Let me begin in personally thanking all of you for being here this evening. I come here with great anticipation as others have before me.
I would especially like to thank the Missouri Military Academy choir, under the direction of Mr. Freddie Lomas and MMA’s president Mr. Charles McGeorge. The very Reverend Father Mark Porterfield my friend and pastor of Saint Brendan Catholic Church in Mexico for his gracious invocation and Dr. Thomas Welsh from Meridian, Mississippi, a colleague and friend for reading the Hippocratic Oath. All of the great talented MSMA staff, for without them we could not do what we do and be successful. To the Alliance, I would like to congratulate Gill Waltman on her new role as president.
Thank you, Dr. Ray Wilbers for taking me into your practice, and all of my loyal colleagues and friends from Audrain County who could join me this evening. I really appreciate you guys and am honored you could make it.
Let’s also please take a moment to acknowledge those physicians who could not be here. Those that are home working and taking care of thousands of patients throughout the state.
I especially want to thank all the patients we serve daily who entrust in us their care, for without them there would be no need for us.
To Dr. Warren Lovinger who has done a superb job as president this past year. I doubt I will be able to fill his shoes visiting all 114 counties that’s incredible no small feat. Again, thank you Warren for your leadership.
I would like to acknowledge Mr. Philip Gustafson, CEO and president of SSM Health mid-Missouri, and Mrs. Donna Jacobs, president SSM Health St. Mary’s Audrain for being here tonight, along with the many hospital staff members, with whom I work with daily.
Also I’d like to acknowledge some truly special guests here tonight. All of our past presidents, my exceptional staff Mrs. Joy Dodge and her husband Brad, my nurse Missy Hoer and husband Matt, who’s combined service spans more than a half a century, they are truly dedicated and I am grateful.
Dr. Corrado, (right) with the official MSMA “Bones” gavel, takes the reins from Dr. Lovinger.
And finally first and foremost my lovely wife Donna of 42 years whom I love and cherish, for without her as my life partner, office nurse, and the Alliance’s past president, I would not be as good as, or be doing this tonight.
Also it’s of course all about family, if they would please stand as I call their names. I have my five extraordinary children and their spouses who I am so proud of and love. First, my son Jason and wife Charlotte Corrado, Jamie and Matt Jackson, Meredith Hume and twin sister Melissa Corrado, all the way from Bangkok, Thailand, Matthew and Danielle Corrado, and all of my 11 fantastic grandchildren: Isabella, Sophia, Eva, August, Josephine, Homer, Clementine Juniper, Georgianna, Nicola and baby Marius. They all think it’s great to be here at grandpa’s party, you can just imagine what Italian holidays are like at my house.
I also want to thank my brother Paul from Maine, my brother Peter and sister Linda and husband Gunter-Rosenthal from Montreal, Canada, and mother-in-law Faye Varney. And of course last but not least, I am so blessed and proud to have my parents Joe and Anna Corrado from Boston, to be able to share this occasion with me.
My mom tells everyone I practice in St. Louis and wants to know if I am a specialist or just a general surgeon. So mom now you know. Thank you and I love you.
If I could also specially acknowledge my dad, who left the twelfth grade to serve in the South Pacific during World War II, just two years ago was honored and given his original high school diploma, which they still had by the way, at age 90. Dad, thank you for your service, inspiration and support. We are truly proud.
It seems very fitting that it was here, in St Louis four decades ago, that I was bestowed the degree of doctor of medicine.
As I stand here before you, I am filled with pride and honor that you have given me the opportunity to be your 160th president, representing all the physicians of this great state of Missouri. I promise to do the very best I can and ask your indulgence in doing so, hopefully I’ll make you proud.
In my research I’ve found that I would be the third president of MSMA from Mexico, Missouri, a town of 12,000. The first was Dr. J. Frank Harrison in 1932, but I am so grateful to the second and last president from my hometown in 1986. You all may remember the late Dr. Pete Ekern and, thank you Nancy, for being here this evening, It’s because my mentor Pete three and half decades ago, who brought me as a young surgeon to my first MSMA meeting and introduced me to organized medicine. I have been here ever since.
One good thing about being “out state” is that you’re here on the council forever. I believe this will be my fourth executive VP. So Mr. Mills, I expect you to be here a long time!
In preparing this evening I thought that maybe a little past history may be helpful. Where have we come from and how can a rural community like Mexico make a difference?
