Cover photo: mscornelius via iStockPhoto.com

C M EMEETINGC M EMEETING

2017Sheraton Hotel & Spa, Anchorage

4/20–4/22

Alaska Chapter of the American College of Physicians and Alaska Osteopathic Medical Association

CME MEETING 2017

Table of Contents

Welcome Letter Page 3

ACP Disclosure form Page 4

Program at a Glance Page 6

Program Details:

Thursday, April 20, 2017 Page 7

Friday, April 21, 2017 Page 11

Saturday, April 22, 2017 Page 19

Conference Information Page 26

CME Credits Information Page 28

Attachments

List of Attendees

AKOMA Attestation of Attendance

Exhibitors Signature Card/Raffle Entry

SEP Instructions

Dear Colleague, Thank you for your participation in our CME Meeting 2017. The Alaska Chapter of the American College of Physicians (AK ACP) and the Alaska Osteopathic Medical Association (AKOMA) joined together again this year to offer you an outstanding continuing medical education program. We would like to thank the entire education planning committee for their hard work planning the program. Please review the agenda and note that in addition to the CME lectures there are several social functions you are welcome to attend. Thursday evening will feature a Wine and Cheese Social. The dinner banquet Friday evening will include guest speaker Dr. Jennifer Dow-Medical Director of the National Park Service Alaska Region on Wilderness Medicine in Alaska: Experiences and Opportunities. Sometimes the best education we get is from one another, so please take these opportunities to get to know each other. We have a great group of exhibitors. There will be a prize drawing for a FitBit on Saturday before the final lecture. To be eligible, obtain the signature of each exhibitor and return your form to the registration desk. Winner need not be present to win. We hope you enjoy the meeting and welcome any feedback you have. Sincerely, Nancy Kragt, DO Molly Southworth, MD, FACE, FACP Julie McCormick, MD, FACP AKOMA President AK ACP Immediate Past Governor AK ACP Governor

RM1768 April 20 -22, 2017

American College of Physicians

2017 Alaska Chapter Annual Scientific Meeting

Disclosure of Financial Relationships

Planning Committee and Staff

Robert Bundtzen, MD, FACP 1

Mary DeMers, DO, FACP 2

Prabhu Gounder, MD, FACP 1

Samyuktha Gumidyala 1 AKOMA Staff

Elizabeth Harano, CHCP 1

Don Hudson, DO 1

Nancy Kragt, DO 1

Julie Lake 1 ACP Staff

Cindy Lee, DO 1

Julie A. McCormick, MD, FACP 1 Chair

Kristin Mitchell, MD, FACP 1

Molly Southworth, MD, MPH, FACP 1 Governor

Krystal White 1

Meeting Faculty and Presenters

Ankie-Marie Amos, MD 1

Karen Barbosa, DO 2

Marc G. Cote, DO, FACOI, FACP 1

Jennifer E. Dow, MD, FACEP, FAWM 1

Alan Failor, MD 1

Melissa Hagman, MD, FACP 1

Irl B. Hirsch, MD, FACP 2

Julie McCormick, MD, FACP 1

Brian Miller, DO 1

Janine D. Miller, MD, FAAD 1

Debra S. Roman, DO 1

Stanley P. Watkins, III, MD, MHS, FACC 2

Steven E. Weinberger, MD, FRCP, MACP 1

Members of the College’s Postgraduate/Chapter Education Management Advisory Committee provide oversight of chapter education programs:

George M. Abraham, MD, MPH, FACP 2

Lynn M. Cleary, MD, FACP 1

Capt. Mark L. Dick, MC, UN, FACP 1

Mitchell D. Forman, DO, FACP 1

Eileen Moser, MD, FACP 1

Robert J. Nardino, MD, FACP 1

John H. O’Neill, Jr., MD, FACP 1

Sharon S. Rubin, MD, FACP 1

Todd L. Simon, MD, FACP 1

Joyce E. Wipf, MD, FACP 2

RM1768

April 20 – 22, 2017

NOTES:

1. Has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.

2. Has disclosed relationship(s) with entities producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. See below.

Disclosures: George M. Abraham, MD, MPH, FACP Research Grants / Contracts: Gilead/Abbvie Consultantship: Gilead/BMS/Abbvie Speakers Bureau: Gilead/Abbvie

Irl B. Hirsch, MD, FACP Research Grants/ Contracts: Novo Nordisk Consultantship: Abbott Diabetes Care, Roche, Intarcia

Karen Barbosa, DO Stock Options/ Holdings: Genomic Health

Stanley P. Watkins, III, MD, MHS, FACC Employment: Alaska Heart & Valvular

Mary DeMers, DO, FACP Stock Options/ Holdings: Genomic Health

Joyce E. Wipf, MD, FACP Royalties: UpToDate

The American College of Physicians (ACP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The ACP designates each live activity for the number of AMA PRA Category 1 Credit(s)TM listed below. Physicians should claim only the credit commensurate with the extent of their participation in the activity. The Alaska Chapter Scientific Meeting for a maximum of 17 AMA PRA Category 1 Credit(s)TM The SEP module post course, for a maximum of 2 AMA PRA Category 1 Credit(s)TM Successful completion of this CME activity (the Alaska Chapter Scientific Meeting), which includes participation in the evaluation component, enables the participant to earn up to 17 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

A grant from Staff Resources, Inc was received for general meeting expenses.

