President's Corner

I am honored to serve as President of the Academy of Medicine of Cleveland & Northern Ohio (AMCNO) for the 2017-18 term year.  Under the able leadership of my predecessors, this organization has strongly advocated for the physicians of Northeast Ohio for almost 200 years.  Much of the AMCNO’s work goes on quietly and behind the scenes, and we all have benefited greatly from it.  The Academy has weathered many storms.  This coming year, along with our EVP/CEO Elayne Biddlestone and her able staff (who truly are the heart and soul of the organization), I plan to continue fulfilling the AMCNO’s mission as we enter uncharted waters in medicine.

The advocacy work we do is extremely important.  Tort reform, intrusions into the practice of medicine, and ill-informed restrictions on practice are just some areas where the Academy is very active. Many entities are competing for influence over the redesign of our healthcare system, including for-profit entities (ie, health insurance companies, pharmaceutical companies), hospitals, politicians, interest groups of all varieties, and our government.  By virtue of our training, experience, ethics, and most importantly, our bond with our patients, we physicians are best suited to inform those who are restructuring our healthcare system.  We owe it to our patients and ourselves to maintain a seat at the table and advocate strongly for a healthcare system that provides affordable health care for our patients without penalizing them for health issues beyond their control.  Our patients need access to basic primary care, affordable drug prices, access to mental health addiction care, and complex specialty care when necessary.  Realistically, some restraint will have to be applied to extremely expensive interventions now available; we clearly can’t provide unlimited care to everyone, regardless of cost.  Providing everyone with a basic set of healthcare services, and protecting them from bankruptcy when they do need more expensive care, is a reasonable starting point.  Physicians practicing evidence-based medicine are in a good position to play a key role as our healthcare system is reformed.

To do this, we need to remain healthy ourselves.  Physician burnout, even among our physicians-in-training, is an area of high concern, as we already anticipate a significant physician shortfall within the next 10 to 15 years.  Burned-out physicians practice less effectively, struggle to maintain good patient relationships, have less satisfying personal lives, and hope to retire early.  We cannot afford this.  Physician burnout has many causes, and it is beyond the scope of my short article to go through them.  I believe, however, the causes boil down to the following: more work (electronic health records [EHRs], pre-authorization, quality metrics), less control over how that work is done (50% of physicians are now employed), and with no end in sight (the Medicare Access and CHIP Reauthorization Act [MACRA], population management demands).  A recent study concluded that physicians are spending 49% of their time on administrative tasks and only 27% with their patients.  A similar study of residents showed only a small percentage of their time is spent face-to-face with patients and much more on computer and EHR tasks.  I work with family medicine trainees, who chose our primary care specialty not for the money, not for the fame, but to form meaningful long-term relationships with their patients and make a difference.  The current system is not allowing them the time to do that.  It’s not just primary care—many subspecialists I speak with are feeling the same pressures, feeling like they’re on a treadmill that’s going faster and faster. This is the recipe for burnout.

Luckily, we are not alone.  Our state and national physician organizations have recognized this important issue, as have our large healthcare institutions, and are beginning to address it.  One of my goals as President of the AMCNO this year is to keep this issue front and center and bring the physician perspective to the forefront.  We must help work on meaningful solutions.  I believe the overall workload and the workplace environment for physicians will need adjustment.  This will require an expanded physician workforce and a redesigned clinical care system to share the work of population management and the increasing clinical demands of an aging population.  We will need to work with our colleagues and allied health professionals to achieve this.  I trust that we can be part of the solution—for the good of our profession and the good of our patients.

Fred M. Jorgensen, MD

President 2017-2018

To see an interview between Dr. Jorgensen and AMCNO member Dr. Anthony Bacevice, Jr., click here





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