Working Together for Docs, Medicine, and Community

I AM VERY PROUD to be recognized by my community of physicians and my hometown by the honor of becoming president of our medical society. This is an important responsibility.

When I was in residency, Larry (Dr. Larry Bass, now my partner) and I would have conversations about whether or not I should return to Sacramento to practice. In the early to mid-90s, medicine was changing as managed care and larger medical groups expanded in this area.

I knew that I wanted to return home to Sacramento and am grateful for the opportunity to practice with wonderful people in what I believe is a great medical community. The changes in Sacramento in the 90s were changes that have happened across the country.

Medicine will always be changing. As President of the Medical Society I see a role in helping to make sure that SSVMS adapts to our membership's changing needs and plans for the future.

Sacramento is a community of all modes of practice: solo, small group, large multi-specialty group, large single-specialty group, hospital-based physicians and a teaching university hospital. Working with our SSVMS board, practicing in the community, and working with the residents in the dermatology department, I get to experience many of these modalities. I have also had the viewpoint of being a patient or family member of a patient.

Medicine is changing in other ways. Medical school admissions are at least 50 percent female, which has changed the workforce. Women may practice on average four hours less per week during family years, but women are not retiring as early as the men. We make up for it later!

All young physicians as a whole are choosing schedules that allow them time to parent or enjoy other interests and overall the physician work-hours have changed. Yet at the same time, we face a population that is living longer, and a baby-boomer generation hitting the years when they will have increased medical needs. The predictions are that we will be at least 15-20K short of physicians in the next five to ten years. How is society going to meet that need?

In our community we are feeling some of this already; patients often talk of the difficulty of getting a primary care physician. Some specialties in particular are also facing workforce shortages. All of us here can talk about the difficulty in recruiting physicians to the area. And this is the same story I have heard in many other regions of the country.

At the same time, physicians and all of medicine are being squeezed with flat or lessened reimbursement, yearly lobbying to stave off Medicare cuts, an abysmal Medi-Cal fee schedule. As witnessed by all the complicated negotiations at the state level, health care reform is a complicated problem.

So here we are with a workforce shortage and yet a tight financial future of health care. As a medical society, we must help advocate for our patients by making sure we have physicians providing the wonderful care we can provide in this community. SSVMS is an active part of CMA's advocacy as we in this area are often called upon to testify at the capital, and I encourage all of you to help out on this when called upon.

Locally, under the strong leadership of my predecessor, Dr. Richard Jones, and Executive Director Bill Sandberg, we have been working on a county community health coalition addressing the needs of Sacramento county residents. The Medical Society's history of community care through CSERF and the SPIRIT Project are evidence of our commitment to care for our community. I encourage all of us to participate at some level in our time here.

And watch as we work with others with health care interests in improving community health. Our other member counties, Yolo and El Dorado, also have community engagement to help serve their counties' needs.

Medical school applications are up nationwide after some slow years. Also, many medical schools are bumping up their class size to meet the workforce physician shortage. UC Davis has expanded its class by 12 students with a program focusing on rural outreach.

The increase in applicants bodes well that we will continue to have the best and brightest coming into medicine. With the move of UC Davis Medical School students in their first two years to Sacramento from Davis, I hope that student engagement in organized medicine will grow.

Why is organized medicine important? We must advocate for ourselves, our patients, and our communities. We come from many specialties and modes of practice, yet most of our goals are common ones.

Membership allows us to keep the organization fiscally healthy. Participation in committees and boards makes this organization strong and vital. Leadership in our community on other boards and organizations continues the legacy of physician leadership and the importance of health in the community.

During his tenure as president, Dr. Richard Pan talked about the importance of SSVMS and physician leaders on community boards and hopefully school boards, park boards and other organizations. At its meeting this week, the Public and Environmental Health Committee discussed obesity and the CMA Foundation's training for physician leaders on this tremendously important health issue. We also heard from El Dorado County on its high skin cancer rate of melanoma - now surpassing San Diego County. Hmmm. I think I hear a role for physician advocacy of shade structures at park board meetings!

As we continue this 140th year of this Society representing three counties, we must insure that we are:

• Relevant to membership as the face of medicine changes and grows
  
  
• Relevant to the mission of the society and our member counties.
  
  
• Relevant to our community as we stay visible and advocate for our patients
  
  

I invite all of you to work with us at all levels in helping keep SSVMS strong and vital. I always feel so fortunate to be a physician, even on a day when paperwork and legislation and regulation are making me quite grumpy. The intellectual challenge of a tough case, the knowledge that I have discovered a cancer early in its course and helping save a life, and the "thank-yous" from patients for taking care of them, make medicine so rewarding.

Our working together as physicians advocating for the practice of medicine and the health of our communities is what will keep medicine strong and rewarding.

I look forward to working with all of you this coming year. Let us know your ideas, thoughts, and concerns so that our board can continue to do the work that the membership needs SSVMS to do. We are fortunate to have truly outstanding staff, led by our Executive Director Bill Sandberg, that help us accomplish the needs and mission of the society's membership. In a year starting with Health Care Reform with a bill numbered ABX1-1, a six-month Medicare package, and stressed county budgets...I have no doubt a lot will be going on!

mepmd@ix.netcom.com