Concurrent Sessions

Breakfast 7:00

Maintenance of Certi�cation: Where Do Things Stand? 8:00 Steven E. Weinberger, MD, MACP, FRCP

Long Term Metabolic Complications 9:00 of Gastric Bypass Surgery Marc G. Cote, DO, FACP, FACOI

Break – please visit the Exhibit Hall 10:00

Contemporary Management of Heart Failure 10:30 Ankie-Marie Amos, MD

A Rational Approach to Diabetes Medications in 2017 11:30 Irl B. Hirsch, MD, FACP

Box Lunch 12:30

How Will Minimally Invasive Spine Surgery 1:00 Help Patients? Brian Miller, DO

ABIM MOC SEP MODULE: 2016 Updates in Hospital Medicine 2:00 Melissa (Moe) Hagman, MD and Julie McCormick, MD, FACP

Mindful Medicine: Insights from Neuroscience (continued) 2:00 Debra S. Roman, DO

Meeting Adjourned 4:00

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SATURDAY, April 22nd

Diabetes Technology in 2017: 4:00 What Every Internist Should Know Irl B. Hirsch, MD, FACP

Adjourn 5:00

Banquet Dinner 6:30 Guest Speaker Jennifer E. Dow, MD, FACEP, FAWM “Wilderness Medicine in Alaska: Experiences and Opportunities”

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Registration/Breakfast 7:00

Daily Intro 7:55

Natural Disaster or Terrorism: 8:00 How Prepared Can You Be? Marc G. Cote, DO, FACP, FACOI

Articles that Have Changed My Inpatient 9:00 Practice of Medicine in the Last Year Melissa (Moe) Hagman, MD, FACP

Break – please visit the Exhibit Hall 10:00

Pulmonary Medicine: Testing Your 10:30 Knowledge with Interactive Questions Steven E. Weinberger, MD, MACP, FRCP

Mindful Medicine: Insights from Neuroscience 11:30 Debra S. Roman, DO

Bu�et Lunch 12:30 ACP Town Hall AKOMA Membership Meeting

Dermatology Pearls for the Primary Care Physician 1:30 Janine Miller, MD

Thyroid Nodule Management in 2017 2:30 R. Alan Failor, MD

Break – please visit the Exhibit Hall 3:30

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FRIDAY, April 21st

Registration Begins noon

Introduction to 2017 CME Meeting 12:55

Internal Medicine: Re�ections 1:00 on the Past & Look to the Future Steven E. Weinberger, MD, MACP, FRCP

Pituitary Disease 2:00 R. Alan Failor, MD

Break – please visit the Exhibit Hall 3:00

Updates in Breast Care 3:30 Karen Barbosa, DO

Transcatheter Valve Therapies 4:30 Stanley P. Watkins, III, MD, MHS, FACC

Wine & Cheese Social 5:30

ACP Council Meeting 7:00

AKOMA Board Meeting 7:00

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THURSDAY, April 20th

NOTE: Program details are subject to change (revised 2/06/2017)

ABIM SEP Learning Session Notes: “2016 Updates in Hospital Medicine”

The SEP Learning Session fee is in addition to the conference registration fee.

The Alaska Chapter will provide you with a learners copy of the ABIM module at the meeting. Participants who are enrolled in ABIM’s Maintenance of Certi�cation program can download a copy of the 2016 Updates in Hospital Medicine from ABIM’s website, www.abim.org , and transfer and submit the answers discussed during the Learning Session to ABIM for scoring. Participants will have access to a score report that con�rms whether or not the module was completed successfully. Those who complete the module successfully will receive 10 points for completing a 30-question module toward ABIM’s Self-Evaluation of Medical Knowledge requirement for Maintenance of Certi�cation. You must be enrolled in ABIM’s Maintenance of Certi�cation program to submit completed medical knowledge modules for scoring, feedback reports, and eligibility to receive Maintenance of Certi�cation points.

