There is some promise here. Quite a bit of work has been going on in the medical homes arena, for example. This is a principle that we have been in favor of for a while, and yet we need to have some pilot projects and see how it works. Of course, trying to get everybody on electronic health records is very important, although very expensive and painful in the transition. The peer grouping is still being worked out as I understand it. Some of our ideas will probably get picked up by other states and by the feds as well.
when the governor signed the early Medicaid Expansion Act, because that infuses $1.2 billion into our state to help care for these people. These are people who probably have higher medical needs than the average Minnesotan. And they cost the average Minnesotan a tremendous amount in tax dollars and in health premium dollars. To not be able to care for them at the preventive level makes it much more expensive for the rest of us when they show up in the emergency room. I think we also want to be closely involved with continuing the quality improvement, community measurementtype movement. We would like to see increased transparency among the health plans that are administering the Medicare Advantage Program, for example, and the PMAP programs where they get paid extra dollars to coordinate care of some of these patients. We don’t know where that money is necessarily going—that is an issue. The budget is a challenge, both at the state and federal levels. We are very aware of that, but we think that investing in prevention and public health will save us money in the long run.
■ What are the top legislative priorities for
■ Why did the MMA oppose Medica’s
The MMA and I personally agree with the individual mandate, that all people should have insurance and be responsible for that, whether it is subsidized or whether we pay for it ourselves. In our plan, the Physicians Plan for a Healthy Minnesota, that was one key part of health insurance reform. Because if people do not all pay into the system, then when an uninsured patient, as often happens, has a serious illness and goes to the hospital and cannot pay for their care, then the rest of us pay for their care. ■ What about state reforms such as med-
ical homes and peer grouping—how do you see those?
recent online physician ratings program?
MMA this year in Minnesota? Our top legislative priority is to keep safety net programs intact. We were very pleased
We opposed it because it is very different from the ongoing work that has been hap-
pening in the rest of Minnesota. The MMA is a founding member of Minnesota Community Measurement. We sit on the board, as does Medica. [For that program], we use agreed-upon standards of care that aggregate data from the entire clinic. The Medica program is trying to rank individual physicians. We feel that methodology is flawed. If we are all aggregated together in our clinic groups, then if we see outliers of quality in one area, our clinic can work on that. We can do a quality improvement program. But if you have individual doctors all over the board—especially when it is on limited data, limited to one insurance company—who knows what to do with that information? ■ What message do you have for
physicians in Minnesota? The MMA is all about physicians and our patients. We need to remember that supporting each other and maintaining the professionalism of medicine is not going to happen from business people and a business model. It is going to happen for those of us who are idealistic and care about the standards of our profession and who frankly understand the burdens of our profession. For me, adding an emphasis on physician wellness will make MMA more relevant and move valuable to physicians in Minnesota.
Supporting Our Patients. Supporting Our Partners. SupportingYou. In 2008, Tanzanian missionaries brought little Zawadi Rajabu to the U.S. to seek treatment for her two severely clubbed feet. A physician referred Zawadi to Dr. Mark T. Dahl of St. Croix Orthopaedics. Using the Ilizarov Method, Dr. Dahl surgically changed the course of Zawadi’s feet and her life. Dr. David Palmer and Russ McGill, OPA-C, recently traveled to Tanzania on another of their frequent medical missionary trips. They dedicated an entire day to checking in on their partner’s patient. To their delight, they were greeted by 6-year-old Zawadi her face aglow, her healed feet dancing toward them.
David Palmer, M.D. & Zawadi’s brother Russ McGill, OPA-C & Zawadi
Appointments:
Online or Call 651-439-8807
Providing P roviding care care at at multiple ultiple modern modern clinics in Minnesota Minnesota esota and Wisconsin Wisconsin
MARCH 2011
MINNESOTA PHYSICIAN
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