There are no green jackets or golf clubs to be found among the masters at Jefferson. Instead, you’ll find white coats, stethoscopes, and a group of doctors who have dedicated their lives to furthering the field of internal medicine.
Mastership is the highest honor that can be bestowed upon a physician by the American College of Physicians and is a testament to a doctor’s contributions to and achievements in the field of internal medicine. Masters have earned recognition as industry leaders and are often viewed as the physician’s physicians.
Looking Back, Moving Forward
To understand the place of the master in the future of healthcare, it’s important to understand its role throughout history.
Positioned between the tail end of the Renaissance and the advent of the scientific revolution, the 16th century was a period of economic prosperity, artistic expression, and scientific discovery. Yet, the “physicians” of the time were often killing as many people as they saved. In an attempt to distance themselves from the plague doctors, “balancing of humors,” and bloodletting of old, a group of physicians—led by scholar Thomas Linacre—gathered together to legitimize medical practice and education in England.
The Royal College of Physicians (RCP)—originally just the College of Physicians—was established in 1518 by King Henry VIII to raise the standard of healthcare. The RCP is the oldest medical college in England and still plays a major role in public health, medical education, and research in the United Kingdom and throughout the world.
The American College of Physicians (ACP) draws on influences from the RCP after Dr. Heinrich Stern—German-born physician and eventual founder of the ACP—attended a conference in England in 1913. That conference convinced him that it was vital to have a similar institution stateside; two years later, the ACP was established with the mission to “enhance the quality and effectiveness of healthcare by fostering excellence and professionalism in the practice of medicine.” With nearly 160,000 members, the ACP is the largest medical-specialist society and second-largest physician group in the country.
Since its inception, the ACP has served in an educational and advocacy role for U.S. internal medicine physicians and their patients.
There are several levels of membership in the ACP: medical student, associate, member, fellow (FACP), and master (MACP). To become a fellow, a member must be recognized by their peers and endorsed by their local chapter, and have their credentials reviewed by a national subcommittee. Masters are recognized for their continued excellence through scholarly inquiry, publications, leadership, and dedication to the field of internal medicine.
Of the 29 active masters practicing in Pennsylvania today, five internists call Jefferson home. As with all masters of the ACP, these Jeffersonians were elected to the level of master because of their “integrity, positions of honor, eminence in practice or medical research, or in attainments in science or the art of medicine.”
Mastership at Jefferson is nothing new. Willis Maddrey, MD, who sat as chairman of the Department of Medicine from 1982 to 1990 and served as president of the ACP from 1992 to 1993, was elected to mastership in 1993. Thomas Nasca, MD ’75, the former dean of Jefferson Medical College (now Sidney Kimmel Medical College) and CEO of the Accreditation Council for Graduate Medical Education (ACGME), became a master in 2006. Two more Jeffersonians joined the ranks in 2013 when both Drs. Howard Weitz, MD ’78, MACP, FACC, FRCP (Lond.), and Geno Merli, MD ’75, MACP, FHM, FSVM, were elected to the rank of master.
Dr. Weitz, the Bernard L. Segal Professor of Clinical Cardiology, has spent decades advocating for ACP’s educational mission. For more than 20 years, Weitz has contributed to the Annals of Internal Medicine, the ACP’s flagship publication, which is the most-cited general medical journal in the world, and served as a long-term associate editor for the ACP’s Medical Knowledge Self-Assessment Program, a resource physicians use to keep up to date with internal medicine and its subspecialties.
“It’s an amazing acknowledgement for us to be among the less than 1% of all fellows to be recognized above the crowd,” Weitz says of mastership. “We feel this responsibility to uphold the duty of elevating the field of internal medicine and, in doing so, enhancing the care for patients in America.”
Dr. Merli, senior vice president and associate chief medical officer at Thomas Jefferson University Hospital, co-director of Jefferson Vascular Health, and the division director of vascular medicine in the Department of Surgery, is a nationally recognized expert in the prevention and management of deep vein thrombosis and pulmonary embolism. Dr. Merli is both a contributor and a dedicated reviewer for Annals of Internal Medicine.
“It’s an acknowledgement that our focus at Jefferson is education,” Merli says. “It recognizes that we spend time investing in the careers and training of our future physicians and healthcare leaders.”