For additional information about the ABIM Maintenance of Certi�cation program requirements, visit ABIM’s website, www.abim.org/online , or call ABIM Customer Service, 800-441-ABIM. To enroll in Maintenance of Certi�cation go to your password-protected “Home Page” in the Physician Login section of www.abim.org/online . Once enrolled, you will be able to order an ABIM medical knowledge module from your home page.Howard Rock BallroomABC

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Alaska ACP and AKOMA 2017 AgendaSpring Meeting at the Sheraton Hotel & Spa, Anchorage, AK—April 20 to April 22. Room key appears at bottom left

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Alaska ACP and AKOMA 2017 CME Meeting

THURSDAY, APRIL 20

1:00 PM Steven E. Weinberger, MD, MACP, FRCP Internal Medicine: Reflections on the Past & Look to the Future

DR. WEINBERGER retired in September 2016 from his position as Executive Vice President and Chief Executive Officer (EVP/CEO) of the American College of Physicians (ACP), the largest medical specialty society in the United States. He is currently serving part-time for one year as Associate Executive Vice President to advise the new EVP/CEO and help with the transition. Dr. Weinberger assumed the position of EVP/CEO in 2010, after having served for 6 years as ACP’s Senior Vice President for Medical Education and Publishing. An internist and pulmonologist, Dr. Weinberger is also Adjunct Professor of Medicine at the University of Pennsylvania and Senior Lecturer on Medicine at Harvard Medical School. During his tenure as ACP’s EVP/CEO, Dr. Weinberger was an early leader in national efforts to improve quality of care and control healthcare costs through reducing overuse and misuse of care, including creating ACP’s High Value Care Initiative. He has also been a national leader in advancing partnership between patients and clinicians, and has worked closely with leading patient/consumer organizations in collaborative efforts to improve delivery of care by practices and healthcare systems.

Slides have been posted to website and are on the handout jump drive.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Describe the trends in internal medicine resident plans for future professional careers

Discuss how external influences are affecting the practice of internal medicine and its subspecialties, including changes from regulatory and certifying organizations

Recognize the major issues at a national level about which internal medicine specialists and subspecialists are concerned

THURSDAY, APRIL 20

2:00 PM R. Alan Failor, MD Pituitary Disease

DR. FAILOR is an endocrinologist in Seattle, Washington and is affiliated with multiple hospitals in the area, including Harborview Medical Center and University of Washington Medical Center. He received his medical degree from Icahn School of Medicine at Mount Sinai and completed his residency at the Cedars-Sinai Medical Center. His fellowship took place at the University of Washington, Department of Endocrinology. Dr. Failor has been in practice for more than 20 years. Outside of work, Dr. Failor is a “weekend farmer” and enjoys being outdoors. He is also a self-professed compulsive exerciser.

Slides will be posted to website once received from the presenter.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Identify the incidence of pituitary incidentalomas

Describe the appropriate evaluation of pituitary incidentalomas

Define the evaluation of potential Cushing’s syndrome

Recognize signs of acromegaly

THURSDAY, APRIL 20

3:30 PM Karen Barbosa, DO Updates in Breast Care

DR. BARBOSA attended a post baccalaureate program at Columbia University followed by a Doctor of Osteopathic Medicine degree at Ohio University College of Osteopathic Medicine. She then completed a Breast Surgery Fellowship at the Cleveland Clinic, followed by several Oncoplastic courses since 2008 and as recent as 2015. A well-known lecturer, and recipient of the Leaders of Excellence Award from the FACT Foundation, Dr. Barbosa has also published numerous articles in several prestigious medical journals. She is currently working on a study here in Alaska on genetics. She has brought several new technologies that will benefit patients suffering from breast cancer and other health issues.

Slides have been posted to website and are on the handout jump drive.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Discuss the history of breast surgery

Discuss new treatments for breast surgery

Discuss new tools and strategies for breast cancer patients, including screening for high risk patients

THURSDAY, APRIL 20

4:30 PM Stanley P. Watkins, III, MD, MHS, FACC Transcatheter Valve Therapies

DR. WATKINS is a full time physician at the Alaskan Heart Institute. He specializes in cardiovascular disease and interventional & invasive cardiology. Dr. Watkins received his Degree in Medicine from the University Of Maryland School Of Medicine in 1997. His internal medicine residency was completed at the University of Texas Southwestern Medical Center, Dallas, TX, followed by a one-year Fellowship in Clinical Cardiovascular Research in 2001. He completed a three-year Cardiology Fellowship and a one-year interventional Cardiology Fellowship at Johns Hopkins Medical Institutions, Baltimore, Maryland, in 2005.

Slides have been posted to website and are on the handout jump drive.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Explain pathology and natural history of aortic stenosis

Discuss treatment options for aortic valve disease

Explain treatment indications for transfemoral aortic valve replacement

FRIDAY, APRIL 21 8:00 AM Marc G. Cote, DO, FACP, FACOI Natural Disaster or Terrorism: How Prepared Can You Be?

DR. COTE, DO, FACOI, FACP is the Chair of Clinical Medicine and the Chief of Internal Medicine at Pacific NW University of Medicine and Health Sciences in Yakima, WA. He has a wide base of experience including executive medicine, patient care, research, and clinical teaching of residents. He served as the 2013 President of Washington State Osteopathic Medical Association and continues to serve on the board of directors for that organization in addition to the Northwest Osteopathic Medical Foundation. Dr. Cote previously served as the civilian Senior Medical Officer and Regional Medical Director of Clinical Operations from 2010 through June 2014 for the previous US Army Western Regional Medical Command. He received his BA in Biology from the University of Southern Maine and subsequently worked as a research technician in exercise and high altitude physiology at the US Army Research Institute of Environmental Medicine in Natick, MA before attending medical school. Dr. Cote received his Doctor of Osteopathic medicine from Kansas City University of Medicine and Biosciences and his military commission through the Health Professions Scholarship. He completed his Internship, Internal Medicine residency and a Nuclear Medicine Fellowship at the former Fitzsimons Army Medical Center in Aurora, Colorado.

