Though they're at the low end of the physician pay scale, pediatricians are often found in leading activist or management roles in the healthcare system.
I was reminded of this when, at an event in Washington this week highlighting the Healthier Hospitals Initiative, Dr. Jeffrey Thompson, Gundersen Lutheran Health System's CEO, told an anecdote about how his organization was saving $1 million annually in energy costs after a $2 million investment in 2008. He then punctuated his remarks by noting how that math was easy to understand "even for us pediatricians."
I didn't know Dr. Thompson's specialty before, but I wasn't surprised to learn that the leader of an innovative, high-performing organization was a pediatrician.
After all, former CMS Administrator Dr. Donald Berwick and patient-safety pioneer Lucian Leape have pediatric backgrounds.
So does Dr. William Jessee, currently senior vice president and senior adviser with Integrated Healthcare Strategies and the former president and CEO of the Medical Group Management Association. Jessee has appeared on Modern Healthcare/Modern Physician's 50 Most Influential Physician Executives list six times.
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Although most public pronouncements from healthcare organizations these days sound like they're prepared from the same we're-all-in-this-together template, the latest scope-of-practice court fight showed that all sides still seem ready to drop the gloves at any moment.
A Colorado state appellate court affirmed a decision from the state's former governor permitting certified registered nurse anesthetists to administer anesthesia without a physician's supervision in the state's critical-access and rural hospitals.
Doctors then squared off against nurses and hospitals, and national organizations representing all sides joined in. The court acknowledged it was ruling narrowly on the issues of whether the governor had the authority to make his decision and whether the decision was consistent with state law. It said yes to both, but its opinion (PDF) also included this note:
"Our role is limited to determining whether Colorado law permits CRNAs to administer anesthesia without physician supervision. We may not pass on the wisdom of the decision to allow CRNAs to do so."
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When pay raises are small, some can take solace if their compensation rose above the rate of inflation, but that rate—as measured by the consumer price index—is a moving target, so using it as a historical measure may be of limited value. But that won't stop me from trying to do so.
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Stating that "Ohio is a battleground state and healthcare is a battleground issue" in the upcoming presidential election, the president of the Ohio State Medical Association said his organization is pushing to have President Barack Obama and his presumptive Republican challenger, Mitt Romney, hold a debate on healthcare issues in Ohio.
"We challenge them to have a debate just on healthcare, and we'd be happy to help organize it in the state of Ohio," said Dr. Deepak Kumar, president of the OSMA.
For Kumar, a Dayton-based colon and rectal surgeon, the healthcare reform fight is not over despite the U.S. Supreme Court ruling to uphold the Patient Protection and Affordable Care Act.
"The president had a great opportunity to make a real great change in healthcare, but he fumbled it," Kumar said. "Now we are going to have to spend time and resources to fix it."
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Debates featuring continued backlash from American Medical Association members over the AMA leadership's support of the healthcare reform law seem to be becoming an annual ritual at the AMA House of Delegates meetings, and the ritual is one that might be repeated at the American Academy of Family Physicians' meetings.
Dr. Glen Stream, the AAFP's president, said he expects discussion of the issue to continue at his organization's Congress of Delegates, scheduled to take place Oct. 15-17 in Philadelphia.
"The political part is still playing out," said Stream, who practices in Spokane, Wash. "Repeal will be a big issue in the election."
He said any large organization contains a spectrum of political views, and the recent Supreme Court ruling "reawakened some controversy" within the academy.
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"You've boarded a boat, and you don't know where it's going," Dr. Donald Berwick told Harvard Medical School graduates in a speech published in the Journal of the American Medical Association, but, he added, you still made "a spectacularly good" career choice.
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