Membership in many physician associations had been flat or declining in recent years, but now appears to be on the upswing. This could be the result of better times, better marketing or the fear generated by the regularly repeated threats of precipitous Medicare pay cuts.
Membership dues are often the first things to be sacrificed when the economy stalls. Docs rejoining groups like the American Medical Association or state medical societies could be a sign that better financial times lie ahead. It could also be a sign of a growing interest among physicians to advocate for their profession. Or, according to a theory put forth by Princeton University economist Uwe Reinhardt, it may not be a positive development at all.
According to a California Medical Association news release, there are between 60,000 and 70,000 physicians in the state of California, and 37,222 are CMA members—which represents a more than 4% increase from the year before. The growth is significant, according to the release, because membership had been “relatively flat” for nine years.
“The increase in membership is due to outreach to medical groups and more targeted recruitment and retention activities,” the release said. (The release didn’t mention that CMA dues for medical student, resident and fellow members were eliminated last year and that the CMA asked county medical societies to do the same.)
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Go team! Or, more accurately, “Go physician-led team” was one of the battle cries of the American Medical Association House of Delegates interim meeting.
But what if there are no physicians around to lead the team? Would the AMA be willing to call for a draft where doctors are pulled from comfortable suburban practices and dragged to the rural hinterlands like a professional athlete picked by a new team in an expansion draft?
OK. No more sports analogies. But there is a definite trend of physicians calling for physician-led teams without addressing the realities of the projected physician shortage and the existing “maldistribution” of doctors.
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Noting that healthcare is in the beginning of its “Decade of Transformation,” healthcare strategist Marc Sauve told attendees at the 25th annual Healthcare Facilities Symposium and Expo in Chicago that “We are going to have to rethink everything.”
“There is going to be a lot of anger, fighting and people getting mad,” said Sauve, a consultant on healthcare provider growth strategies with Gresham Smith & Partners in Nashville. Then, quoting Dr. Seuss, he said the questions are complicated, but the answers are simple—and that these answers include shared sacrifice, compromise and negotiation.
Sauve, a perennial speaker at the symposium, noted how he successfully predicted last year that Congress wouldn't come to a meaningful agreement on deficit reduction. An easy prediction, Sauve acknowledged, but he said he also correctly predicted the Patient Protection and Affordable Care Act's personal insurance mandate would be upheld by the U.S. Supreme Court and Chief Justice John Roberts would cast the deciding vote.
“Maybe we were lucky,” he said.
For this year, Sauve predicted Congress would prevent sequestration-driven budget cuts called for in last year's Budget Control Act, but only do so by “kicking it down the road for six months.” He also predicted failure for legislative attempts to overturn the ACA.
“If you're waiting for repeal, good luck,” Sauve said, though he later praised GOP vice presidential nominee Rep. Paul Ryan for proposing Medicare reform. “At least he had has some guts to put the thing on the table.”
Each year, Sauve runs down the nation's top 15 causes of death and compares U.S. healthcare statistics with other countries. He noted how homicide fell off the list last year after a 10-year run, but countered by stating how the nation's suicide rate is “going through the roof” and how deaths from accidents are on their way up because of driving and texting. But all others are way behind the first and second causes—heart disease and cancer—despite “great strides” made in the treatment of both.
Sauve cited how the World Health Organization ranks the U.S. health system 37th out of 190 countries. While U.S. infant mortality figures are improving, he said the current rate of 6.8 deaths per 1,000 live births is “still embarrassing” and that statistics indicate the high rate is poverty related.
This link continues into adulthood as high school dropouts have a 2.5 times higher death rate than students who go onto college, he said, adding that our “28% high school dropout rate is killing us.” Education is the key to getting people out of poverty and toward a healthier lifestyle, he said.
As health systems transform, Sauve said “there needs to be a physician at the head of the table,” and he criticized how hospital CEOs are all talking about how they need “physician alignment.”
“You need physician partners—just because they're employees now doesn't mean they are cooperating,” he said, adding that nurses need to be empowered as well.
Follow Andis Robeznieks on Twitter: @MHARobeznieks.
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Consolidation is occurring everywhere in healthcare. Without the involvement of public shareholders' or taxpayers' dollars, private companies have become very private about how much they're spending on their latest acquisition—unless the deal lands in court.
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A friendly reminder to those tweeting from the American Medical Association meeting: Unless you like reading notes about Taylor Swift with your Medicare premium support diatribes, the code #AMA is useless.
The preferred hashtag appears to be #AMAmtg.
In fact, very little that is found while searching with #AMA will get you anything about the nation's oldest and largest physician organization. But you will find comments about the American Music Awards, American Motorcycle Association, American Freestyle Motocross Association, American Marketing Association and a lot of stuff in Spanish that I can't figure out.
But, speaking about premium support, I e-mailed former Medical Group Management Association President and CEO Dr. William Jessee for his take on the debate over whether the AMA should endorse transitioning Medicare into such a system.
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