Physician, Business, Professional and Information Technology Communities Networking to Restore Accountability in HealthCare & Medical Practice
MedicalTuesday Introduction, 2002
When I was the editor of Sacramento Medicine, I wrote monthly editorials as well as an anecdotal column called Hippocrates and His Kin, book reviews on medical topics, and book reviews on any subject written by physicians or nurses. During this time, I had the opportunity to network with the journal editors of other county medical societies. There were a number of insightful articles written about the problems confronting health care which the physician authors determined could not be solved by the medical profession alone–solutions they maintained would require networking with the business and professional communities.
I also spent two years on the editorial board of California Physician, my assumption being that I would write similar articles for the state journal. However, I was immediately informed that the employed staff preferred to write the articles since it was less time consuming than making articles written by doctors "correct." I was also asked by the staff at Sacramento Medicine to cease writing articles on behalf of doctors working in a free market environment, the contention being that I should assist them in accepting the reality that Managed Care is here to stay.
Thus, it became apparent that I would need a different venue to network with physicians. About this time, one of my daughters (both have MBAs and do business networking) who lives in London, and works in the Venture Capital arena, began missing the dynamic interchange of silicon valley. It compelled her to develop a business email list of 850 on her laptop. Thereafter, she partnered with three associates to develop this network into 80,000 email addresses in 80 cities, 40 countries, on 5 continents. I was impressed that she could write a memo and, with a mouse click, send that business letter to 80,000 business associates.
In the past, our medical societies met on Tuesday evenings which then became known as "Medical Tuesdays." Since Monday and Friday are busy days in any practice, that precludes evening meetings on those days. Many doctors take a half day off on Wednesdays or Thursdays in order to compensate for working the nights and weekends required to cover their practice. Hence, that left Tuesdays for colleagueal and professional meetings. In our community, the Medical Society met on the third Tuesday of each month. Huge turn-outs occurred, filling the largest meeting room at the convention center, to discuss the professional and practice issues of the day. The Internal Medicine Society met on the fourth Tuesdays to discuss their unique problems; the family physicians, surgeons, pediatricians and obstetric-gynecologists also met on Tuesdays.
As Managed Care became more assertive in telling doctors how to practice, the agenda at the medical meetings changed and attendance dropped. Meetings were reduced from monthly to quarterly. Patterns were broken. Doctors could no longer rely on meeting times or the month meetings were scheduled. Gradually, the professional meeting began to disappear. It was counter-productive to the interests of Managed Care for doctors to assemble and discuss issues since it increased resistance to compliance. On two occasions in the past two years, the medical society, in a community of more than 3,000 physicians, had less than 30 attendees (1%). Effective physician leadership disappeared. The once noble profession was gradually being de-professionalized.
Top down health care reform was not materializing. There were too many conflicting interests, not only among the administrative controllers, but also in a hostile Congress, which, in concert with our own organizations, began to restrict and suffocate our profession. It became apparent that another approach was required. More of our colleagues, such as Bob Cihac, MD, in his electronic column, began contending that health care reform had to begin at the grass roots level. We have the mechanism to directly reach unlimited members of our profession, as well as the entire business/professional community, without going through the rose-colored media.
We began writing a biweekly MedicalTuesday Electronic Newsletter in April, 2002. We sent it to those in our physician address book who we believed would still be interested in returning their medical practice to the Medical MarketPlace. The list expanded and essentially doubled every month. It went to Canada and then overseas to the UK, Europe, Asia, S Africa and Australia. Some of the most earnest responses were from physicians as well as the business and professional communities in countries where socialized medicine was ready to implode. Long emails encouraged us to continue our efforts world wide in order to facilitate the return of private medical care which would be more economical than government-controlled care. Privatization was being tried in such bastions of socialized medicine as England and Sweden. The United States remains the only country which still has a relatively complete infrastructure of private care. We must guard this before it’s too late; otherwise, it will become like our senior care. For instance, when Medicare started in 1966, my father had excellent Blue Cross and Blue Shield policies. A few years after the advent of Medicare, he gave up his Blue Cross and Blue Shield and had only Medicare. Now that Medicare in ready to implode under the burden of excess costs and utilization brought on by being essentially free, our poor senior citizens will be left without an effective system of private care. We must preserve the infrastructure for the majority of our citizens before it suffers a similar fate.
The father of government social insurance, German Chancellor Otto von Bismarck, observed how Napoleon III used state pensions to buy support for his regime when he was Ambassador to Paris in 1861. "I have lived in France long enough to know that the faithfulness of most of the French to their government... is largely connected with the fact that most of the French receive a state pension." According to Brink Lindsey’s article in the journal Reason, the appeal of social insurance for Bismarck was that it bred dependence on, and consequently allegiance to, the state. Social insurance, whether social security, Medicare, or single-payer medicine, was thus born of a contemptuous disregard for liberal principles: What mattered was not the well-being of the patient or workers, but the well-being of the state.
Welcome to the MedicalTuesday network. MedicalTuesday has an e-mail newsletter that is sent out on Tuesdays that is global in its outlook as it compares the health care of the United States with the world health community. We have demonstrated that quality as well as access deteriorated in countries with national health plans. The ideal and workable HealthPlan for the USA is evolving from these MedicalTuesday electronic gatherings. Your comments and feedback are greatly appreciated.
Del Meyer, MD, CEO & Founder