Doing Good for Those Who Do Good

As I begin my tenure as your new SDCMS president, I am reminded often by family and colleagues of the time that I put into medical society involvement at the local, state, and federal levels. I am usually asked things like “Do you get paid?” or “Do you also practice medicine?”

Yes! I have a full-time practice! And my work at SDCMS-CMA has received little ‘payment’ beyond expense reimbursement — unless you count the satisfaction of trying to advocate for colleagues and patients, working to maintain the good aspects of our relationships with patients, and the satisfaction of practicing medicine, as well as fighting against draconian changes driven by purely economic forces that, unfortunately, are greatly aligned against the practicing physician.

In these troubled times, many question what organized medicine has done for them. I can assure all physicians in all modes of practice that without the California Medical Association and its component societies, the world in which we practice would be far worse for patient and physician. Politically, we are most effective when we stress our points in terms of the good of the patient. But in my mind, our purpose in organized medicine is to advocate for physicians in order that we may advocate and be available for our patients.

If physician practices cannot survive and if new physicians cannot be attracted to handle the increasing needs of a growing and aging population, there will be no one to advocate for patients. Poor reimbursement forces early retirement of physicians and physician flight from poorly reimbursed but high-cost areas like San Diego. We must push for sustainable reimbursement and viable practice conditions, or we will not be here to care for our patients.

A few of your colleagues work hard for all physicians. Many physicians contribute to the many needs of physician and patient advocacy. Nonetheless, there are too many who continue to believe that everything takes care of itself, failing to understand the efforts that go into blocking or modifying political “remedies” that would destroy the patient-physician relationship. Some continue to demand that physicians bear the burdens that government itself has accepted on behalf of the public.

I thank all physicians who contribute in some way — even if solely as dues paying members — and call on each of you to do a little more in the coming year. Your San Diego County Medical Society and your California Medical Association need your expertise and your ever-louder voice when working on your behalf. But even more, I call on current members to talk to their colleagues about the benefits of membership, even if not seen as monetary gain to the individual. Finally, I call on non-member physicians to participate with those of us who strive to improve the lots of our colleagues, their patients, and the community as a whole. Consider joining SDCMS, and help us by using your voice and expertise to advocate for your needs and those of the people you serve in your practice.

There are multiple threats facing San Diego physicians currently and in the immediate future, including recent Medicare and Medi-Cal cuts that are being put in place out of political abandonment of both public need and physician economic realities, consolidation of managed care entities with ever-greater profits and disregard for physician value, continued issues of unsustainable medical liability premiums and suits, as well as continued attacks on the rights of physicians to seek fair payment for their services. It truly is Everydoc’s job to work on behalf of doctor and patient to avert a collapse of access to care. Anydoc can do things that often Nodoc does, but the truth is that Everydoc can do the things that only Somedocs are doing. In the end, what is needed is for Everydoc to participate, in unity, to effect the needed changes that will preserve the best of medical practice and access to care, as well as allow medicine to continue the remarkable progress of the past decades in patient care.

I look forward to working hard with my colleagues to bring economic realities to bear on those who purport to pay for medical services on behalf of purchasers or the public, improving the ability of San Diego physicians to sustain their practices in order to serve the patients of our community and to improve physician satisfaction with the practice of medicine. These things can best be accomplished with the active participation of practicing, retired, and in-training physicians. I ask for all of you to consider what roles you may play in these endeavors and to contact me or SDCMS with your ideas for participation. In the words of our executive director, I look forward to “doing good for those who do good.”