PRESIDENT’S MESSAGE J O H N R . G AT E S , M . D .
RMS-Officers
President John R. Gates, M.D. President-Elect Robert C. Moravec, M.D. Past President Lyle J. Swenson, M.D. Secretary Jamie D. Santilli, M.D. Treasurer Peter H. Kelly, M.D. RMS-Board Members
Kimberly A. Anderson, M.D. Charles E. Crutchfield, III, M.D. Peter J. Daly, M.D. Kelly duFord, Medical Student Thomas B. Dunkel, M.D. Michael Gonzalez-Campoy, M.D. James J. Jordan, M.D. F. Donald Kapps, M.D. Charlene E. McEvoy, M.D. Ragnvald Mjanger, M.D. Joseph L. Rigatuso, M.D. Thomas F. Rolewicz, M.D. Paul M. Spilseth, M.D. Jon V. Thomas, M.D. Randy S. Twito, M.D. Russell C. Welch, M.D. Mark E. Wiest, M.D. RMS-Ex-Officio Board Members
Blanton Bessinger, M.D., MMA President-Elect Raymond Bonnabeau, M.D., Sr. Physicians Association President Kenneth W. Crabb, M.D., AMA Alternate Delegate Stephen P. England, M.D., Community Health Council Chair Michael Gonzalez-Campoy, M.D., Education Resource Council Chair Duchess Harris, Alliance Co-President Nicki Hyser, Alliance Co-President Frank J. Indihar, M.D., AMA Delegate William Jacott, M.D., U of MN Representative F. Donald Kapps, M.D., Council on Professionalsim & Ethics Chair Melanie Sullivan, Clinic Administrator Lyle J. Swenson, M.D., Public Policy Council Chair Russell C. Welch, M.D., Communications Council Chair
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THIS ISSUE OF MetroDoctors is devoted to Community Health issues. A significant community health issue that I would like to discuss this month is: What is the future of our metropolitan specialty care? Though HealthPartners recently suggested in an expensive insert into both metropolitan papers that patients should approach their doctors and ask them to lower their fees, physicians in the metropolitan area have one of the lowest fee schedules in the entire United States. As a result, I hear increasing reports of metro physician specialty groups having difficulty in recruiting new associates. Infectious disease, dermatology, and neurosurgery are cases in point where recruitment efforts have been ongoing by some specialty groups for several months, without any obvious takers. Assuredly, some of this frustration is due to the lack of adequate specialty trained graduates, especially in infectious disease to fill the nationwide demand. There is strong evidence that the residency training programs over-reacted to the alleged impending oversupply of specialty physicians, at least in some areas. However, the factor of Minnesota’s non-competitive reimbursement environment must be considered. Already, significant discussion for restricting infectious disease services only to certain hospitals are ongoing in the east metro. What does this mean for the future of comprehensive medical services in the metropolitan area? Are resident physicians who complete our own state-subsidized training programs finding better job opportunities elsewhere? Are more senior, experienced physicians retiring early
rather than spending ten more years in frustrating, undervalued, under-reimbursed practice? Are other specialty groups finding it difficult to recruit compared to other geographic areas? We don’t know. We can only rely on anecdotal reports. I am gravely concerned for the future of our medical services in the metro area. Our current quality of care is second to none, despite the assault of reimbursement erosion. It is a true tribute to the physicians of RMS and HMS that they are committed to the highest quality of medical care in the face of major intrusions into every aspect of how we deliver care, as well as reimbursement. In the future, however, it may be a much different story. Simple supply and demand economics may overwhelm all aspects of established practice and community commitments. Resident physicians with $100,000-$200,000 of medical student debt and no burning established community ties or commitments will work for Willy Sutton — elsewhere (where the money is), and many physicians with over 20 years in the trenches, who have paid their societal dues, will go elsewhere, too. I don’t believe that is what the community wants. Let’s get the data! I would like to know when the Titanic will hit the iceberg, or if it will truly miss it. Until then all I can do is sit in my full immersion suit and rearrange the deck chairs! ✦
RMS-Executive Staff
Roger K. Johnson, CAE, Chief Executive Officer Doreen Hines, Assistant Director
24
May/June 2000
MetroDoctors
The Journal of the Hennepin and Ramsey Medical Societies