved.

Present: Drs A. Hamaoui, D. Deen, J. Halbach and J. Rodriguez.

Excused: Drs Yudin and Neuedorf

The items of the agenda were opened and discussed in sequence. The delegates to the COD were chosen as follows: Abraham Hamaoui, Meg Rosenberg, Jose Rodriguez and Howard Yudin. Alternates Bruce Soloway, James Mumford, Rebecca Williams (Montefiore)  Sudhir Vadya and Fabienne Daguil.
An annual meeting for FMIG was called for and the NYSAFP should support this event.
A decision was made to continue as group to support the BWAFP activities for the next five years.
Next year's calendar was approved.
A motion to adjourn was called, seconded and the meeting ended.  March 14, 2000 Board Meeting
Prior to the meeting, medical students from Albert Einstein College of Medicine and New York Medical College were introduced to board members and Family Physician attendees. A lively, informative discussion ensued regarding career possibilities in Family Practice.
At 6:40 P.M. Formal Board meeting commenced.
Minutes of the prior board meeting were reviewed and accepted.
Dr. Hamaoui opened the meeting with congratulations, offered to the Bronx members for consistent representation at the board meetings.
It was recommended that an additional position of vice-president from the Bronx be added to board membership. Attending members concurred and Dr. Bruce Soloway was nominated for the position.
Norma Lopez was nominated as the delegate to the Women's delegate and Nereida Correa MD was nominated as the Minority delegate.
Dr. Hamaoui reviewed with the members, the highlights from NY State Academy's - Albany cluster and lobbying activity. It was recommended that attempts be made to increase this chapter’s involvement at the state level as well as entertaining local lobbying or political actions. (i.e.; meeting with or state and Federal representatives).  A sub-committee will be formed to review the feasibility of this issue.

Yearly Activities were presented:

1. Spring ALSO, Advanced Life Support in Obstetrics course scheduled for April 7& 8, 2000 at the Bronx Lebanon Hospital. The board congratulated Drs. Hamaoui  and Soloway on their efforts and involvement with organizing this course.
2. Board member elections would occur in May and for the first time via E-mail, in attempt to reach a larger percentage of members.
   Proposed nominees:
   President- Dr. Abraham Hamaoui
   Vice President- Westchester- Dr. James Neuendorf
   Vice President- Bronx- Dr. Bruce Soloway
   Treasurer- Dr. Howard Yudin
   Secretary-
3. NY State Academy's Congress of Delegates and Health Policy Conference is scheduled for June 23-25, 2000 at Hotel Thayer, West Point, NY
   Delegates and Alternates were elected;
   Delegates
   Dr. Abraham Hamaoui
   Dr. James Neuendorf
   Dr. Howard Yudin
   Dr. Bruce Soloway
   Alternates
   Dr. Darwin Deen
   Dr. Meg Rosenberg
   Dr. Joseph Halbach
   Dr. Norma Lopez
4. The next Board meeting will be held at La Refuge on Tuesday, June 27, 2000.  Agenda for the meeting will be:
   a) Installation of Board Members
   b) Educational talk on Diabetes Mellitus.  Dr. Yudin will secure arrangements for the educational portion of the meeting.
5. Resident Teaching Day will be tentatively scheduled for September 9^th or October 21, 2000, so as not to interfere with the National American Academy of Family Physicians in Dallas, Texas in September. 
   Options for suitable locations for the day conference were presented to the committee and a final decision will occur at the next meeting.  Topics will include both didactic and procedural instructions in the areas of Sports Medicine and Gynecology.  Dr. Cohen offered her assistance in organizing the sports medicine portion of  the program.  In addition, the program will be centered around a luncheon with a topic of generic interest in medicine.  The topic will be decided later and will depend partly on availability of speakers. 
   The conference will be offered to all Family Practice Residency programs in Bronx-Westchester area and mandatory for most senior residents. 
   New Business:
   As an addition to the agenda, Dr. Soloway inquired of Board Members, if anyone had expertise regarding billing for special procedures, under Managed Care Contracts.  The Board concurred that most contracts are site specific and that it would be necessary to refer directly to the contract in place.  In most cases, special procedures are encompassed in the contracted fee.  However, in some cases addendums to the contracts have allowed for enhanced reimbursement for procedures.  
   With no additional new business, the meeting was adjourned at 8:10 p.m.   
   
   

Respectfully submitted, 
James L. Neuendorf MD
Vice- President

Board Meeting:  Friday, December 3^rd 1999

Minutes of the meeting of the Board and the Ad Hoc on Scope of Practice Committee. This meeting on December 3^rd, 1999 followed the course on “Family Practice in the Next Millennium” and will accept the course as integral part of its minutes, including the discussions of the questions and issues brought up in the course.

Below is the schedule of the course:
Family Practice in the Next Millennium
Obstetrics in Family Practice

8:30 AM to 2:00 PM
At the Fulton Board Room at the Bronx-Lebanon Hospital.
(The Board Room is on the 2^nd floor (the street level) of the Fulton Division of Bronx-Lebanon Hospital at 1276 Fulton Avenue, corner of 169^th Street.)
Sponsored by the Bronx-Westchester AFP, the NYSAFP, the AECM and NYMC Depts. of Family Medicine.
Directors: B. Soloway, MD and A. Hamaoui, MD

8:30        Welcome: Bruce Soloway MD

8:35        A Few Words: George Dunn MD

8:40        Induction of Labor. New Strategies: Moderator: Donna Meltzer MD.  Speaker: Shabnam Sachdeva MD

