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PRESIDENT’S
MESSAGE

IT’S TIME TO DO SOMETHING

DIFFERENT

By Adam Ratner, MD, 2019 BCMS President

By the time you read this, the Texas Legislature will be in session. other while the private and governmental payers and regulators,
This triggered thoughts of deep disappointment about the influ- big Pharma and other large corporate interests look on.
ence we as physicians have lost over the last decade and a half. Second, we must learn from what has worked in the past. The
Back then, we celebrated a just and hard-fought victory over the battle for tort reform was ultimately won because of unity of pur-
tort system which had gone awry and impaired our ability as physi- pose, persistence, effective organization and marshaling of re-
cians to practice medicine. So, what has happened since? sources. There were very few physicians who opposed tort reform.
The tort reform victory has had very long legs and for that we We were united and we ultimately won.
all should be very grateful. But what else? My political friends have Third, we must identify a new unifying strategic goal or two upon
an answer to this: Some relatively obscure but terrifying bills that which almost all of us can agree and focus. It is up to us, the mem-
we fought off or some legislation that protected somebody’s turf bership of BCMS and TMA, to decide what the goal or goals should
for another two years. Agreed, but where are we in the big picture? be and not be distracted by the smaller issues that divide us.
Despite our major tort reform victory and the subsequent Fourth, we must create and execute a plan to achieve our goal(s).
smaller victories/defeat avoidances, I see serious decline. Physicians Many of us are offended by the “pay-to-play” environment of
have less power and influence over how we practice medicine and Austin and Washington and don’t want to waste our hard-earned
serve our patients. We seem to be unhappier. More and more of financial fuel on the fire of institutional political corruption, par-
us feel we are forced to accept one-sided contracts that rob us of ticularly if we will always be out-gunned financially.
our ability to use our hard-earned knowledge, skills, experience and That said, we have other resources we can deploy, if properly
devotion to help take care of our patients. Many of us feel we are engaged and motivated, to win and win big. There are more than
indentured servants to our non-physician employer masters. 50,000 TMA and 5,700 BCMS members. We have the BCMS and
Some say we’ve already lost the battle in Washington, too many TMA Alliances including all of our spouses/significant others and
big players and too much money against us. While there is some families. We have our Circle of Friends, business associates and
truth to this, particularly regarding Medicare, we should remember staff/employees. If we wisely choose a goal our patients can sup-
that health care and insurance are largely regulated at the state level. port, they can multiply our influence in traditional and social media,
This means that actions of our state legislators and regulators are in the halls of power, the marketplace, as well as the ballot box.
still critically important. Please let our Legislative/Socioeconomics team leadership, Alex
So, what are we going to do about it? Kenton, MD, Committee Chair (alexander_kenton@pediatrix),
First, we must take stock. Mary Nava, MBA, Chief Government Affairs Officer
Our strengths: The physicians of Bexar County and Texas are (mary.nava@bcms.org), and me (adam.ratner@bcms.org) know
very smart, hard-working and honorable professionals. We want to one or two unifying issues that you think will make your life and
do the right things for our patients and our practices. We are still your patients’ lives better.
relatively wealthy. We have some strong physician-led institutions.
Our weaknesses: We spend so much time working and thinking It’s time to do something different and do it now!
about our patients and practices, we are vulnerable to those who
can and do spend the time and effort to take advantage of us and Dr. Adam Ratner is President of the Bexar County Medical Society and
our work ethic. We are politically diverse and, on many issues, have serves as Professor and Assistant Dean of the University of the Incarnate
conflicting views. Our specialty societies too often fight with each Word School of Osteopathic Medicine and Chair of The Patient Institute.

8 San Antonio Medicine • February 2019