Slides have been posted to website and are on the handout jump drive.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Prepare your family, yourself and your institution to respond to disasters and active shooters

List various physician roles in communities and hospitals preparing and responding to a natural disaster or terrorism

Identify various national data sources for training your hospital and first responders

FRIDAY, APRIL 21 9:00 AM Melissa (Moe) Hagman, MD, FACP Articles That Have Changed My Inpatient Practice of Medicine in the Past Year

DR. HAGMAN received her doctor of medicine degree at the University of Washington in Seattle. She then went on to complete her residency training at the University of Washington Medical Center and the University of Washington Affiliates in Boise, Idaho. She currently serves as the program director of the Boise Internal Medicine Program and as an associate professor in the Boise VA Medical Center’s Department of Medicine. Dr. Hagman is also a member of the Palliative Care Team at the Boise VA Medical Center. She is board certified in internal and hospice/palliative medicine.

Slides will be posted to website once received from the presenter.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Discuss advances in inpatient internal medicine in the last 12 months

Explain when to evaluate for pulmonary embolism in patients hospitalized for syncope

Summarize mounting evidence on the harms of hyperoxemia in critically ill patients

FRIDAY, APRIL 21 10:30 AM Steven E. Weinberger, MD, MACP, FRCP Pulmonary Medicine: Testing Your Knowledge with Interactive Questions

DR. WEINBERGER retired in September 2016 from his position as Executive Vice President and Chief Executive Officer (EVP/CEO) of the American College of Physicians (ACP), the largest medical specialty society in the United States. He is currently serving part-time for one year as Associate Executive Vice President to advise the new EVP/CEO and help with the transition. Dr. Weinberger assumed the position of EVP/CEO in 2010, after having served for 6 years as ACP’s Senior Vice President for Medical Education and Publishing. An internist and pulmonologist, Dr. Weinberger is also Adjunct Professor of Medicine at the University of Pennsylvania and Senior Lecturer on Medicine at Harvard Medical School. During his tenure as ACP’s EVP/CEO, Dr. Weinberger was an early leader in national efforts to improve quality of care and control healthcare costs through reducing overuse and misuse of care, including creating ACP’s High Value Care Initiative. He has also been a national leader in advancing partnership between patients and clinicians, and has worked closely with leading patient/consumer organizations in collaborative efforts to improve delivery of care by practices and healthcare systems.

Slides have been posted to website and are on the handout jump drive.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Assess their understanding of common but important clinical problems in pulmonary medicine

Identify areas of knowledge deficiency in pulmonary medicine

Close knowledge gaps for common pulmonary problems

FRIDAY, APRIL 21 11:30 AM Debra S. Roman, DO Mindful Medicine: Insights from Neuroscience

After a pediatrics internship at the State University of New York, DR. ROMAN completed her advanced three-year Dermatology residency training at Case Western Reserve University. Dr. Miller has also completed specialty fellowship training in Photobiology and Photomedicine (laser therapy) at Case Western Reserve University and dermatology fellowship training at Harvard University.

Slides from this speaker may not be shared.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Identify ways in which the challenges and stresses of clinical practice can result in diminished enthusiasm for professional work and affect our state of well being

Define mindful practice/mindfulness

Discuss ways that these approaches enhance physician health and well-being and cultivate resilience

FRIDAY, APRIL 21 1:30 PM Janine Miller, MD Dermatology Pearls for the Primary Care Physician

DR. MILLER is a Board-Certified Cosmetic and General Dermatologist who specialty trained at Harvard Medical. Dr. Miller is a Diplomat of the American Board of Dermatology. She is also a fellow of the American Academy of Dermatology and Society of Investigative Dermatology. Dr. Miller specializes in general adult and pediatric dermatology, cosmetic dermatology, and laser therapy.

Slides from this speaker may not be shared.

Learning Objectives At the conclusion of the presentation, learners will be able to: NOTE – Learning Objectives will be provided by the speaker on site

FRIDAY, APRIL 21

2:30 PM R. Alan Failor, MD Thyroid Nodule Management in 2017

DR. FAILOR is an endocrinologist in Seattle, Washington and is affiliated with multiple hospitals in the area, including Harborview Medical Center and University of Washington Medical Center. He received his medical degree from Icahn School of Medicine at Mount Sinai and completed his residency at the Cedars-Sinai Medical Center. His fellowship took place at the University of Washington, Department of Endocrinology. Dr. Failor has been in practice for more than 20 years. Outside of work, Dr. Failor is a “weekend farmer” and enjoys being outdoors. He is also a self-professed compulsive exerciser.