9:00        Herbal Approach to Prenatal Maladies:  Moderator and Speaker: Leonard Scicutella MD

9:20          Addressing The New Tighter RRC Requirements for Prenatal and Maternity Care: Moderator: George Dunn MD. Speaker: Rhea Barton MD

9:50        HIV Management in L & D:  Moderator and Speaker: Bruce Soloway MD

10:05      Coffee Break

10:20      A Word from the President: Steve Tamarin MD

10:25      The Downstate ALSO Course Experience. What is the next step?: Moderator: Andreas Cohrssen MD Speakers: Enitza George MD and Fred Caston MD

10:55      Privileges & Liabilities For the Family Doc:  Moderator: Richard Bonnano MD
Speakers: Ariel Rodriguez MD, Maury Greenberg MD, Miriam Vincent MD PhD, Cheryl Parham, Esq, and Bruce Soloway MD

12:15      Lunch Buffet

1:00        Diversity in L&D. The (Team) Approach To Improve Outcomes:  Moderator: Meg Rosenberg MD

Speaker: Nereida Correa MD

1:50PM Closure   Abraham Hamaoui MD and Richard Bonanno MD.

Present at the meeting and course:

Steve Tamarin MD and Cheryl Parham, Esq, NYSAFP; Richard Bonanno MD and Fred Caston III MD, Southside Hospital; Donna Meltzer MD and Maury Greenberg MD, SUNY/Stony Brook; Miriam Vincent MD PhD and Enitza George MD, SUNY/Health Science Center; Shabnam Sachdeva MD Ariel Rodriguez MD, Lutheran’s Medical Center; Leonard Scicutella MD and Douglas Montgomery MD, Catholic Medical Centers; Rhea Barton MD and Abraham Hamaoui MD, NYMC at St. Joseph’s; Bruce Soloway MD and Meg Rosenberg MD, Bronx Lebanon; Nereida Correa MD from Montefiore Medical Center; Andreas Cohrssen MD, Wyckoff Heights Medical Center; Ginger Gillespie MD, Beth Israel; Larry Sokolski MD, South Nassau Communities; Liz Muggatt MD, Terri Clark CNM and Julie Denney CNM, Bronx-Lebanon Hospital. Justified absence: George Dunn MD, Marji Gold, MD and Sam Sandowski, MD

Dr Tamarin spoke in name of the NYSAFP thanking all for coming to the meeting and stressed the importance of the lectures and discussions to come out of this meeting. Dr Hamaoui stated that the course should receive CME (still in process - might not happen). He thanked Drs Soloway and Rosenberg for their help and support in preparing for the meeting.
Dr. Bonanno chaired the meeting. Opening, Dr. Soloway distributed policy statements of the AAFP and ACOG. He commented on several issues: clinical collaboration between OBs and FPs, joint responsibility of OBs and FPs for training FP residents in OB/GYN skills, core OB/GYN skills that need to be taught to FP residents and the general definition of "consultation". Dr. Hamaoui distributed recent articles published on family practice OB issues. The meeting permitted many to speak and discuss their point of views. Some questions were without consensus, given the different settings, and some were not able to be fully discussed due to the given limited time.

Among the issues brought up in the meeting are:

1. Difficulties in obtaining privileges, especially for inductions and almost impossible for C/S.
2. Privileges questioned whenever possible by OB/GYN Departments, especially if in a multi-residency hospital.
3. Not enough deliveries for the residency practice.
4. Low continuity delivery numbers for the residents.
5. Lack of FP role models who include OB in their community practices.
6. Lack of enthusiasm for obstetrics among faculty and residents.
7. Poor support or antagonism from obstetric attendings and residents and some midlevel practioners.
8. Honing and maintaining OB skills in teaching faculty.
9. Financial and incentive aspects of attracting and keeping OB-capable FP faculty.
10. Weak procedure training: vacuum, forceps, anesth., ultrasound, C/S.
11. RRC requirements for delivered patients.
    
    

Many of the problems stem from multi-residency sites with conflicting objectives and goals. OB and FP residencies need to endeavor to define a harmonious working environment. FP residencies need to have on site and use NST and US machines and sometimes encounter strong opposition from OB and radiology. As many programs are struggling with privileges and number for vaginal deliveries the issue of C/S is miles away. On emphasizing maternity care, some residents want to do C-sections (a reasonable expectation for rural docs at least).  There is no clear answer, at this time of who would train, where and how.

All seem to agree that residents are required to take ALSO and NRP. The general conclusion is that residency programs should preferentially require that each year a class of its residents, whether PGY-1s or PGY-2s to take the course. Also suggested a formal lecture on maternity care at least twice a month. An idea of a fellowship where family physicians are able to hone their skills was also suggested.

Drs. Sachdeva and Greenberg among others were in favor that OB privileges should be recommended by the Chair of the Dept of Family Medicine to the governing body rather than through a conjoint recommendation with the OB Department. There was a suggestion of e a block of core privileges to be recommended. A suggestion was emailed in by Dr. Gold to develop a collaborative fammed/midwifery birthing center designed for service and teaching of fammed residents.

A suggestion for a listserve for the downstate group of family physicians interested in doing OB was also made, seconded by Drs. Cohrssen and Meltzer.
The development of a joint research project in maternity care was brought up and Dr. Hamaoui stated he would do the initial work to get this up and running though there would be need for a small committee or task force to work together for this to become a reality. Dr Bonanno concluded the meeting thanking all who have taken the time to come and bring their contributions to such important matters. The minutes above are only a summary and do not do any justice to the many discussions and the intensity of the meeting.

Rhea Barton MD and Abraham Hamaoui MD