Sex and the CMA

I LIED. This column has nothing to do with sex. But now that I have your attention, please read on.

On January 21st the RETF presented its first full report to the CMA Board of Trustees with the Presidents' Forum sitting in. The Task Force has analyzed CMA's current problems, taking in comments and advice from a wide variety of sources, and its recommendations fall into four broad areas.

Jack Lewin, MD, told us he intends for CMA to begin implementing about half of the recommendations immediately because they require no policy changes. The rest will need approval of the Board of Trustees and the House of Delegates. Here, in brief, is what the RETF proposes:

Economic Advocacy
This is the area that nearly all members want CMA to zero in on, virtually to the exclusion of everything else. Economic advocacy will become the central focus of our CMA for the foreseeable future. California is always at the cutting edge of change-including the cutting edge of a looming economic collapse of our health care system. The Task Force recommends that CMA develop an Economic Advocacy Task Force and "SWAT Team" to respond both rapidly and proactively to economic threats to our profession.

This must be done carefully. We cannot simply turn the economic issue into protection of doctors' income levels. Economic advocacy is more about having some form of medical care left to meet the needs of our patients even as economics become increasingly difficult for doctors, hospitals, nursing homes, pharmacies and the like.

We cannot afford to let worsening conditions lead to complete collapse of our health care infrastructure. We need this advocacy; we want this advocacy. CMA is making advocacy of our economic problems its number one priority.

External Communications
Ironically, I am writing this column in a format-the printed magazine article-that fewer and fewer people bother to read (hence, the misleading title). Collectively we are paying less and less attention to written material at a time when our medical associations need to keep us informed of their activities. We live in an age of information overload, with attention diverted by many competing voices. Organized medicine's voice and message is too easily lost in the noise.

How can CMA (or SEDMS for that matter) effectively communicate with its members? What formats will allow good communication between CMA and medical societies? Or with the government? The answer will come from the burgeoning world of Internet communications. The message: plan to get online if you aren't already. Electronic media is the way we will work together now and even more so in the coming years. For our children e-mail and Internet communication are as natural as the telephone is for us. Don't be left behind; you can't afford it.

Membership and Dues
The response is unanimous: everyone wants substantially lower dues for medical associations and societies. How do we get there? Well, if all doctors belonged to organized medicine we could cut dues in half today, but that clearly is not going to happen. The RETF has proposed several ways of streamlining and unifying the dues procedure. Much of this rests on the fourth area of emphasis.

Specialty Society Relations
The movement at the national level is toward consolidating the various medical associations under an umbrella "House of Medicine." Ultimately, membership in any organization (such as ACOG or AAFP or ACS) could mean automatic entry into all the appropriate organizations in the House of Medicine. Someday we may have one application, one dues payment and one unified membership. We would not have to choose between our specialty organization and the general organizations that represent us all. Obviously, this will not happen overnight, but RETF plans to have a pilot project underway later this year involving three specialty organizations. If your specialty organization is chosen, get involved to make sure that the experience provides good information on the pros and cons of the concept.

What does it all mean to you?
The implications of the CMA Re-Engineering Task Force for us in SEDMS are profound. The very structure of CMA (and AMA as well) will be changing over the next several years. We will either change or die. SEDMS cannot exist in some sort of isolated splendor away from all these proposed changes or the rapidly evolving health care conditions driving these changes. They will impact us directly whether we are ready for them or not.

We better get ready.

edpmg@inforum.net