I am honored to be the incoming President of the Bucks County Medical Society, for the 2020 term. This is actually my second term; my first one was in 1997, 12 years after I moved to Bucks County and became a member of the society. Since then there have been marked changes in the practice of medicine, but one thing has remained constant and that is the need for robust Pennsylvania and county societies to represent the physicians who are trying to do the best job feasible in a very trying environment.
I believe the most critical situation is the tort environment. Physicians worry about being sued every day they go to work. If patients don’t listen to their advice, they can be sued. If the patient is in a difficult situation where either choice can have bad consequences, they can be sued. And even if things work out well, but there is a feeling that things just didn’t move quick enough, they can also be sued. Act 27 and the Pennsylvania Supreme Court's subsequent adoption of Rule 1006 gave partial relief, but certainly not enough and yet the trial bar is actively trying to dismantle it and is starting by going after the “Change in Venue” component of the Act. If they succeed in this aspect, not only would this cause major effects on the practice of medicine, raising rates to be insured, increasing litigation and worsening the need to practice defensive medicine, but I believe they will then go after other aspects of the Act until the malpractice environment will be in serious meltdown. The physicians will be left with the choice of quitting practice, moving to another state or trying to hold on, further increasing the stress of the practice of medicine. If for no other reason, having a strong medical society to attempt to counter the trial bar is reason enough to support the society.
There are other aspects of practicing medicine that also need our societies to be involved. As an example, clunky EHR systems that are designed to satisfy the requirements of the insurance industry and government mandates, but work counter to actually taking care of patients have become a major issue. A group of us representing the county medical society met with our Congressman, Brian Fitzpatrick and spent time explaining how this is making providing care incredibly more difficult.
Then there is the insurance industry. Wall Street loves the current situation and refers to the health insurance industry as a money-making machine. Where does that money come from is what I would ask. It comes from physicians and others who actually provide the care not getting paid for services provided or getting paid at rates that are so low that it is impossible to stay in practice. Why is it that when a Medicaid HMO is bought by another insurer, it is bought for billions of dollars, but physicians are paid so little by them that few physicians can afford to belong? How is it that executives of insurance companies become wealthy, but physicians fear their their reimbursement rates cut to levels that are no longer sustainable to stay in independent practice and have to become employed physicians of large health care entities? The only thing that scares a practicing physician more than the current situation is the fear of what could happen if we move into a national system such as Medicare for All.
It is obvious that there will be further challenges in the healthcare delivery environment in the coming years and the best organizations to represent us, the practicing physicians, are our county and state wide societies. It is imperative that doctors belong and stay active in these organizations. I am honored to be the incoming President of the Bucks County Society and I hope that I am up to the job at hand.