President's Report to the House of Delegates: Interim Meeting 2008

Thank you, Mr. Speaker. Six months have passed since we last met. These have been eventful times for our medical society, our health care system, and our nation.

Most notably, we elected a new president, and we already see the hope that flows from that new beginning. We have also seen our nation’s financial system lose its balance – and come terribly close to utter collapse. It’s clear our economy’s problems are not over. In fact, they may have only begun. We don’t know how long, or how deep this one will be … and that’s exactly our challenge: If no one knows what will happen, how do we plan for the future?

I want to tell you how these events have affected our medical society, and how our senior staff is managing this organization during these times.

First, our endowment and reserve funds. Thanks to the generations of success in our publishing division, we have been blessed with extraordinary resources. As a result, we’ve done amazing things. But the last six months have not been kind to our endowment and reserves. Since June 1, our combined funds have lost about 28%. That’s somewhat better than the market’s benchmarks. But it still hurts.

At the same time, Publishing is moving from a business based on paper to one based on semiconductors and software code. I would be tempted to call it an evolution – but it’s much happening faster than that. It’s more like a REVolution. Our Publishing Division is managing this transition period much better than our competitors, but this period of uncertainty has only begun.

So: We have financial uncertainty on one hand … And a paradigm shift in our core publishing business on the other. Where will it lead us?

I want to assure you: Our society is not in any imminent danger. But we can’t pretend that we will never be in danger. … and we can’t ignore the current environment.
Given the volatility and uncertainty of the economy, we must be very prudent in how we manage and invest our resources. Our resources are not limitless.

We have to plan better than we have ever planned before. Interesting ideas must be matched with solid business planning. If we don’t have the plan, then maybe we shouldn’t do it … until we do.

Innovation makes for a better future, that’s for sure. But innovation must be coupled with discipline. As our Society’s major policymaking body, your role is obviously critical. We ask that you work with us in charting a prudent, disciplined course through these times. This is the essence of responsible stewardship, and I look forward to fulfilling that duty with you together.

This message comes, ironically, after a season of great accomplishment for our Medical Society. Since we last met:

• Organized medicine across the country worked together to block a big cut in Medicare fees, and set the stage for what we hope will be
  long-lasting Medicare reform. One of the heroes of that victory was Senator Ted Kennedy. I will never forget his dramatic appearance on the Senate floor to cast the decisive vote. That moment summarized everything he’s done for health care during his distinguished career. Regardless of your political inclinations, it is hard to deny his indelible impact on our health care system. We’re exploring a suitable way for the Medical Society to honor his career. We’ve decided nothing yet … but we hope to do so relatively soon. We’ll keep you up to date on this … and of course, we welcome your suggestions.

In other areas …

• In May, we formally began our litigation against the GIC’s physician tiering program. Our colleagues in Medicine welcomed this development warmly. The initial hearing on our claims is scheduled for next month.
• A new era has begun at the Board of Medicine. We have high hopes that the Board’s new leadership will be committed to a respectful, productive process to advance professionalism and patient safety.
• The public and private sectors are at work addressing the growing crisis in the physician workforce. We have been talking about this for a long time, and now, people are listening. At least a half dozen pilot projects are underway on the advanced medical home. We all hope this will make our health care system more effective, more productive, more rational, and more rewarding for physician and patient alike.

Put all these developments together, and it seems to me that we are at a defining moment in the evolution of our health care system. The old ways brought us this far, but they can’t bring us much further. The old solutions aren’t working either. Either they’re very limited in their impact, or worse than the disease itself. We need a new approach, and the world is asking us to provide the solution.

If you were at our State of the State conference last month, you saw many speakers call on the physician community to lead us out of this mess. They are begging us to define a world where care is efficient, safe, equitable, and affirming to both physician and patient. The community needs us, and they know it. And why not? Physicians are the in best position to lead the discussion. We must assume that responsibility. We have to listen, and above all, we must be selfless.

I challenge everyone in this room to be bold and to be creative. We must not squander this opportunity. People trust us with their lives, because we have earned it. They are now willing to trust us with the re-design of their health care system. This weekend, let us prove to them that we remain worthy of that trust.