President's Message Our Medical Society And Managed Care Mike F. Mass, M.D., President

It is clear that our society must assume a larger role in representing the values and concerns of our members as they interact with the various managed care entities. Many of these interests are primarily economic and are pursued by individual negotiation or through other advocacy groups. Our medical society should play a different, but important, role regarding the interactions of physicians, consumers (including our patients), and managed care entities.

I feel sure that we all can agree that issues relating directly to patient care must be debated. For instance, the changing nature of the referral process has caused us all concern and often has resulted in great anxiety for our patients. While advocates of managed care point out that various restrictions on direct access to care have slowed increasing costs, it must also be noted that these restrictions are often cumbersome and arbitrary. As such, they can delay needed tests or procedures and even act to divert sound professional judgement. This causes us to have concern over the quality of care that each " system" will allow us to deliver. Our patients worry about getting timely evaluation and treatment of their more complex problems. There must be an honest dialogue amongst all the parties that will allow managed health care to evolve into a friendlier system while remaining aware of proper utilization of resources.

Dr. Alan Harmon started a managed care committee during his term as president, but it suffered from a case of disuse atrophy. I have reinstated this group and insured its success by appointing Drs. Jim Clower and Alan Harmon as its co-chairs. Joining them will be physicians with both varied experience and concerns to make this committee work. It is essential that appropriate issues be defined. These might include primary and specialty interaction, choice of best diagnostic services, the bewildering number of drug formularies, and even the possible deterioration of inpatient care. I hope that this committee will move decisively to evaluate these and other issues and bring them to our board for consideration and action. I am confident that we will be able to find common ground in our discussions with medical directors and the companies they represent.''

This new committee can maintain its visibility only through a reputation for credibility. It will do this by remaining focused on good patient care. As managed care becomes increasingly market driven and our patients demand greater choice, our medical society must represent them in a meaningful way. We must develop the intellectual skills to become care managers while we continue to be physicians. It is critical that our membership communicate with the managed care committee so that it may begin its task of formulating positions for our Society. Please call or fax your concerns to Phil Gilbert!

April, 1998/ Jacksonville Medicine

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