Organized Medicine - Present and Future  1/94

by Del Meyer, MD

Richard Johnson has been at the helm of our Journal for 15 years. We've been blessed with good leadership, excellent direction, the "King's English," and one of the finest county Medical Society Journals. I hope I shall be able to come up to his boot straps. We wish him well in his much deserved retirement.

We are starting the year's topics with a discussion on organized medicine. The Lead Guest Editorial "Organized Medicine, Is it Organized?" didn't materialize. Perhaps the decision couldn't be made whether Organized Medicine was Organized or whether there was just a number of Medical Organizations. It is obvious that we need a primary organization to have the overview, to look after the practice of medicine and protect it from intrusions on all fronts for the ultimate benefit of our patients which in turn is in our own best professional interest. There is no reasonable alternative to our SEDMS, CMA, AMA structure. The specialty societies frequently are single issue organizations. They can assist us, but would never be able to provide even a fraction of the functions that Medical Societies do. We just have to be involved to make sure that the official position represents the membership.

We appreciate Dean C. J. Tupper, a member, who gives us his overview on Organized Medicine. We thank our legal representative, Carol Lee, J.D., who works on our behalf in our CMA's Sacramento office, for giving us insight into CMA legislative activity.

Dr. Bill Weil, president of CAL-PAC, will elucidate its workings. It is an important area for us to understand. Some members feel that Cal-Pac doesn't represent their interest. Hopefully this dialogue will increase our understanding and the effectiveness of the contributions they receive.

We should not be oblivious to other competing medical organizations. Our bylaws allow, and we now have, Osteopaths as members. We have invited the president of the Sacramento Valley Osteopathic Society, who is now President Elect of the Osteopathic Physicians and Surgeons of California, to give us his views on organized Osteopathic Medicine. We have invited Dr. Karpan, Dean of the College of Osteopathic Medicine of the Pacific, to tell us about his mission for the state and his emphasis on primary care.

The Union of American Physicians and Dentists now represents hundreds of physicians in our area who work for the city, county, and state, many of which are not members of our society. Physicians are represented in the state departments of Consumer Affairs, Social Services, Corrections, and Health Services. Our thanks to Gary Robinson, the Executive Administrator for the UAPD in the Oakland headquarters, and to our member, Dr. Deane Hillsman, for giving us insight into their background and activities. It is important that UAPD, CMA, and CAL-PAC all participate in a dialogue so that we are unified in our actions in-so-far as possible. If physicians feel that one represents us better than the other, and as we may need labor union type of representation with further government encroachment to possibly eventual employee status for many of us, we may have a loss of membership and loss of voice for practicing physicians. This forum should help us communicate with our Osteopathic and possibly Nursing colleagues also.

The cost of organized medicine has been questioned in many circles. Our own dues structure is $420, $450, $425 ($65 Library), for national, state, and local, with local and state required ($940). The Osteopaths have dues of $427 for national and $250 for state, each individually. The Podiatrists have dues of $775, $625, $110 for national, state, and local, with state and national required ($1400). The Optometrists have dues of $450, $678, $185, ($75 for public litigation), all required ($1388). The Dentists have dues of $330, $525, $220 for national, state and local, with all three required ($1075). The UAPD is $60 per month as a payroll deduction or $720 per year for physicians in practice.

After reading the Executive Director's report, our dues appear to be not only a bargain, but reasonable in comparison. And our license is an unlimited license as opposed to all but the osteopaths as being very limited. The specialty societies also have a significant dues structure with mine equal to our society dues. The squeeze perhaps comes with the increased dues structures of hospitals, some as high as $300, and managed care. In a recent discussion with a managed care company that is assessing us $50 per month for the privilege of providing service to their patients, I noted that some weeks I was sending them more money than they were sending me. And I was seeing the patients. I asked their staff if they would continue working for their managed care company if they had to pay more some weeks for the privilege of working there than they got paid for doing the work. They all said it would be stupid to even consider working under those conditions. That seemed like a logical response and I followed suit.

If this symposium on the various branches of organized medicine will increase our understanding of each other, facilitate mutual cooperation, and lead to more effective action on behalf of those we serve, it will have served its purpose. For only by helping our patients, will we be able to continue to maintain high standards of care which will help us regain our professional heritage.