CAN PHYSICIANS BECOME REPLACEABLE?

By Michael A. Cromer, M.D., President, Hillsborough County Medical Association

This is a question that I asked myself the other day as I was opening up an App on my iPhone to quickly obtain some medical information for a patient. It was sort of an ironic question when one thinks how esteemed the profession of medicine once stood in our society. To now wonder if we could ever be replaced by robots (artificial intelligence), Apps, or … nurse practitioners and physician assistants!

Venture capitalist Kai-Fu Lee told CNBC, “Artificial Intelligence (AI) will be bigger than all other tech revolutions, and robots are likely to replace 50 percent of all jobs in the next decade.” A Silicon Valley investor Vinod Khosla said, “machines will substitute 80 percent of doctors in the future in a healthcare scene driven by entrepreneurs, not medical professionals.”

If one thinks that our profession, or even some of our specialties like primary care or radiology, could become a thing of the past, we must start now to guard against this from happening. What are some things we can do now to assure our existence in the future?

First of all, to show our worth we must remain highly trained. The training of physicians in this country has long been an arduous process, and so it should be. Society as a whole partly respects physicians because they know that we have received a lot of training to get where we are. We didn’t get there by cutting corners or taking the fast track. We must let people be aware that there is a lot of difference in the amount of clinical training hours received by a nurse practitioner (500), vs. a physician assistant (2,000), vs. a medical student by the end of their 4th-year (6,000), vs. a physician with three years of residency training (15,000).

After residency or fellowship, stay relevant and up-to-date. Pursue staying current with

Continuing Medical Education available to us and Maintenance of Certification required of us. These at least provide some sort of standards for society to know that their physicians have some ongoing accountability process.

As physicians gain experience the more they realize that, no two patients are exactly alike. Humans, unlike robots, can bring creativity and subjectivity into the exam room and more effectively narrow down differential diagnoses and treatment possibilities. Only we, as physicians, can apply critical thinking to best assess what the optimal treatment plan for a patient might be.

Next, we need to show compassion. Some of us have this innately in our personality; others of us have to work on it. It might be taught some in medical schools but it is rarely rewarded by corporate employers once we start working in the profession. It is, however, one of the ways that allows us to have an impact in patient’s lives and one of the main things that our patients remember us by. Apps don’t show compassion, artificial intelligence won’t either. The compassion we give our patients will set us apart and be one of the reasons our patients will want to choose us.

A cousin to compassion is empathy – having the capacity to understand or feel what another person is experiencing from within their frame of reference, that is, the capacity to place oneself in another's position. An algorithm will not be able to build trust to help someone make an important decision for a loved one. A robot will not be able to walk a patient through a difficult medical crisis.

Be a leader on the healthcare team. At least in Florida, the dam was already broken when our legislators thought it was prudent to allow Nurse Practitioners to practice independently. However, there are many more settings where we physicians work as a part of a health care team that includes nurse practitioners, physician assistants, nurses, and medical assistants. A physician should always be the leader of that team. Not just in clinical acumen, but also in our work ethic, our moral ethic, and in how we treat others on the team. Be a role model that others look up to and try to emulate.

Attempt to control your destiny. Part of this is done by carrying out the three objectives above. But it also comes up in our choice of who we work for and being careful of what kind of employment contracts we sign. At present, over 50% of physicians are employed by hospitals or healthcare corporations. There are some companies more than others that value physicians respect physician’s input. However, don’t be lulled into complacency believing that your employer will always make the decisions that are best for you or the medical profession. They will always look out for their own interests first.

Controlling your destiny also means being a part of the decision making when it comes to your profession. The latter often involves getting involved in your county medical society or specialty association. It may also include getting involved in the political arena. I encourage each of you to get involved in organized medicine before it is too late. As the saying goes, “if you don’t have a seat at the table, you are more likely to be on the menu.”