It was 168 years ago on May 18, 1850, that the Missouri State Medical Society was formed, meeting in St. Louis. Your annual membership was only two dollars. At that first meeting they talked about recording and standardizing proper registration of births, deaths, and marriages for the state. I thought just how long ago that was and what it must have been like at that time?
The family of Joe Corrado, MD, at the MSMA Presidential Inauguration.
Well, Washington DC was a town in pasture, with grazing cows and sheep and bare dirt paths; a great war hero General Zachary Taylor was only the twelfth president of the United States after his most famous victories in the Mexican War, old “rough and ready” became president at age 64. An interesting aside is, that’s how Mexico, Missouri, got its name because of the recent battle “remember the Alamo.”
The most feared disease at this time was cholera, the president had to hide his slaves from the public view, and Congress was agitated on whether the federal government had the power to prohibit slavery in the new territories acquired as a result of the recent Mexican war. California was admitted as only the thirty-first state of the union, and the compromise of 1850 was being debated in Congress.
Shortly thereafter president Taylor would be only the second president to die in office. The first being William Harrison, remembering at that time his medical treatment was bleeding; cupping with hot metal cups to create acute blisters; he was given calomel, laudanum, castor oil and powders with increasing doses of opium, along with whiskey and roots.
As for Taylor, the story goes that on that hot fourth of July after being at the Washington monument for an event, he gorged on ripe cherries, cream and sugar. The president got stomach cramps, and doctors came from Baltimore. He was given herbs and laxatives, and later that day the president died, he was embalmed and lay in state at the White House as the Vice President Millard Fillmore became the thirteenth president, all in one day.
I also learned that the MSMA actually has met on two occasions in Mexico for the Annual Meeting, first in May 1881, converging at 4:15 pm in the Audrain County Opera House they were welcomed by the president of the city council, the newly formed Audrain Medical Society organized in 1872, which was then a branch of the Union District Medical Society which at that time included most of northeast Missouri.
By 1892 there were eight counties including Audrain, Montgomery, Warren, Boone, Pike, Callaway, Lincoln, and St. Charles, then called the Lenten District Medical Society boasting about 100 physicians. Audrain met every fourth Friday at the Ringo Hotel.
Again in May 1900, the Medical Association of the State of Missouri was entertained in my fair city Mexico. An event of great importance to the county physicians, as the forty-third Annual Meeting was called to order in the opera house at 9:30 am. The topics discussed were ophthalmology, cancer, syphilis, smallpox, hysteria, coxa vera, gallstones, the progress of gynecology, the cure of old sinuses, and the modern treatment of appendicitis presented by Mexico’s own Dr Pinckney French.
The city made a formidable impression upon the state wide assembly. For three days they met at the Ringo, Planters, and Windsor hotels, which are all long gone. The closing banquet, however, was a fitting finale for the doctors, meeting at the elegant Windsor hotel dining room they were served green turtle soup, Saratoga chips, caviar on toast, lobster salad and lambs tongue, topped off with ice cream, sherry and cigars, just like tonight.
But what were the medical conditions like around 1900 in Audrain County. At that time if one was sick in the community they were placed on the front page of the newspaper on the sick list. Cholera was lessening, malaria was diminishing, but the cause was still not clarified, smallpox had not been eliminated, diphtheria was woefully present as was typhoid, scarlet fever, whooping cough, and measles.
The lives of all children were precarious. There was a very high mortality rate in anyone under five years gold. Countless babies never made it past their second summer. Frequently families would suffer the death of several offspring with faded notations in their family bible dwindling from a dozen to only two or three children who would reach adulthood.
In those times, living conditions contributed to enormous health problems; there were no indoor plumbing or bathrooms. With unpaved streets, garbage, and animals were running wild and polluting common drinking wells; flies and mosquitoes swarming everywhere.
Surgery was very limited and attacks of appendicitis were referred as “knotted bowels” and left for nature to take its course. However after 1890 more often were subject to a surgeon’s knife, most likely on the kitchen table.
The family stood by at that time making sure that the doctor took out something so that they could get their monies worth; remarkably many were successful.
