Thanks for the Opportunity      12/97

by Del Meyer, MD

When I was appointed to the editorial committee in 1992 after writing three articles for the Journal, (thanks to Floyd Cothran for the stimulus to get started) I thought this might be an intriguing new experience. When I was appointed as Editor after another series of three articles, I was worried whether Peter’s Principle was already running. I appreciate the opportunity to serve the society during these four years as Editor.

In July, 1993, Richard Johnson gave me the go-ahead to write a monthly column, "Hippocrates & His Kin." It has received the most comments of anything I have written. After a hectic morning in the office, I always enjoyed hearing comments about the latest issue from my colleagues in the hospital staff room at lunch. I shall plan to continue this column as well as a companion column, "Hippocrates & His Colleagues" for another journal.

In October 1993, we began the "Physician/Patient Bookshelf," a regular book review column. We have reviewed over 50 books either written by physicians or about aspects of medicine, and a number of our members contributed reviews. I would hope that this column will continue on a regular basis.

And of course, since January 1994, I have written the monthly "editorials" for each of the eleven issues during my four-year term, which I consider my most important obligation. Since I was not a professional writer, I employed an editorial assistant to polish my submissions. Some articles got more attention than others depending on how soon I got them to her. I want to thank Colleen Kozumplic, a science writer, physics teacher, and workers’ compensation instructor, for her help and also for the article she wrote on Kaiser health care, which we published in September 1996. I greatly appreciate the efforts of Catherine French, also a writer and editor, for her assistance since last summer as we’ve expanded to writing articles and reviews for several other medical journals.

Early on, we found that many of our officers and board members were not reading our publication. We thought perhaps we should take pains to address the relevant issues of our time. I subscribe to Forbes only to read Thomas Sowell’s column; in the process I end up reading a few more articles. We determined the strength of Sacramento Medicine would also be greatly enhanced by a number of columns. Society members would take interest in a particular column and in the process become more enlightened by what else was being written. We felt our goal was to provide a forum for the discussion, dialogue, and debate of professional and practice issues and ideas important to our members. This concept was formalized as our mission statement this year.

Eleanor Rodgerson, a former newspaper columnist, has given us monthly running commentary of her perspectives on medicine, past, present, and future. Gilbert Wright gave us a cutting edge "Curmudgeon’s Corner" as he saw it. Jim Coyle has been reviewing the journals of the other county societies to see what the concerns are around the state. In his "Other Voices" column he gave us his perspective and synthesis of California’s medical happenings.

Although this is not a scientific journal, we thought that "Medical Case Reviews" could be used to point out some of our peer review and managed care problems. This was a rather sensitive issue and contributors were not forthcoming. John Loofbourow has been a diligent editor of those that did come through and has been a regular contributor. Our newest columnist, David Lehman, has given us a new perspective in "The Other Side of the Bedrails. "

I was able to persuade George Palma, who has written computer columns elsewhere, to favor us with "Computer Talk" which he has faithfully done the past two years. He has touched upon important aspects in the practice of medicine as we enter the digital age. We really need to take what he says to heart and computerize our practices, even if only to survive the onslaught of the government, the medical board, managed care, and others who would like to control us. George Palma’s column is of paramount importance as we make our defense against the threats to our profession.

When I became editor, I challenged each member of the editorial board to strive for excellence. We increased our meeting time from 60 to 75 minutes every month to manage the sheer volume of work we had to do, and everyone was prompt with good attendance by members. Every member of the editorial board took his/her role seriously and contributed articles. The last two years, we asked editorial board members to take on the job of guest-editing an entire issue. This allowed me to devote the main editorial to the "practice issues and ideas" as I saw them. Most members took on at least one issue. Our thanks to Ed Rudin who was the guest editor several times both years and contributed a large number of articles and obtained a large number of contributions.

We thank all the society members who have written, phoned, faxed, E-mailed, or just stopped me at meetings, in restaurants, or even at the airport to tell me their thoughts, concerns, and make suggestions. We’ve had requests to review numerous books related to practice problems. Even after doing 50 reviews, we still have over 30 on our shelves that were beyond Sacramento Medicine’s capabilities. The research and writing took about 40 hours a month or 500 hours a year or 2,000 hours that I was able to donate to organized medicine. From all indications, it has been well-received by the rank and file members. Since the average American working full time works 2000 hours during an entire year, the question was asked whether the editorship should be a paying position. The short answer is no. It has to be a labor of love or it has no value. The long answer is that the editorial position would be destroyed by being held accountable to our administration rather than to the doctors. I feel the same principle applies to the payment to a hospital staff position. When the chief a service receives a check from the administrator of the hospital, he ceases working for the doctors and starts working for the hospital administration. That is a conflict of our professional interests. We all need to donate a quantity of time for our collective welfare from time to time when our other professional obligations allow it.

For the past four years, the primary emphases and direction has been in the interest of our patients and not our personal or economic interests. The latter will be automatic if the first occurs. At the recent CMA leadership conference at La Quinta, the CMA Executive Vice President and many of the speakers pointed out that our primary goal should be our patients’ welfare rather than our own economic concerns. If this priority filters up through the AMA, it will again show that change can best be accomplished starting at the grass roots level.

I give my sincere thanks and appreciation to presidents Jack Ostrich, William Vetter, Joanne Berkowitz, and Ben Berry for appointing me and allowing me to serve the society as the Editor for these four years. I could not have done it without the superb assistance and hard work the editorial board provided. And of course, none of us could have provided you with the journal without the excellent and diligent work of our managing editor, Chris Albasio, PhD. Thanks to the Editorial Board, Dr Chris, the Columnists, all who have written articles, and best wishes for a continued vibrant and relevant Sacramento Medicine with the free and unfettered exchange of ideas from and for the members of our society.