A call to action

By Samuel T. Coleridge, D.O., TAFP President

Decreases in Medicare reimbursement, expanding scope of practice by non-physicians, non-reimbursement by managed care organizations, pay for performance misinterpretation by lawmakers, shopping mall clinics providing cosmetic procedures and primary care without direct physician supervision … business initiatives have translated medical practice into a pure service industry where safety, the medical home and the viability of the current health care system is in serious jeopardy. Is change good? Of course, but are these changes beneficial for patients and the nation’s health?

I would answer no, nein, non, etc, etc. Why? Access, cost and convenience are business-drivers and obviously have a role in medicine as in all “businesses,” as indeed all medical practices are businesses, but I add that our business is different because we are involved in the career of keeping people alive, healthy and capable of propagating to the next generation.

Industry and corporations thrive on cheap, 24/7 access to fast foods, clothing, gasoline, snacks and where has this led us? We have emergi-centers that do not address many emergencies but are convenient for some urgent and non-urgent health complaints to replace drugstore OTC medications. Pharmacists are willing to provide immunizations and blood sugar checks with no feedback to the primary care providers. Do we or don’t we care about safety and long-term health care? Our global obesity epidemic shows us the answer to this question easily. Take a look around wherever you go and it’s plain to see that the public needs our leadership and guidance.

We need to work together within the House of Medicine and we need to educate our legislators because ours is a country where laws determine our future. Legislation was passed but not funded for school PE programs. Laws were passed but not followed to enforce prompt pay. Both of these examples required new legislation in another legislative session to clarify the non-specificity that allowed independent school districts and managed care organizations to carry on business as usual, cutting costs at the expense of good, solid health care.

As we enter 2006, we family physicians find ourselves facing one of our greatest challenges ever. The further inequities in Medicare and Medicaid reimbursement and proposed cuts to both systems threaten our patients and our practices more than ever before. As more and more corporations reduce medical benefits — or eliminate them altogether — our position as front-line, family physicians becomes even more precarious.

I don’t see a knight in shining armor on the horizon ready to champion us on the field of battle. I believe that only we can make a difference for our patients and ourselves. If we want fair laws, then we must elect fair lawmakers, and 2006 presents us with that opportunity. We must seize that opportunity if we are to have any hope of our voices being heard in Washington and Austin.

This year, the entire Texas Congressional delegation is up for election. So is the entire Texas House of Representatives, half of the Texas Senate and numerous members of the judiciary. We will elect a new governor and lieutenant governor. The outcome of each of these elections will impact our patients and our practices. And more so than any other specialty, family physicians must get involved!

There are many ways we can become involved in the political process this year, from participating on the grassroots level in our communities to helping raise campaign contributions for the candidates of our choice. The very first step all of us should take is to join and become active in TAFPPAC, our political action committee. Over the years, TAFPPAC has been part of some of the most dramatic political victories in Texas history and has made a positive impact advocating for Texas patients, physicians and the medical profession as a whole in the Texas Legislature and U.S. Congress, including the battle for meaningful tort reform, victory over the tobacco industry and HMO reform. TAFPPAC is now ready to continue the fight for us and our patients during this election cycle and next year’s Legislative sessions.

But the only way TAFPPAC will be successful in the future is with our support now. I urge all TAFP members to visit the new TAFPPAC Web site at www.tafppac.org and be sure to view TAFPPAC’s new and fun-to-watch video, “We Did It Before and We Can Do It Again.” You’ll see that we are, indeed, one of the strongest forces in organized medicine today; however we have much work to do and we cannot stand on the sidelines. If we do not personally have the time to participate at this phase of our practices, then we must provide the funds for our colleagues who are working with legislators. As a profession, we make a good living and we provide the least amount of money per individual as a professional organization, about $14 per member for PACs. Surely we can dine out one or two times less during the year and contribute even this little bit or more to our TAFPPAC. I don’t think that we have a choice if we want to see change.

With your participation, we will only grow stronger. We did it before and we will do it again! Thank you for your continued membership.