Don’t misunderstand me, I know that more artificial intelligence will appear in healthcare in the next 10 years, many of it being helpful for physicians and improving health outcomes. As physicians, we need to speak up and get involved in how the automation happens and in what context it is best used. Due to AI, some tasks will disappear, while others will be added to the work routine. However, if we as physicians do the things we need to do now, there will be fewer opportunities where computers, either through a robot or an algorithm, will take the place of a doctor.

Reprinted with author permission from the HCMA Bulletin, Vol. 69, No. 1, Summer 2023.

Your Dose Of Medical Humor

Capital Medical Society Foundation Supports Access To Bereavement Services

Pam Irwin (pictured left), Executive Director of the Capital Medical Society Foundation, presented a check for $4,000 to Dena Strickland (pictured right), President of the Big Bend Hospice Foundation on July 10, 2023. “The CMS Foundation is happy to support Big Bend Hospice Bereavement Services Program,” said Pam Irwin. We applaud Big Bend Hospice for serving the community through this program. The funding may be used to provide individual, group, and community grief counseling to youth, schools, and caregivers.

Capital Medical Society Foundation Supports Access To Healthcare For Seniors

Pam Irwin (pictured second from right), Executive Director of the Capital Medical Society Foundation, presented a check for $3,500 to Elder Care Services on July 19, 2023. The grant award was accepted by Elder Care Services’ Brian Marquez (pictured left), Communications and Development Coordinator; Nicole Ballas (pictured second from left), Chief Development Officer; and Jocelyne Fliger (pictured right), President and CEO. The grant award aligns with the Capital Medical Society Foundation’s mission that includes supporting efforts to increase access to health care services. Elder Care Services’ program of home-based care for seniors provides necessary services in-home, as well as, transportation to doctors and other healthcare providers. We appreciate Elder Care Services ongoing commitment to make these important services available to seniors in our community.

Capital Medical Society Foundation Supports Access To Child Safety Seats

Capital Medical Society Foundation’s Executive Director Pam Irwin (pictured middle) presented a check for $3,000 to KidSafe of Lutheran Social Services of North Florida, Inc. on July 11, 2023. Lutheran Social Services Executive Director Dorothy Hinkle (pictured left) and Board of Directors President Barbara Ehlmann (pictured right) accepted the grant award that will help fund the KidSafe program. KidSafe provides life-saving new safety seats to economically vulnerable families who cannot afford to buy them. The funding will be used for the expansion of the safety seat program and for the development of an educational/assistance community component that will increase the efficacy of child safety seat use in Tallahassee/Leon County. The Capital Medical Society Foundation is pleased to support this child safety program.

Capital Medical Society Foundation Supports Those With Vision Impairment

On July 17, 2023, Capital Medical Society Foundation’s Executive Director Pam Irwin (pictured left) presented a check for $3,500 to Lighthouse of the Big Bend to assist in the purchase of aids for their clients with vision loss. Lighthouse of the Big Bend Chief Executive Officer Tina Torrance (pictured second from right) and Chief Development Officer Debara Jump (pictured far right) accepted the grant award. The aids improve the quality of life for the visually impaired and help them manage their health and medical care more independently. We applaud the work of the Lighthouse of the Big Bend!

THANK YOU FOR SUPPORTING THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE TALLAHASSEE REGIONAL CAMPUS FOOD PANTRY!

The Capital Medical Society Foundation and the Florida State University College of Medicine Tallahassee Regional Campus thank you for helping our next generation of physicians.

Financial donations may be made by check payable to the Capital Medical Society Foundation with “FSUCOM Food Pantry” on the memo line and mailed to the CMS office, 1204 Miccosukee Road, Tallahassee, FL 32308. You may make online gifts at https:// capmed.org/donate/ with “FSUCOM Food Pantry” selected in the dropdown.

A picture is worth a thousand words! On July 12, 2023, Yvonne Brown, Capital Medical Society Foundation Board Director (pictured left), delivered Food Pantry items to Elaine Geissinger, FSU College of Medicine Tallahassee Regional Campus Administrator (pictured right). Elaine Geissinger and the medical students continue to express their gratitude to CMS Foundation for helping address food insecurity issues on campus.

