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Isolation or Participation? POSIT: The practice of medicine is now largely dictated by public policy. To be most effective in the public arena, physicians must abandon traditional isolated professionalism, and work together, regardless of affiliation or specialty. Participation in a local medical society is the most inclusive, democratic, and efficient way to do so. This Posit is intended to provide the Board of Directors with information about SSVMS membership. Results will be reviewed by the Board in March, 2006. There were 118 responses, with 24 comments. Since the posit was directed at members, general agreement was the rule with notable exceptions, comments follow: "I agree, but Medical Societies must work harder to be more relevant to the wide range of Physicians under their aegis." - Paul Kelly, MD "Working together in a group practice would be more effective, in my opinion." - Edward Doehne, MD "All policy discussions should be resolved at the local level initially." - E.T.Rulison Jr., MD "We are in vastly different care settings so this makes local participation interesting, but sometimes not pertinent to our practice." - Evalyn Horowitz, MD "If physicians do not band together and make policy, it will be made for them and they will not be happy with the results." - Joanne Berkowitz, MD "The medical profession has a long and generally proud tradition. Stay the course." - Deane Hillsman, MD "...Our profession has never been isolated.… However, some of us have acted as if we are isolated resulting in difficulties mostly related to the hassles with the business side of medical practice. The science that supports our medical practice has never been better…. Patient communication is facilitated with hand-held E-mail access. The public policy fostered by the Medicare program is highly responsive and accountable compared to the private insurance products - the evidence for which is the recent success of organized medicine's class action lawsuit…" - Gerald Rogan, MD "...I believe that one should have a balance of participation in specialty, general and local or regional professional societies. There are somewhat different, but important organizational or political issues at each of those forums." - Edward Panacek, MD "...there are multiple organizations with local, regional, and national ties and impact through which physicians can be active and involved with public policy…" - James Goodnight, MD "...Employed physicians and physician owners may have some different issues. With so many physicians now employed they may need to re-think their traditional aversion to "unions." The larger the organization or the further from the source of power, the greater need for an organized voice...The second part of the posit, I do not think follows… it does not seem that [local medical] societies have been generally out there in midst of public policy issues, or that they would necessarily be the most effective or efficient…" - Nancy Gilbert, MD "There are 3 completely separate and distinct questions being asked…in this posit! [The writer addresses the second two, the first being self evident.] "2. We must work together to have any chance of having a positive impact and affecting change. There are a variety of options available to physicians.... These include medical groups, medical staffs, specialty societies, etc. "3. Although a local medical society is inclusive and democratic, I have not experienced this structure as efficient in leading change…by virtue of the intrinsic need to serve a very diverse constituency…the ability of local medical societies to provide effective leadership in public policy has unfortunately been very limited…in its ability to effectively take positions of leadership in responding constructively to the pressures we face from the payor and business communities." - Don Wreden, MD [The writer doesn't like the posit, and suggests an opinion poll preceded by a premise.] "PREMISE: The practice of medicine is now largely dictated by public policy. "How strongly do you agree or disagree with the following (3) statements? "1. To be most effective in the public arena, physicians must abandon traditional isolated professionalism, and work together, regardless of affiliation or specialty… "2. To be most effective in the public arena, physicians should participate in: …(a list of options follows.) "3. Participation in a local medical society is a democratic, inclusive and efficient means of influencing public health policy." - Malathi Srinivasan, MD "We need the voices of all of medicine to cope with those who affect us and our patients. Unfortunately there are a number of isolationists in the body of medicine who get a free ride as they do not join organizations that represent us. In spite of very serious issues and difficult times some continue to opt out…" - Byron Demorest, MD "I think that it will be hospital and business affiliations such as the physician's group (K-P, SMG/Sutter, Med Clinic/CHW, UCD, etc) that will drive the 'working together.' Outside of this economic driver I am afraid that the various specialties will find it difficult to reach consensus on many issues. "This mantra of organized medicine is all the more applicable in today's practice environment and most likely in the future." - Charles Maas, MD "[the local medical society] is one of the better inclusive, democratic, and efficient ways to do so. You also should belong to the CMA, AMA and your specialty societies. The more organizations that speak as one the more effective…" - Philip L. Levy, MD "More physicians need to join medical organizations and take part in the political process. And medical organizations need to make membership as attractive as possible. Otherwise medical interests and medical expertise will not take its proper place in the political dialogue and the legislative process." - Irma West, MD "While there is considerable public influence in the practice of medicine, there is some backlash against this influence. For instance, laws are being written that protect physicians and pharmacists from prescribing birth control or abortion pills when it is against their personal beliefs. Medical societies are political by nature, and many physicians may be alienated by political positions taken, …creating rifts as wide as those that separate Republicans from Democrats." - William Lewis, MD "I agree. [But] I suspect members who don't agree are probably not members of SSVMS-so the poll will be biased." - John Tucker, MD "I don't feel that primary care has…been well represented by the CMA or any other forum.... Probably this is one explanation for med students veering away from Primary Care... many of my contemporaries would not go into Family Med of IM again knowing what we know of the work/compensation trade off..." - Bob Talkington, MD "The problems faced by the medical profession…stem from isolationist and selfish attitudes the various specialties…developed to preserve and control 'their share' of the pie." - Jose Ma C. Leuterio , MD "…Although public policy wields a large gavel, the practice of medicine is still dictated to large degree by tradition of the trade and to some degree by science. Yes, physicians need to work together but not just in a medical society but in other critical public policy areas like government and education." - Jose Arevalo, MD |
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