Slides will be posted to website once received from the presenter.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Determine which thyroid nodules need further assessment

Apply the new concepts of molecular evaluation to the assessment of thyroid nodules

Identify the risk of thyroid cancer in the analysis of thyroid nodules

FRIDAY, APRIL 21

4:00 PM Irl B. Hirsch, MD, FACP Diabetes Technology in 2017: What Every Internist Should Know

DR. HIRSCH is professor and Diabetes Treatment and Teaching Chair at the University of Washington School of Medicine in Seattle. Dr. Hirsch received his medical degree from the University of Missouri School of Medicine in 1984. He completed residency training in internal medicine at Mount Sinai Medical Center in Miami and Miami Beach, Florida. Dr. Hirsch also was fellowship-trained in endocrinology and metabolism at Washington University School of Medicine in St. Louis. Dr. Hirsch has dedicated his career to patient care, clinical research and teaching. His focus in these areas is the treatment and management of diabetes.

Slides from this speaker may not be shared.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Explain the basic concepts of interpretation of blood glucose meters

Recognize the potential benefit of professional CGM and FGM

Evaluate upcoming technology including smart insulin pens

FRIDAY, APRIL 21

6:30 PM Dinner Speaker Jennifer E. Dow, MD, FACEP, FAWM Wilderness Medicine in Alaska: Experiences and Opportunities

Since coming to Alaska in 1997 as a new physician with Denali Emergency Medicine Associates, DR. DOW has immersed herself in the wilderness community. Beginning with the mountaineering rangers in 2000, she now is the medical advisor for the National Park Service: Alaska Region, and works with the NPS rangers as a colleague in the field. Her passion is rescuer safety, and she believes that providing the knowledge and skills to those in the field will benefit all Alaskan adventurers. This extends to providing training to multiple small guide services in Alaska, lecturing on topics of Wilderness medicine – both nationally and internationally, and being available to those in the field at all times.

Slides from this speaker may not be shared.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Recognize what conditions require immediate evacuation

Develop their own medical kit appropriate to their situation

Anticipate possible illness or injury in the Alaska wilderness

SATURDAY, APRIL 22

8:00 am Steven E. Weinberger, MD, MACP, FRCP Maintenance of Certification: Where Do Things Stand?

DR. WEINBERGER retired in September 2016 from his position as Executive Vice President and Chief Executive Officer (EVP/CEO) of the American College of Physicians (ACP), the largest medical specialty society in the United States. He is currently serving part-time for one year as Associate Executive Vice President to advise the new EVP/CEO and help with the transition. Dr. Weinberger assumed the position of EVP/CEO in 2010, after having served for 6 years as ACP’s Senior Vice President for Medical Education and Publishing. An internist and pulmonologist, Dr. Weinberger is also Adjunct Professor of Medicine at the University of Pennsylvania and Senior Lecturer on Medicine at Harvard Medical School. During his tenure as ACP’s EVP/CEO, Dr. Weinberger was an early leader in national efforts to improve quality of care and control healthcare costs through reducing overuse and misuse of care, including creating ACP’s High Value Care Initiative. He has also been a national leader in advancing partnership between patients and clinicians, and has worked closely with leading patient/consumer organizations in collaborative efforts to improve delivery of care by practices and healthcare systems.

Slides have been posted to website and are on the handout jump drive.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Identify the concerns that have been raised about the ABIM’s (American Board of Internal Medicine) Maintenance of Certification (MOC) process

Describe the reforms that ABIM has instituted and those changes it is planning

Recognize what advocacy efforts the American College of Physicians has been undertaking regarding MOC reform

SATURDAY, APRIL 22 9:00 AM Marc G. Cote, DO, FACP, FACOI Long Term Metabolic Complications of Gastric Bypass Surgery

DR. COTE, DO, FACOI, FACP is the Chair of Clinical Medicine and the Chief of Internal Medicine at Pacific NW University of Medicine and Health Sciences in Yakima, WA. He has a wide base of experience including executive medicine, patient care, research, and clinical teaching of residents. He served as the 2013 President of Washington State Osteopathic Medical Association and continues to serve on the board of directors for that organization in addition to the Northwest Osteopathic Medical Foundation. Dr. Cote previously served as the civilian Senior Medical Officer and Regional Medical Director of Clinical Operations from 2010 through June 2014 for the previous US Army Western Regional Medical Command. He received his BA in Biology from the University of Southern Maine and subsequently worked as a research technician in exercise and high altitude physiology at the US Army Research Institute of Environmental Medicine in Natick, MA before attending medical school. Dr. Cote received his Doctor of Osteopathic medicine from Kansas City University of Medicine and Biosciences and his military commission through the Health Professions Scholarship. He completed his Internship, Internal Medicine residency and a Nuclear Medicine Fellowship at the former Fitzsimons Army Medical Center in Aurora, Colorado.