We Thank Our Donors

We thank the following donors who made a gift to the CMS Foundation this past month:

Capital Medical Society Foundation –included with their annual dues payment

C. William Applegate, M.D.

David E. Craig, M.D.

Larry Taylor, M.D.

Frank Walker, M.D.

Charles D. Williams, M.D.

Capital Medical Society Foundation –Area of Greatest Need

Robin McDougall, LCSW

We Care Network

Anonymous

The CMS Foundation Scholarship Fund

David Bellamy, M.D. – In Memory of Myrle R. Grate, Jr., M.D.

David Bellamy, M.D. – In Memory of Eleanor Hutchinson Smith

David Bellamy, M.D. – In Memory of Daniel Van Durme, M.D.

Capital Medical Society Foundation –FSU College of Medicine Tallahassee Regional Campus Food Pantry

Anonymous

J. Alan Cox

Elaine Geissinger

Patricia Holliday

Dr. and Mrs. David A. Jones

John P. Mahoney, M.D.

Francis C. Skilling, Jr., M.D.

Your gifts to the Capital Medical Society Foundation transform lives in the Big Bend.

The Impact of Private Support:

The Capital Medical Society Foundation’s community of donors strategically help fulfill its mission “to support the charitable efforts of physicians and others, increase access to healthcare, promote education and serve the community’s health needs through innovative projects that are exemplary, affordable and dignified.”

➢ Access to healthcare is increased through gifts to the We Care Network and the We Care Network Endowment Fund. More than $129 million in donated specialty medical and dental care has been provided to low-income, uninsured patients since the program was created in 1992. In fiscal year 2022-23, which ended June 30, 2023, more than $5 million in healthcare was donated. Gifts support the operational expenses of the program including salaries and benefits of the case management team who coordinate the donated care.

➢ To provide incentives to keep medical students trained at the FSU College of Medicine in the Big Bend after completion of their residencies and help meet the growing demand for physicians in Florida, gifts to the CMS Foundation Scholarship Fund provide scholarships to FSU College of Medicine students who have expressed an interest in returning to the Big Bend to practice after completion of their residencies. $50,000 was awarded in 2022. An additional $1,000 was awarded from The Anesthesiology Associates of Tallahassee Scholarship Fund. $1,000 was also awarded from The Charles D. “Pedro” Williams, M.D. Scholarship Fund. In 2022, the first Julia Revell St. Petery, M.D. Scholarship in Pediatrics was awarded.

➢ Gifts to the Capital Medical Society Foundation help provide operational resources for the Capital Medical Society Foundation. In addition, modest grants are awarded to area non-profits whose programs improve access to healthcare for the underserved. In 2023, the CMSF awarded a total of $14,000 in grants to the Big Bend Hospice Foundation for bereavement services, Elder Care Services for in-home services to seniors, Lighthouse of the Big Bend to provide services to the visually impaired, and to Lutheran Social Services of North Florida, Inc. for the KidSafe program.

Gifts to Honor and In Memoriam:

You can make a gift to the CMS Foundation in memory of someone who has passed away or in honor of someone, such as a fellow physician, you hold in high esteem or has taken care of you or your family. The CMS Foundation will send an acknowledgement letter to those you memorialize and honor.

How to Give:

Through the generosity of donors, funds have been created in order to establish financial stability to meet our mission. You can make a gift at any time to one of the CMS Foundation’s current funds:

Gifts should be made payable to the CMS Foundation. Indicate on the memo line of your check to which designation you would like to give. Bring your check to the CMS Office or mail it: Capital Medical Society Foundation ~ 1204 Miccosukee Road ~ Tallahassee, FL 32308.

Gifts may be made by credit card or direct debit from the CMS website.