One case in 1890, a Dr Carson was called to Mexico from St Louis. After performing an appendectomy at the patient’s home and leaving him in the care of the local doctor, the surgeon went back to St. Louis, sending a bill for his services of $1,200. The patient survived but had to sell his business to pay the bill. It was called the largest doctor’s bill ever known in Mexico at that time. Later they found a similar operation only a few months earlier by a local doctor who had only charged $38. See, there is a good reason for getting your care locally. By the way, the average lifespan in the United States then was only 47. So that’s a glimpse at what medicine was like and how Mexico has been an integral part of Missouri medicine’s history.
In all seriousness I would like to make a few comments and say to you that we are not merely just providers. That term bothers me. I would like to discuss with you the importance of the role of being a physician, and what that means. What a privilege, a calling, unlike any other. With extraordinary demands and personal sacrifice to you and family. The importance you have to your community and patients.
Just think how much time and effort you have spent getting where you are. When kids ask me, “how long does it take to become a doctor?” I tell them for me after graduating high school it was like starting all over again from kindergarten and going to the twelfth grade again. I don’t always remember the long road it took in becoming a physician. Those sleepless nights-in-training, the never-ending call, the years of sacrifice in your personal lives, and years of missed time with your family and friends. However, you should never lose sight of all the lives you’ve touched during those “lost times.”
Just think of the injured you have cared for, the deadly diseases you’ve encountered, or even the simple “repairs” in people’s lives as a rare event like an operation which you may have performed.
Because of this gift and your talent. Whether, in the lab doing research, or in a community health clinic, it truly is a calling in service to patients and the public, we’re doing more than just providing. Imagine the surgeon who can repair a congenital malformation in utero. This is more than just providing! Or the neonatologist agonizing over saving a premie - more than just providing!
Remember that the greatest reward we get in our profession is the trust we receive from our patients. As others before me have said, for us it may be just another day at the office, or that patient in room 2049, but to the patient before you it may be one of the most important times in their lives.
A week doesn’t go by, that I sit across from a patient and family and have to give them a new diagnosis that their biopsy was positive for cancer. Just as you once they hear those words, they become numb, and their personal lives and those of their families are thus changed forever.
They may never remember anything else you said to them that day, but then I tell them the good news that we can usually do something about this. In fact, I tell them that as they leave the room, if they look on the wall there are photographs of women who were diagnosed with breast cancer some 25, 30, and 35 years ago who are still doing quite well, and that I still have the privilege of caring for them…just as they were sitting in front of me at that time, getting the same shattering news, now they are quite well and thriving. In fact, when my staff reminds me I try to bring them a bottle of sparkling grape juice on their twenty-fifth anniversary year of survival, it gives them great hope that they can be there for their own families a quarter of a century from now.
Oh, the joys of being in a small town. Again, I would say that is more than being a provider.
I would never have imagined myself a rural surgeon, a dinosaur, solo practitioner in the middle of the country. Coming from Boston, a proud product of immigrant grandparents living an impoverished existence in their native Italy, coming here, as so many do, for a better life in America. Like many of you, I ask how and why are you here? I don’t have the answer, could it be fate?
Medicine has changed, as I have described, over the past 168 years, but what do you think it will be like in the year 2186? None of us will be here; can you just imagine? When I started there were no ER doctors, nor even that specialty, I remember physically having to come in and see every patient who came through the ER as the “nubie.” Oh, the good old days. Not really.
I’ll never forget one of the first cases I saw was a woman who had put her hand in a corn auger. Looking at her mangled hand I said “what the he… is a corn auger?” I’m from Boston. So I told the nurse “call plastics or ortho,” and I’ll never forget, Sue stood there and said … “Doctor, you are plastics and ortho,” At that moment I realized what I had got myself into.
Looking back, I wouldn’t have changed a thing. Being in a small community, as Warren knows, is different. When I was at the great tertiary care centers in Boston, I would see the patients maybe once or twice, but never outside the hospital.
Now a day doesn’t go by that I don’t see my patients at the grocery store, in the bank, or on the square, or even showing me their incisions on aisle 3 in Walmart. When the banker’s wife perforates her colon, before I get home my family knows about the patient and how they did. So much for HIPPA! And they better have done well, know what I mean?
In short, doing what every one of you do on a daily basis is extra ordinary. You are more than providers! You make a difference every day in your lives and careers as physicians. Patients depend on and trust you for their personal care and you help them through the most monumental decisions of their lives. And for that I applaud each of you. Please continue the great work you do with passion.