The next Jeffersonian master designation came in 2018, when Gregory C. Kane, MD ’87, MACP, the Jane and Leonard Korman Professor of Pulmonary Medicine and chairman of the Department of Medicine at Sidney Kimmel Medical College, was elevated to master in the ACP. Currently, Dr. Kane sits as the treasurer of the ACP, and is the immediate past-governor and local membership chair for the Southeastern Pennsylvania Region chapter of the ACP.
“The unique position of Jefferson with three masters in medicine and two in medical oncology underscores Jefferson’s commitment to strong clinical education and patient-centered care,” Kane says. “It reflects Jefferson’s national reputation for excellence in clinical care.”
In 2018, Ana María López, MD ’88, MPH, MACP, professor and vice chair of medical oncology at Sidney Kimmel Medical College and chief of the New Jersey Division of Sidney Kimmel Cancer Center, was also elevated to the level of master. Dr. López is the immediate past president of the ACP and served as chair of the Ethics, Professionalism, and Human Rights Committee and governor of the Arizona chapter of the ACP. Dr. Lopez’s passion and commitment are to improve care, to improve access, and to improve outcomes. Dr. Lopez’s clinical expertise is in women’s cancer and integrative oncology. Her research has focused on cancer health equity, symptom management, and access to care, and employs novel technologies and innovations in care delivery.
Dr. López notes; “I joined ACP as a resident. It was one of the ‘must-dos’ that Dr. Maddrey, the chair of internal medicine when I was a student, recommended, and like his other words of wisdom, they were right on the mark! The ACP is a community and what binds us together—globally—is our commitment to our patients. ACP policies and efforts hold the patient as the North Star. Sharing this passion with colleagues is an honor of a lifetime.”
Most recently, Edith Peterson Mitchell, MD, FACP, FCPP, the director of the Center to Eliminate Cancer Disparities, was welcomed into the ranks of ACP masters. Dr. Mitchell has been a trailblazer for women and minorities in the medical profession, as well as a champion for underrepresented populations in her battle against inequity in healthcare. Throughout her storied career, Dr. Mitchell was the first female physician to achieve the rank of brigadier general in the U.S. Air Force, the first female medical oncologist to serve as president of the National Medical Association, and the first black woman to receive Thomas Jefferson University’s Academician of the Year and PHL Life Science’s Ultimate Solution Award. In 2019, Dr. Mitchell was elevated to the level of master in the ACP.
“As there is a continuously increasing minority population in the United States, it is important to apply precision medicine standards and know differences in prevention, diagnoses, and appropriate therapeutic interventions,” Mitchell says. “Moreover, it is also important to increase diversity in the pipeline of trainees in internal medicine and its subspecialties to match the percentage representation of minorities in the population.”
With backgrounds in cardiology, vascular medicine, pulmonary medicine, and medical oncology, the masters at Jefferson bring together a wealth of knowledge and experience from their subspecialties. Each master still believes it’s essential to approach patients with the mindset of a general internist and treat each patient comprehensively, and that is part of the reason they consider mastership such an honor.
The Future of the Master Clinician
Since the first master, Dr. James M. Anders, was elected to the ACP in 1923, the medical field has drastically changed and the role of the master clinician has changed alongside it. Historically, the master was a “groundedly learned” physician with a photographic memory who could make a quick, accurate diagnosis, but whose bedside manner left something to be desired. In the modern era—thanks to advances in technology and access to information—the role of the master is changing once again.
There’s no denying that accurate identification and timely treatment are still vital requirements, but the master clinician now needs to view patients as more than simply a disease and a diagnosis. Physicians now have the entirety of the National Library of Medicine at their fingertips, and establishing a trusting patient-physician relationship and treating a patient holistically are of growing importance in the master clinician’s skill set.
As a master himself and a senior associate dean of Sidney Kimmel Medical College, Dr. Weitz understands the need to keep the patient-physician relationship paramount, and is building an educational program for young faculty and physicians so they can sustain and grow their connection to patients in an ever-changing healthcare landscape.
“It has to come out of Jefferson, because Jefferson lives the life of the patient-focused, patient-oriented medical school and academic healthcare center,” Weitz says.