Giving them the business

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On May 22, 2014 the University of Louisville Residents’ Business seminar was the last group I would address as President of the Greater Louisville Medical Society. It went something like this…

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I didn’t have a course like this when I was a resident.

I wish I had.

Somewhere between respiratory acidosis and cardiac preload, learning to read a spreadsheet could have been worked in.

But it wasn’t.

You’re very fortunate that your university is enlightened and generous enough to offer this course for you.

Today, with healthcare taking up about 20% of our nation’s GDP, there are many non-medical types grasping for our nation’s healthcare steering wheel.

Soon you will be finishing your residencies.

You’ll board the healthcare industry train.

You can either be a passenger or a driver.

It’s your choice.

As I prepared for today’s seminar, I thought about what I would say to myself if I could time travel back fifteen years to when I was sitting where you are now, finishing my residency.

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I would tell myself that there are three balls I will have to juggle.

The first ball is your “clinical” ball. Thus far, keeping this ball in the air has been the primary focus of medical school and residency training. Patients’ needs must be met. Your patients must be well.

The second ball is your “family” ball. You’re not on this journey alone. Your loved ones and close friends depend upon you as much as you depend upon them. Lose their support and the stress of being a physician can be overwhelming. Your family must be well.

The third ball is your “self” ball. Do not neglect your own health, outside interests, passions, talents, or loves. Your self must be well.

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The best way to keep these balls in the air is by juggling them yourself. Don’t delegate that job. Even though most of you will be employed, avoid dependence by becoming as comfortable in boardrooms as you are in operating rooms. You must not ignore the business of medicine.

*

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(A letter arrives. It is from the future. It reads…)

Dear 2014 Me,

I’m writing you from the year 2025. Physicians are no longer considered necessary. They just get in the way. Healthcare is a mess. It’s all based on metrics. Everything is quantified and graded. There is no creativity. No innovation. No flexibility. No passion. No compassion. But at least we get to go home when the whistle blows at three p.m.

Yours truly,

2025 Me

*

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This does not have to be our default future. We can do better. But only if we have physicians willing to lead. And physician leaders now must understand the business of medicine, or else medicine will be nothing more than a business. We must be in boardrooms and wrestle back control of the steering wheel.

*

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(Another letter from the future arrives…)

Dear 2014 Me,

I’m writing you from the year 2025. Physicians are the essential driving force in medicine. Metrics are used to add structure to the art of medicine, not to govern or discipline. The patient-physician relationship is secure and flourishing. Creativity, innovation, and compassion fuel our passions. I don’t know what you told those residents back in 2014, but it must have worked. Thank them for me and for all of us.

 Yours truly,

2025 Me

*

Someone here must have listened. Someone decided to fill the vacuum created by the lack of physician business leadership. Someone stepped up and took firm grasp of the steering wheel guiding our nation’s healthcare. Someone refused to accept our default future.

Who was it?

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*

*

 

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Continuity of Care

TourtheTower

On June 1, 2014 at Louisville’s historic and newly renovated Water Tower, the Greater Louisville Medical Society held its annual Presidents’ Celebration.

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As outgoing president I had the honor of introducing Dr. Bruce Scott – my esteemed colleague and childhood friend – as our new President. I also thanked some of the many great folks who worked so hard to make this the most satisfying year of my professional life.

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Before I handed over the President’s gavel to Bruce and assumed my new role as Chair of the GLMS Board of Governors, I had this to say…

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A year ago, as your newly elected President, the last words I said on that stage were:

The Greater Louisville Medical Society is our organization, our tribe, our road to a place where medicine is both science and art, where our community enjoys wellness, and the sacred bond between our patients and us is secure. And my goal this year is to see us united.

murphy speech at pres celeb

It’s one year later, and our profession is under attack as never before. Physician burnout is an epidemic. This is why, more than ever, we must be united.

Back in the day, physicians were a more homogenous group. There were fewer specialists. We shared common values and common goals.

Now government, employers, specialties, patients, and family pull us in many directions. There is an ever-increasing burden for maintenance of board certifications and licensure. Each separate payer and practice facility requires its own credentialing. Medical liability risks keep mounting. The insatiable quest for quantifying quality with data points and benchmarks threatens to crush our creativity and mandate cookbook-style care. Rival non-physician tribes continuously grab pieces of what used to be our acknowledged scope of practice.

How do we respond? All too often by retreating to presumed “safe houses” provided by the one, two, three or more specialty societies each of us believes offers the most protection of our turf.

Got to survive, you know.

The irony is that these refuges are not safe at all. They are static. Stationary. It makes us benign targets for attack by all who would prefer a leaderless mechanized conveyor belt of universal one-size-fits-none healthcare. This sanctimonious deconstruction of our profession is done in homage and servitude to the inscrutable holy trinity of cost-effectiveness, quality, and value.

Survive?

Why not thrive!

Regardless of where your professional journey has led, you and I and our colleagues remain connected at our roots. We still share common values and must share common goals. We are physicians by education, oath, and calling.

And more…

We love our profession.

We love humanity.

And we love each other.

That is why we get up every day, put on our white coats, and go out to save the world.

Because it must be saved.

And we know…

We are the ones who must do it.

United.

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