I recently saw a commercial on television that said, “If it was easy, everybody would become a doctor because it’s the best job in the world.” I still think it’s the best job in the world.
Another point I would like to share with you is “get involved” and “make a difference.” I know I am preaching to the choir, because those of you who are here ARE already involved.
When I say get involved, I know every one of you, on a daily basis is involved with face to face patient contact, involved with nursing service, medical records departments, and insurance companies. Yes, it’s true that a lot of things we do, take us away from patient care. For that’s what we do best.
It’s important that you get involved in your hospital, in their bylaws and on the medical staff, and the various and sundry committees that you may be asked to serve on. It’s most important that WE as physicians continue to represent ourselves. That we make a difference here. Make a difference in your community, it is very important that you be a physician leader, whether on your local school board, or just going to a PTA meeting. It’s important that they see you as a community leader. As I told you before, living in a small town is like living in a fishbowl. It can be both a blessing and a curse.
We all understand the problems of burnout in our profession. Don’t hang around the doctor’s lounge too long. You surely will be discouraged. But I truly believe that if you get involved in both your personal and professional life you will be a better person and a better physician. It’s most important that you get involved with your friends and family, with your church, your spouse, and your children. That’s what’s most important, so that at the end of the day, at the end of this great professional career you can say YOU made a difference.
There may be a few blips along the way, remember as Warren said last year, dwell on the positive!
The mayo clinic proceedings recently showed that those physicians who are uncomfortable with EHRs are more likely to reduce hours and leave practice. Some of the unintended consequences have been decreased efficiency and increased clerical burdens which also increases burnout.
It is said that four minutes of keyboard time for every one minute of true face to face time with the patient, not only increases fragmented care during the patient visit, while doctors often choose navigating their records over communicating with them, causing frustration and shortchanging both parties.
I know most of you sitting here ARE already involved in organized medicine. If not, please get involved. Be active in your county and state societies. You may ask “what does organized medicine do for me?” They see and follow hundreds of bills a year at the state house, many in some way impacting medicine.
We represent each and every specialty every day. Remember not long ago we were fighting for tort reform and caps on malpractice premiums and what insurance companies can and will do with premiums and payment.
It is very important that we stay involved as individuals and also collectively as a state medical society. Every year we are fighting scope of practice issues. We are on the front lines in confronting the opioid epidemic in America.
We have issues with telehealth, we are partnering with Kansas to create a health information exchange so that we can share clinical data. We are trying to get a PDMP passed in this state, and fighting insurance companies such as Aetna from retroactively denying Emergency Room visit payments, this is all in a day’s work.
Remember we have exceptional lobbyists battling with us at MSMA fighting for us every day. I have firsthand experience, and just had the pleasure of returning from Washington DC with Warren and visiting with all of our Missouri congressmen and senators.
We were also very proud and honored to have with us, our own Dr. David Barbe, president of the AMA, fighting there beside us. Thank you Dave, we are ALL proud of you and your accomplishments!
We will continue to be there for you, but we, of course, need your backing. We are very much committed in Graduate Medical Education, and making sure the future physicians have the same opportunities as we in their practices.
Medicine is changing, the majority of physicians now are, or will be employed. I understand that now women make up the majority of medical students and that my perspective as a private practitioner may be obsolete.
Lastly, I feel it important that we must always put the patient first. If we do, we will never go wrong. If WE take the attitude of “what would I do if this were my mother, wife or daughter?” If you always do what is right for the patient, you will never regret it, and neither will the patient.
Wise mentors before me have said, “to be successful remember the three A’s: Be Available, Affable and Able,” in that order. And that has worked well, I can tell you.
There is a saying on the wall of my private office that I got in Italy when I visited with my Grandfather Pasquale in 1973. Boy, would he be proud today. It says: “Il denaro fa l’uomo ricco, ma educazione lo fa signore” which basically means money makes men rich, but education makes them gentlemen.
We as educated physicians make a difference every day in our patient’s lives and don’t you ever forget it. Continue to do what YOU DO with a passion and make a difference. You are more than providers, you are physicians with more than 16,000 hours of training on average. Be proud of your professional degrees.
I want to again thank all of you for being here. My friends, family, and fellow members of the Missouri State Medical Association. Again, I am truly honored for the opportunity to represent you and work with the great MSMA staff.
Thanks again to all of you, God bless you and God bless America.