Slides have been posted to website and are on the handout jump drive.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Explain various types of bariatric surgical procedures and their impact on nutrition

Review the role of some vitamins & micronutrients

Recognize some clinical presentations of various nutritional deficiencies

Review the relevant laboratory tests for maintenance of health in gastric bypass patients

Discuss follow-up care and long term follow-up considerations in post bariatric patients

SATURDAY, APRIL 22 10:30 AM Ankie-Marie Amos, MD Contemporary Management of Heart Failure

DR. AMOS trained at Duke University for Internal Medicine, Cardiology, and Advanced Heart Failure and Transplant. She chose the subspecialty of heart failure so she could know her patients personally and be challenged by the many advanced heart failure therapies that are evolving. She has been heavily involved in the effort to bring destination ventricular assist devices to Alaska during the last 10 years.

Slides have been posted to website and are on the handout jump drive.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Identify and appropriate use new medications recently FDA approved for the treatment of heart failure

Define your heart failure patient in terms of fluid and perfusion status in order to guide appropriate treatment strategies

Recognize advanced heart failure and employ new options

SATURDAY, APRIL 22 11:30 AM Irl B. Hirsch, MD, FACP A Rational Approach to Diabetes Medications in 2017

DR. HIRSCH is professor and Diabetes Treatment and Teaching Chair at the University of Washington School of Medicine in Seattle. Dr. Hirsch received his medical degree from the University of Missouri School of Medicine in 1984. He completed residency training in internal medicine at Mount Sinai Medical Center in Miami and Miami Beach, Florida. Dr. Hirsch also was fellowship-trained in endocrinology and metabolism at Washington University School of Medicine in St. Louis. Dr. Hirsch has dedicated his career to patient care, clinical research and teaching. His focus in these areas is the treatment and management of diabetes.

Slides from this speaker may not be shared.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Discuss the controversies in the various treatment algorithms for type 2 diabetes

Explain the results of the currently published cardiovascular outcome trials, in particular EMPA-REG and LEADER

Navigate more cost effective options for their patients

SATURDAY, APRIL 22 1:00 PM Brian Miller, DO How Will Minimally Invasive Spine Surgery Help Patients?

DR. MILLER is a neurosurgeon at Apex Neurosurgery, LLC. He lives and works out of Anchorage and stays physically active enjoying fishing, hunting, mountaineering, back-country and cross-country skiing as well as anything else that lets him enjoy this beautiful state year round. He completed his undergraduate degree at the University of Southern California, his Master’s Degree (MS) in Medical Education and Medical Degree (Doctor of Osteopathic Medicine-DO) at Western University in California. Residency training in Neurological Surgery was completed at Arrowhead Regional Medical Center in San Bernardino County.

Slides will be posted to website once received from the presenter.

Learning Objectives At the conclusion of the presentation, learners will be able to: NOTE – Learning Objectives will be provided by the speaker on site

SATURDAY, APRIL 22 2:00 PM – CONCURRENT SESSION / 2 HOURS ABIM MOC SEP MODULE: 2016 Updates in Hospital Medicine

TWO PRESENTERS: Melissa (Moe) Hagman, MD, FACP and Julie McCormick, MD, FACP

DR. HAGMAN received her doctor of medicine degree at the University of Washington in Seattle. She then went on to complete her residency training at the University of Washington Medical Center and the University of Washington Affiliates in Boise, Idaho. She currently serves as the program director of the Boise Internal Medicine Program and as an associate professor in the Boise VA Medical Center’s Department of Medicine. Dr. Hagman is also a member of the Palliative Care Team at the Boise VA Medical Center. She is board certified in internal and hospice/palliative medicine.

DR. MCCORMICK is practicing general internal medicine in Anchorage, Alaska. Prior to starting her Anchorage practice in 2007, she was working in Juneau. Once back in Anchorage, she became involved in continuing medical education which naturally evolved into participation in the Alaska ACP, for which she will serve as Governor this year. In addition to practice, she enjoys teaching third year students and participating with the WWAMI class. Dr. McCormick is looking forward to her term as ACP AK Governor beginning April 2017.

ABIM MOC SEP MODULE: 2016 Updates in Hospital Medicine (continued) Slides for this session will not be posted. The slides for this session are the property of ABIM and cannot be electronically distributed. A printed learners’ copy will be provided to attendees on site.

Learning Objectives At the conclusion of the presentation, learners will be able to:

NOTE – Learning Objectives will be provided by the speaker on site

SATURDAY, APRIL 22 2:00 PM – CONCURRENT SESSION / 2 HOURS Debra S. Roman, DO Mindful Medicine: Insights from Neuroscience

After a pediatrics internship at the State University of New York, DR. ROMAN completed her advanced three-year Dermatology residency training at Case Western Reserve University. Dr. Miller has also completed specialty fellowship training in Photobiology and Photomedicine (laser therapy) at Case Western Reserve University and dermatology fellowship training at Harvard University.

Slides from this speaker may not be shared.