If you would like to discuss a gift of appreciated securities, an insurance policy, designation of retirement plan assets, estate gift, or multi-year pledge, please contact:

Pam

Irwin

Executive Director

pirwin@capmed.org or (850) 877-9018 or (850) 559-8611

Thank You

To our CMS members and We Care Network partners who provided healthcare to new patients in June 2023.

Your generosity and support of the We Care Network makes a difference.

Physicians

Jay Allard, M.D.

Marie Becker, M.D.

Michael Bernhardt, M.D.

Timothy Bolek, M.D.

Viet Bui, M.D.

Carlos Campo, M.D.

Francisco Carpio, M.D.

Gilbert Chandler, M.D.

Eric Chung, M.D.

William Dixon IV, M.D.

H. Avon Doll, M.D.

David Dolson, M.D.

Chesley Durgin, M.D.

Adam Engel, M.D.

James Farrell, D.O.

Alberto Fernandez, M.D.

Hong Gao, M.D.

W. Harris Green, M.D.

Gregory Hartlage, M.D.

Todd Hewitt, M.D.

Brook Hill, M.D.

Marc Inglese, M.D.

Joey Jarrard, M.D.

Kenneth Kato, M.D.

Sayeed Khalillullah, M.D.

James Killius, M.D.

Fang Sarah Ko, M.D., PhD

Hari Kolli, M.D.

Kurt Luhmann, M.D.

Michael Mangan, M.D.

Mina Mousa, M.D.

Kishor Muniyappa, M.D.

Mitchell Peabody, D.O.

Michael Pentaleri, M.D.

Hussein Rayatzadeh, M.D.

Pablo Rengifo-Moreno, M.D.

Allison Retzer, M.D.

Davis Rierson, M.D.

Tim Ruark, M.D.

Ronald Saff, M.D.

Eliot Sieloff, M.D.

Hardeep Singh, M.D.

Bhavik Soni, M.D.

Robert Steinmetz, M.D.

Ronald Sullivan, M.D.

John Thabes, M.D.

William Thompson, M.D.

Jean-Paul Tran, M.D.

Ernesto Umana, M.D.

Beatriz Cepeda Valery, M.D.

Kaisa van der Kooi, M.D.

Andrea Venturini, M.D.

David Vermess, M.D.

Tony Weaver, M.D.

William Yaakob, M.D.

Brian Zirgibel, M.D.

Dentists

Briano Allen, D.D.S.

Jean-Pierre Bastien, D.M.D.

David Cardman, D.M.D.

Walter Colón, D.M.D.

Alan Dransfield, D.M.D.

William McFatter, D.D.S.

Lawrence Pijut, D.M.D.

Lawrence Weaver, D.D.S.

Facilities

Advanced Urology Institute

Airway Works, LLC

Allergy & Asthma Diagnostic Treatment Center

Anesthesiology Associates

Apalachee Primary Care

Bastien Dental Care

Beachton Denture Clinic

Bond Community Health Center

Care Point Health & Wellness Center

Dermatology Associates

Digestive Disease Clinic

Enhanced Endodontics

Eye Associates of Tallahassee

FSU PrimaryHealth

Gadsden County

Health Department

HCA Florida Capital Hospital

Cancer Center

HCA Florida Capital Hospital

Primary Care

Jessie Furlow Medical Center

Ketchum, Wood, & Burgert Pathology Associates

Lawrence J. Pijut DMD PA

Madison Medical Center

Neighborhood Medical Center North Florida

Nephrology Associates

North Florida Womens Care

North Monroe Medical Center

Periodontal Associates of North Florida

Radiology Associates of Tallahassee

Red Hills Dental Associates

Shepherds Hands – Monticello

Southeast Radiology Partners

Southern Medical Group, P.A.

