SHC launches on-line physician portal

Dean praises student free clinic

Column 1 Michael Sexton, president of
CMA

Column 2 J. Kent Garman and James Hinsdale

Tennis? Innovative medical treatment
for tendonitis

Nurse week scholarship winners

NIMH study seeks memory patient referrals

Letter to the Editor - Sri Lanka

Cop Doc Norris may now carry Glock

Clinics move to Blake Wilbur building

Cat Herding 101

Bruce T. ADORNATO

How many times have I heard the phrase that getting doctors to work together, vote together, do anything together is like "herding cats"? It is an apt visual image most of the time.

Like cats, most physicians are very independent, occasionally bordering on aristocratic. Doctors have fickle tastes and run on their own timetable. And in reality, considering the diversity of our profession, from clinicians to academics, from country doctors to basic scientists, from employed physicians to administrators, from generalists to specialists, from private practice to large HMO's, it is surprising we ever agree on anything.

Furthermore, who wants to be accused of "herd mentality"?

Nonetheless, there are places and times that a little organization is beneficial, as in a little organized medicine finding and protecting common goals. If there was ever a time to circle the kitty litter, this is it.

This month's Medical Staff Update includes two guest pieces from leaders of the Santa Clara County Medical Association and the California Medical Association that are worth your time to read. Here's at least one reason:

For most of our careers, we have experienced slowly increasing numbers of incursions into our professional and personal time by legislated mandates for this and that, e.g., documentation of E/M coding, HIPAA, OSHA, etc. The world of bureaucratic rationing - as in demanding 5 digit ICD-9 coding, letters of necessity, and repetitive medical record copying and transmission - has been taken to new levels. Third party administrators act as bounty hunters to find ways to obstruct care and skim off saved dollars. Medicare is toying with the idea of hiring private groups to audit physician records and then pay them with percentages of fines levied. (I thought such plundering went the way of pirates of the Caribbean). Cohesive groups of specialty interests, such as optometrists, chiropractors, and physical therapists, among others, promote legislation to expand their realm into areas where physicians might have a second opinion about whose role is it anyhow.

In any case, the reality is that politics does affect your life and the lives of your patients. Hoping that good and truth will triumph over not so good as a primary strategy is historically ineffective. My personal view is that anyone practicing medicine in California should be committed to investing a few hundred dollars a year and some time to at least read the Santa Clara County Medical Society Bulletin and CMA Alerts so they can understand the issue and participate in their future.

* * *

On a very local level. . . (As Tip O'Neill famously said, "All politics is local)": We are holding an election for the leadership of your Medical Staff - including the selection of a new vice president to succeed faculty cardiovascular anesthesiologist Kent Garman, who succeeds me to become your president in the fall. There are also some major bylaw issues on the ballot, notably an expanded vice president/treasurer position to give us greater oversight of our staff dues. Watch your mail. I hope you find time to participate.

badornato@stanfordmed.org