Learning Objectives At the conclusion of the presentation, learners will be able to:

Identify ways in which the challenges and stresses of clinical practice can result in diminished enthusiasm for professional work and affect our state of well being

Define mindful practice/mindfulness

Discuss ways that these approaches enhance physician health and well-being and cultivate resilience

2017 CME MEETING General Conference Information Conference Co-Sponsors and Leadership The CME Meeting 2017 Meeting is co-sponsored by the Alaska Osteopathic Medical Association (AKOMA) and the Alaska Chapter of the American College of Physicians (AK ACP). Education Committee Members: Robert Bundtzen, MD, Prabhu Gounder, MD, Nancy

Kragt, DO, Cindy Lee, DO, Kristen Mitchell, MD, Julie McCormick, MD, Molly Southworth, MD, Donald Hudson, DO and Mary Demers, DO

Staff: Elizabeth Harano, CHCP, AOA; Samyuktha Gumidyala,

AKOMA; Julie Lake, AK ACP; and Krystal White, AKOMA Meeting Space and Meeting Materials Presentations will take place in the following rooms: Howard Rock Ballroom ABC, Kuskokwim East, Kuskokwim West and Yukon. Please be sure to stop by the registration desk located in the Howard Rock Lobby daily to sign in. The online link to the meeting materials and handouts is: http://tinyurl.com/alaska-slides and was emailed prior to the meeting. Presentation handouts received on-site will be posted after the meeting. Parking There is a parking lot located to the east, north and west of the hotel as well as a parking garage. Parking is $5/day for self-parking and $15/day for Valet. All parking may be purchased in advance and is paid for at the front desk where attendees will receive a voucher to place on their dash. Wi-Fi Availability WIFI will be available. The WIFI password is CME2017. Exhibit Hall The Education Committee and staff have worked hard to provide a mix of pharmaceutical and medical device representatives with a variety of service providers in our Exhibit Hall. The exhibitor breaks are set for Thursday 3:00 – 3:30 pm, Friday 10:00 – 10:30 am and 3:30-4:00 pm, and Saturday 10:00 – 10:30 am. Please remember that their financial support is very important to keeping our conference rates level moderate. Raffle Prize Drawing A form for exhibitors to initial is in your registration packet. This completed form (with every exhibitor’s signature) will serve as your raffle ticket, so please be sure to turn it in to the registration desk before the start of the last lecture on Saturday afternoon. A prize drawing for a FitBit Charge will be held Saturday before the last speaker. Winners need not be present to win!

Evaluation Forms Both AKOMA and ACP are using the ACP meeting evaluation form. Please complete and turn in at the registration desk before you leave, taking care not to fold the form as it will be electronically scanned. Evaluation information will be provided to BOTH organizations. Meals and Coffee A light breakfast will be provided at 7am on Friday and Saturday. A buffet lunch for registered attendees will be provided on Friday and a box lunch will be provided on Saturday. Friday’s lunch will be a working lunch with an ACP Town Hall Meeting and a concurrent AKOMA Membership Meeting. Fruit and granola bars will be available during the morning break, and crudité and light dessert during the afternoon breaks. Coffee, tea and water will be refreshed and available throughout the conference. Conference Social Opportunities • Thursday 5:30 - 7 pm – Wine and Cheese Social, light appetizers and drinks for purchase. Note that both the ACP Council and AKOMA Board will meet separately at 7 pm. • (New) Friday 5 - 6:30 pm – Wine and Cheese Social, light appetizers and wine. Harold Johnston, MD will be providing additional information on potential Alaska Internal Medicine Residency Program, in the Susitna Room. • Friday 6:30 pm – Banquet Dinner, with a lecture by Jennifer E. Dow, MD, FACEP. Her presentation is titled, “Wilderness Medicine in Alaska: Experiences and Opportunities.” Disclaimer The lectures and presentations are intended for educational purposes only. Speakers and presenters provide their viewpoint and opinion based on their expertise. Their presentations are targeted at the audience as a whole and not to the specific circumstances of individuals attending the program. The presentations do not replace independent professional judgment and study of the specific details an attendee may be confronting. Statements of fact and opinions expressed are those of the individual presenters and, unless expressly stated to the contrary, are not the opinions or position of the CME Meeting 2017 cosponsors, who do not endorse or approve, and assume no responsibility for, the content, accuracy or completeness of the information presented. Satisfaction Guarantee & Grievance Policy We offer a satisfaction guarantee – if meeting attendees are not satisfied with their experience at the meeting, they may write Julie Lake for a refund of their registration fee. All grievances should be in writing and specify the nature of the grievance and any particulars. Initially, all grievances should be directed to either of the co-sponsor Executive Directors. The Executive Director will review all grievances and resolve if possible. If no resolution is possible, the Executive Director may pass the information to the Conference Co-Chairs. If the participant does not receive a satisfactory response, they may then notify the Council on Continuing Medical Education of the American Osteopathic Association at 142 E. Ontario Street, Chicago, IL 60611. Questions, Comments? Please stop by the Registration Desk for program information and activities such as Conference registration and payment, additional conference forms, Conference handouts and evaluations, etc. After the conference, for AK ACP, please call or email Julie Lake at (907) 350-2351 or lake@mtaonline.net. For AKOMA, please call or email Samyuktha Gumidyala at (312) 202-8101 or sgumidyala@osteopathic.org.