Southern Vitreoretinal Associates

Tallahassee Diagnostic Imaging

Tallahassee Ear, Nose, and Throat

Tallahassee Gastro Health Center

Tallahassee Memorial HealthCare

TMH Physician Partners

Cancer and Hematology

TMH Physician Partners

Cardiology and Internal Medicine

TMH Physician Partners

Cardiothoracic Surgery

TMH Physician Partners

Endocrinology Specialists

TMH Physician Partners

Gynecologic Oncology

Specialists

TMH Physician Partners

Heart Rhythm Clinic

TMH Physician Partners

Hospitalists Group

TMH Physician Partners

Pulmonary, Critical Care, and Sleep Specialists

TMH Physician Partners Quincy

TMH Physician Partners

Radiation Oncology Specialists

TMH Physician Partners

Surgical Specialists

TMH Physician Partners

Urology Specialists

TMH Physician Partners Wakulla

TMH Transition Center

Tallahassee Orthopedic Clinic

TOC Canopy

Tallahassee VA Clinic

Wakulla County Health Department

Wakulla Medical Center

Womens Clinic

Women’s Imaging Center

Please contact Diana Bixler at dbixler@capmed.org or (850) 201-0130 if you are a We Care Network volunteer and you provided volunteer specialty care in the month of June 2023, and your name is omitted.

The We Care Network strongly encourages our volunteer physicians and dentists to send their value of donated services to us. The value of donated services is important for us to share with our funders and the community. In addition, up to five hours, per biennium, of CE credit may be fulfilled by performing pro bono medical and dental services to We Care Network patients, if we have received documentation of value of services. You can send your value of donated services via fax to Diana Bixler at (850) 2010085 or mail to 1204 Miccosukee Road, Tallahassee, FL, 32308. Thank you!

We thank our referring providers from June 2023:

Jonathan Appelbaum, M.D.

Adrian Baker, M.D.

Katrina Ball, APRN

Kendra Brady, APRN

Sherry Bramblett, APRN

Daniel Breivogel, APRN

Tim Broeseker, M.D.

Patrick Brown, M.D.

Viet Bui, M.D.

Callie Burch, APRN

Rachel Busby-Drewek, APRN

Francisco Carpio, M.D.

Carlos Castro, M.D.

Melba Colon-Renta, M.D.

Jill David, APRN

Brian Del Carlo, D.D.S.

William Dixon IV, M.D.

Nathalie Esellem, APRN

Cynthia Evans, APRN

Sharron Foster, M.D.

Gian-Carlo Giove, M.D.

Lillie Green, APRN

Judy Griffin, APRN

Aixa Guzman, D.M.D.

Hantz Hercule, M.D.

Todd Hewitt, M.D.

Amit Jain, M.D.

Anneka Johnson, APRN

Christopher Laing, D.D.S.

Elaine Larkins, APRN

Janice Lawson, M.D.

Jessica Lea, APRN

Ashok Manocha, B.D.S.

Damon McMillan, M.D.

Lisa Menchion, APRN

Marie Methellus, APRN

Jennifer Miles, APRN

Kelley Miller, APRN

Marcia Morris, APRN

Abiodun Ogunremi, APRN

Chukwuma Okoroji, M.D.

Rose Origa, APRN

Anthony Otekeiwebia, M.D.

Dianne Pappachristou, D.O.

Jorge Perez de Armas, M.D.

Lisa Perkins, APRN

Angela Pham, P.A.

Hussein Rayatzadeh, M.D.

Charlie Richardson, M.D.

Karen Russell, M.D.

David Saint, M.D.

Expedito Salvador, P.A.

Lucilita Salvador, P.A.

Kyla Shillington, APRN

Benjamin Shivar, P.A.

Jeannine Silberman, M.D.

Paul Smith, D.M.D.

Angela Smith, APRN

Christopher Sundstrom, M.D.

Yusef Syed, M.D.

Cristian Del Carpio

Tenorio, M.D.

Faye Tinson, APRN

Dwanna Ward-Boahen, APRN

Beatriz Cepeda Valery, M.D.

Lakeshia Washington, APRN

Jeffrey Wasserman, D.O.

Eula Weaver, APRN

Tony Weaver, M.D.

Barbara Williams, M.D.

Shana Wood, APRN