By Jeffrey Barg
As Physician’s News Digest reaches a ten-year milepost, Delaware Valley physicians have reached a decisive crossroad. Yet, while forces impinging on the medical community seem to put it in jeopardy like never before, physicians seem to be working at cross-purposes. Conservative impulses battle with calls for change, while others adopt a posture of active or passive resignation. And conflict rages between the competing programs for change: As for-profit medicine threatens to become the dominate mode of health care, should physicians “go corporate” or look to the public sector to take over health care financing? Will physician unions, physician organizations, physician insurance companies or refurbished medical societies be the most effective mode of organizing?
Amid all the uncertainties, one thing seems to be clear: If physicians collectively do not become agents of change with the right program for change, the erosion of physician authority, autonomy and security will continue, perhaps irreparably. The ability of the profession to set standards for the practice of medicine—a fundamental characteristic of what it means to be a profession—could be lost. The doctor-patient relationship could be distorted beyond recognition.
And yet, the conservative impulse must not be dismissed. After all, some treatments may be worse than the disease they are intended to cure. The trick is effectively advancing a program of change that preserves what is admirable and good about American medicine. No small trick.
Over the past ten years, we at Physician’s News Digest have attempted to describe, analyze and evaluate changes in Delaware Valley medicine. Given our current analysis, we shall also attempt to foster the development of a viable program of change that preserves what is good about American medicine and to support the adoption of such a program by the medical community and the public at large.
We begin this process this month with a 10th anniversary supplement titled, “Unionize, Corporatize, Socialize: Visions of Change for Delaware Valley Physicians.” In the supplement, Delaware Valley physicians, who have distinguished themselves as leaders advocating different ways doctors can regain control of medical practice, explain their favored path to a better future: physician unions, physician-owned insurance companies, physician organizations and national health insurance.
While the writers in the supplement may favor different paths, there is a remarkable degree of similarity in where they would like to end up: a place where physicians are free to deliver high quality medical care to their patients without undue influence from outside forces. Another similarity is that in addition to a vision, they all have an institutional base from which they have launched the vision, including the Philadelphia County Medical Society, the Pennsylvania Society of Internal Medicine, Pennsylvania Physicians Care, Millennium Physician Organization and Physicians for a National Health Plan.
We hope to begin a serious discussion with our 10th anniversary supplement, which will continue in Physician’s News Digest in general, and continue in particular in our discussion forum on our web site (https://physiciansnews.com/discussion.html), letters to the editor, and at a panel discussion on November 4th, 1997 from 7:00 PM to 9:00 PM, at the Adam’s Mark Hotel in Philadelphia.
But I urge to participate, if not in this forum, then in some other. The stakes are too high to leave it to others. The largest single obstacle to physicians being able to help shape the changes occurring in health care—even beyond the fact that they are frequently working at cross-purposes—is that too many are not engaged in the process whatsoever. Get involved and don’t allow yourself to be discouraged by some initial setbacks. You’ll be surprised by how much good you can accomplish.