CME Credit Hours Information

The CME credits available for each day are: Thursday, April 20: 4 CME credits through AOA or ACP (and 4 MOC points through ACP)

Friday, April 21: 8 CME credits through AOA or ACP (and 8 MOC points through ACP)

Saturday, April 22: 7 CME credits through AOA OR 5 CME credits through ACP (and 5 MOC points through ACP)

For ABIM MOC SEP Module Either 2 CME through ACP OR 2 CME and 10 MOC points through ABIM

For ACP CME Credits The American College of Physicians (ACP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The ACP designates the Alaska Chapter Scientific Meeting for a maximum of 17 AMA PRA Category 1 Credit(s)™ and for the SEP modules post course for a maximum of 2 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Successful completion of this CME activity (the Alaska Chapter Scientific Meeting), which includes participation in the evaluation component, enables the participant to earn up to 17 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Claiming CME Credit through ACP: Please review attached instruction forms for claiming CME credits and MOC points. CME credit provided by ACP is now claimed online at http://acponline.org/chaptermeetingCME2017 . Login with your ACPOnline.org username and password, this is the same one as for online registration. If you do not have a username and password you will need to create an online account. Creating an account is free and does not require membership. Meeting attendees will be able to claim their CME credit after noon on the last day of the meeting. You will receive an email confirmation of your CME credit claim. If you have any questions, please call ACP Member and Customer Service at 1-800-523-1546 x2600 or 215-351-2600. NOTE: The amount of CME and MOC points claimed through ACP must be equal (although claiming MOC points are not required). If you attended the MOC SEP Module “2016 Updates in Hospital Medicine” and will be claiming MOC points through ABIM for the MOC SEP you must also claim those 2 CME credits through ABIM as well. Claiming MOC Points for the main meeting: Please review attached instruction forms for claiming CME credits and MOC points. You must claim CME credit before you can claim MOC points. Go to www.acponline.org/chaptermeetingMOCRM1768. (Please again use your ACPonline.org login if you are not already logged in) Follow the instructions to complete the quiz. When you score 60% or above, you will be prompted to enter your ABIM number and some personal information. You can then submit for MOC points. You may take the quiz as many times as necessary. When you submit for MOC points, your information will automatically transfer to the ACCME database and then to ABIM. The ABIM will add the points to your MOC transcript within 3 days of your submission.

Claiming MOC and CME for the post course MOC SEP Module: Log in to your American Board of Internal Medicine (ABIM) home page at www.abim.org. Under “My Maintenance of Certification (MOC) Program,” select “Request a Medical Knowledge Module” and then select “2016 Update in Hospital Medicine 83S.” Input answers to questions and submit answers electronically to ABIM. Please also see ABIM handout provided at the session.

For Osteopathic CME Credits You must complete and sign the attached AKOMA Attendance Attestation form and return it to the registration desk in order for your CME credits to be granted and submitted to the AOA Continuing Medical Education office. Please return the CME form when you leave, whichever day that is for you, or by 4:00 pm on Saturday afternoon. The Alaska Osteopathic Medical Association (AKOMA) is accredited by the American Osteopathic Association to provide osteopathic continuing medical education for physicians. This program qualifies for AOA Category 1-A credit under an exemption approved by the Council on CME of the American Osteopathic Association. This program offers a maximum of 19 credits and AKOMA will report CME and specialty credits commensurate with the extent of the physician’s participation in this activity. Personalized osteopathic CME certificates will be e-mailed two weeks after the conference. Certificates cannot be processed on-site and certificates will be held until all fees are paid in full. The last day to submit your form to AKOMA Headquarters is FRIDAY, May 5, 2017. Attestation forms submitted AFTER this date will require a $25 processing fee in order for credits to be granted.

Osteopathic Specialty Credits Information Please note that specialty CME credits do not need to be only in Category 1-A. Specialty CME may be obtained in Category 1 or Category 2. Detailed info is available at https://www.osteopathic.org/inside-aoa/development/continuing-medical-

education/Pages/cme-specialty-hours.aspx.

Here are the anticipated amounts of specialty credits* offered at the 2017 Alaska CME Meeting:

Pending final determination by each specialty board – bolded credit numbers have been board approved.

Dermatology 1 Emergency Medicine 1 Family Medicine/Family Practice/OMT 19 Internal Medicine 16 Neurology 1 OB/GYN & OB/GYN Surgery 1 Pathology - Anat.; Anat/LabMed 6 Surgery - General 1 - Lab Medicine 3 - Neurosurgery 1 - Dermatopathology 1

*FYI: This program has been pre-routed to the Osteopathic Specialty Boards for confirmation of credits. If a specialty is not listed, credits are unlikely.