PRESIDENT'S MESSAGE
I spent a whirlwind couple of weeks advocating for physicians in April that took me from city council meetings to the state Capitol and ultimately to Washington, D.C. on the Sacramento Metro Chamber’s annual Cap-to-Cap trip. One of the biggest takeaways from that experience was discovering how uninformed some of the leaders who decide on health care policy are about what we do as physicians.
That’s not necessarily their fault. Unless we tell them how their decisions affect patients and physicians, or why doing things like expanding the scope of practice for clinicians who don’t have our training can put patients at risk, they shouldn’t be expected to know. That’s why the burden falls on us to educate them to the benefit of our patients and practices.
One of my greatest responsibilities as SSVMS President is to represent Sacramento, El Dorado and Yolo County physicians in the places where the policies that directly affect our livelihoods are being made. On my recent trip to D.C., a lot of the discussion was around Medicare and reimbursement rates so low that 41% of California physicians are not accepting new Medicare patients. We’re seeking an inflation factor to increase reimbursements as costs go up, and it has been difficult to get lawmakers to fully grasp how important this is to ensuring that beneficiaries can get the care they need. As we all know, the population is aging, so that means there will be more Medicare patients but fewer doctors to treat them. That’s a recipe for an access-to-care disaster.
It goes beyond finances, though. When it costs more for physicians to see patients than they get reimbursed, it adds to the stresses that are causing doctors to burn out and rethink their future. We’re losing a lot of our workforce, and with 34% of California physicians over age 60 — and 50% more than 50 years old — it’s not going to get any better. Nearly half of California physicians also say they are looking to retire early.
We constantly see scope-of-practice bills in the state Legislature, and we need to be part of the conversation. When optometrists pushed a bill to allow them to perform LASIK surgery, Dr. Barbara Arnold explained to legislators that ophthalmology residents perform over 3,000 surgeries prior to graduating while an optometrist trainee might see 30 or 40 surgical cases over three or four years.
When you haven’t seen the complications from a surgical procedure, you might believe performing that surgery is easier than it actually is. It just takes one bad outcome to quickly show that you’re not prepared, and the results can be permanently damaging or even fatal. Luckily, our pleas have been heard and this was turned into a two-year bill as the author didn’t have enough votes to get the bill passed in committee.
One frustrating example of how misinformation or a lack of understanding can affect policy was evident during our visit to the state Capitol. CMA has been advocating for a “truth in advertising” standard that will make sure that when a patient gets health care they’ll know exactly who is providing it — a doctor, a physician assistant, or a nurse practitioner. The bill received a “no” vote from some legislators because of a language issue and concerns about a “nurse anesthesiologist,” a position that doesn’t actually exist in licensure.
I’ve learned that physician advocacy can no longer be optional. We need physicians to reach out to our representatives, to be able to testify when key issues arise at the state Capitol, and to participate on advocacy days in Sacramento and Washington. I know that’s not always convenient, but neither is having to turn away patients or being underpaid for the services you provide. Some of the testimony can be done by Zoom and a letter or phone call to your representatives’ offices can make a huge difference.
Like any good team, we need to build a strong bench of effective, enthusiastic members of the physician community who want to make a difference and shape policies that directly affect their daily practice. Because we’re in the Sacramento region, we have a unique opportunity (and responsibility) to have people ready to go to testify at the state Capitol on short notice. We can’t count on CMA to find someone from Southern California who can fly up here and then sit through seemingly endless committee hearings until they get their two minutes to speak. We have eloquent, dedicated members who can be there to represent our colleagues within an hour of a bill’s hearing.
Our advocacy isn’t just for today, it’s for the future of medicine. And when we’re done working and retired, we need to know that quality physicians will be there to take care of us. We’ve seen a hospital close in Madera from low reimbursement rates, a burnout rate of over 60% nationally (but 44% in our area, as you’ll see in the survey elsewhere in this issue), and the door opening wider all the time for practitioners without our training to take on more complicated cases.
It isn’t always easy to get our story told — that’s why being passionate about patients and the practice of medicine is such an important part of advocacy — but it is easy to sign up to help inform the people who are deciding your fate. Just click here to learn more about how to become part of the solution and help us fight for you and our colleagues. We can’t stand by anymore and think that someone else is going to do that job for us. And remember, if we don’t participate in the decision-making process for all of these important issues, those decisions will be made for us — and they could be very, very costly.
