BCMS in the New Millennium: How have things changed?

Interview with Vijay N. Koli, MD

By Monica Jones, BCMS COO

It was January of 2000, Dr. Vijay N. Koli gave his first Board of Directors President’s message by quoting Edward Everett Hale, “Coming together is a beginning; keeping together is progress; working together is success”. It was the dawn of the new millennium states Dr. Koli. Our profession was facing challenges, some old some new. Loss of physician income, barriers to medical care, and the impact of managed care, to name a few. Our challenges were lack of communication between physicians, hospitals, and the public; the emergence of unions; keeping pace with advancing technology; recruitment of new members, especially physicians in large groups, in academics, and the military and attracting new physicians in the workforce. We were preparing for the upcoming election year, pushing advocacy for our patients and activism from physicians, students and others within the medical community.1 Our goal in 2000 was to provide members of the medical community with a political voice and with opportunities for effective political and public-affairs participation. In preparation for the 2000 elections, we searched for even more avenues to involve members of the medical community while simultaneously providing quality healthcare for our patients.

Dr. Koli was born in Mumbai, India. In 1965 he left for Moscow, Russia, to study medicine on a scholarship from the government of India and the Soviet Union (Russia). His postgraduate training was in England and Scotland. In 1978 he came to Texas for four years and worked in a small town called Goldthwaite. He moved to San Antonio in 1982 when he joined the Bexar County Medical Society (BCMS). After 18 years of mem- bership, he was elected President of BCMS in 2000. Dr. Koli has received several outstanding community service awards, including the Golden Aesculapius Award from BCMS for a lifetime of distinguished service in 2016. Dr. Koli is now retired after practicing for more than 40 years.

Dr. Koli discussed how medicine has changed throughout the years. “It’s undeniable that the quality of medical care has never been better.” Robotic surgical systems win U.S. Food and Drug Administration approval. With the emergence of web-based software in the early 2000s, the need for electronic medical record (EMR) systems developed through remotely hosted systems. Accessing information remotely or storing made the method of keeping medical records more appealing and ultimately more affordable for physicians to implement into their practice. However, some things never change. Dr. Koli recalls how pa- tients yearned to spend more time with their doctors. This became obvious when BCMS held a live Doctor’s Day phone bank on KSAT-12 TV on March 30, 2000. Thirty physicians from various specialties volunteered their time. According to Southwestern Bell 10,000 callers tried to get through. We answered only 1,305. It only showed how eagerly patients want to talk to their doctors. The calls were from a simple viral throat infection to a liver transplant.2 Patients want to feel that their doctors are accessible and care about their well-being. Patients also seek convenience which we are seeing today in younger patients and online access. Patients want to schedule an appointment, communicate with their doctors, see test results and health information as well as pay their bills all from their computer or phone. Convenience is key.

There were many notable events in 2000, but one that stood out was when the BCMS

International Health Committee (IHC) embraced the responsibility to portray the high level of medical diversity that exists in San Antonio to ignite interest in medicine among the different ethnic/cultural groups, as well as to strengthen the communication with other countries.3 The BCMS IHC adopted the policy of “Mi casa es su casa” and went global. The committee organized international learning excursions, like going to Peru in June during “The fiesta del sol” festivities in Cuzco and another to India in February of 2001. The purpose was to broaden our understanding of medical systems in other countries.

Challenges in 2000: There was a relative shortage of primary care physicians, the implementation of EMR gave additional burdens, productivity was down, and expenses were up. There was less time spent interacting with the patient. Managed care or HMOs reduced healthcare costs by significantly controlling payments to physicians. Pre-authorization prolonged patient care.

Today in Texas, new medical schools are focusing on increasing primary care specialties. Medical students and physicians are now fa- miliar with and more comfortable using the EMR. Physician burnout is not new but has become more evident and gaining attention at the local, state and national levels. Women physicians are getting more involved despite their professional and personal commitments. The advent of telemedicine has increased efficiency, and patient satisfaction is improved.

Dr. Koli said in May of 2000 “Today’s physician groups are diverse; specialist, super-specialties, from different backgrounds and practice settings. Therefore, cooperative behavior is essential for working together. We need to learn methods to recognize and acknowledge the difference between us. Let us focus on bonds that unite us rather than divide us.”4 His message is still the same today for future generations. Advocacy: Get involved in organized medicine; with your local (BCMS), state organization (TMA), national organization (AMA) and/or specialty organizations.

Special Happenings & Facts throughout the 2000 BCMS BoD Presidency

• Y2K - The year 2000 is the last year of the century, but because the calendar changes to 2000, it is considered the beginning of the 21st century.

• Change of BCMS executive directors, Kay E. Peck replaced Dennis E. Dawson.

• San Antonio Mayor Howard Peak

• Texas Governor George W. Bush (Election night win for George W. Bush took on Dewey-Esque proportions as newspapers across the country scrambled to yank banner headlines declaring Bush the presidential victor)

• President of the United States Bill Clinton

References:

1. San Antonio Medicine, January 2000 page 4

2. San Antonio Medicine, May 2000 page 4

3. San Antonio Medicine, March 2000 page 16

4. San Antonio Medicine, May 2000 page 4

Monica Jones, BCMS Chief Operating Officer