Iowa Medicine article published: 10-1-2020
Brian Privett, MD, IMS President
“We need more physicians to say yes when asked to be involved (in organized medicine) and to follow through with that commitment.” This was the parting advice of my program director, Tom Oetting, MD, at the end of my residency at the University of Iowa. I took the advice to heart. After my first year in practice, I was asked to serve as the president of the Iowa Academy of Ophthalmology (IAO), and I said yes.
During my time on the IAO Board, we worked with the Iowa Department of Public Health to institute a vision screening program in Iowa for children and worked to prevent the practice of surgery by non-surgeons. It was during this time that I was introduced to the Iowa Medical Society and the work they do for all physicians in Iowa.
Ophthalmology is a relatively small specialty. When our specialty’s concerns are amplified by the state medical society, our voice is much stronger. This is the basic principle of organized medicine. Individual physicians’ voices and ability to create change are amplified when we speak with a unified voice. One of my partners, Steve Jacobs, MD, was an IMS board member. When his term was up in 2013, he encouraged me to run for the board, and I said yes. My time on the IMS Board of Directors has been and always will be a highlight of my career. Over the past seven years, IMS has achieved a lot. We helped make incremental improvements to Medicaid and have been a sounding board between physicians and the state on the multiple problems with the managed care organizations.
We continue to pass temporary fixes to the unfair Geographic Practice Cost Index which punishes physicians in rural states like Iowa and, left unchecked, would result in more than $20 million in Medicare rate cuts to Iowa physicians each year. We passed CANDOR legislation which continues to improve the malpractice environment in Iowa along with a certificate of merit to cut down on frivolous lawsuits.
Working with our psychiatry partners, we helped pass and strengthen two mental health reform bills – first for adult patients with complex needs and then to establish the first-ever comprehensive Children’s Mental Health System in Iowa. In conjunction with our family medicine partners, we helped establish and fund the Rural Physician Loan Repayment Program to recruit more physicians to rural communities. IMS secured passage of telehealth payment and coverage parity for Medicaid, and telehealth coverage parity for commercial carriers to help facilitate greater expansion of these critical new tools in care delivery. We also continue to push back on the ever-increasing number of scope of practice expansions put forward each year. Recently, we have retooled our resources to help practices with COVID-19 and pass physician concerns regarding COVID-19 on to state and federal officials.
I was asked to attend AMA meetings as a representative of IMS, and I said yes. I have experienced the power of this organization speaking for the entire country. One recent example of how organized medicine made a difference was regarding the closure of Hahnemann University Hospital in Philadelphia which was the primary teaching hospital for Drexel University. This left 571 residents and fellows stranded without a job and without medical liability tail coverage.
The AMA stepped in and provided the legal services to broker a $9.3 million-dollar settlement for long-tail insurance for 1,500 residents, fellows, and alumni. The state and county medical society also helped place residents and fellows in difference programs across the state. Because Hahnemann was a corporate entity, this type of advocacy for these displaced trainees would have not been possible without the support of organized medicine.
I was nominated to run for the IMS Executive Committee and serve as the 171st IMS President, and I said yes. Sometimes people have asked me why I got involved in organized medicine so early in my career and my answer is, “how could I not?”. Too many decisions at the state and federal level affect how we practice and how we provide for our patients. If physicians’ voices are not heard, others will make these decisions for us. If anything, younger physicians and students should advocate more for themselves as the decisions that are made now will have a greater impact on their career than a physician who is closer to retirement.
The IMS Board has been an extremely welcoming group for me despite my younger age and we encourage younger physicians to speak up and be involved early in your career. I can attest that your life only gets busier if you have a family and raise kids. There is no better time to become involved than the present.
A side benefit of being involved in organized medicine has been the relationships I have made over the years. Working with my specialty society, I was able to meet a number of my ophthalmology colleagues across the state. As a person new to Iowa, my wife and I have made many friendships through our involvement with the Linn County Medical Society. We have also made many lifelong friends through my involvement on the IMS Board. These friendships outside of my practice are extremely valuable and well worth the time I have given up in my practice.
I believe saying yes also helps with physician burnout. Many of our IMS members have taken part in our burnout programming across the state and found them to be useful. One way to combat burnout is to become involved in organized medicine. One reason physicians experience burnout is that we have all these expectations about what a career in medicine should be, but in our daily practice these expectations are not met.
By advocating for yourself and your patients, you can help take back control of your practice, or at least make your voice heard. There is healing in knowing you did everything in your power to help your patients, your colleagues, your care team, and yourself. It is also helpful to learn that many of the burdens and frustrations you have in practice are shared by many of your colleagues.
No matter what career stage you are in, I encourage you to advocate for your patients and your profession. I hope when you are asked to participate in organized medicine, you will say yes.