I would like to thank all of you for attending this evening’s event. I would like to especially thank my family, friends, and coworkers from Nevada for being here. I will ask each of you to stand as I introduce you: Marilyn, my wife of 37 years; our children: Dr. Sarah Florio and husband Rev. Andrew Florio, Dr. Tom Lovinger and wife Dr. Kate Lovinger; Laura Lovinger and Christian Hornhuber; Dr. Dan Lovinger and wife Mariette Lovinger; the two wonderful ladies who have been my nurses during the past 35 years – Ruthanne McCoy, and Verna Jaross RN; the administrator of Nevada Regional Medical Center – Mr. Kevin Leeper; all of my physician colleagues from Nevada; and our excellent musicians. To all of you—thanks very much—I am very proud of you!
As I begin my address—let me make a confession: I am an eternal optimist! I always try to look at the good side of an individual, an issue, or a situation. I find that this attitude helps things go better—or at least makes me feel that they did. Current events in our country, which are fraught with negativity and divisiveness, suggest that we could all benefit from a large dose of happiness! We, as physicians, have a special opportunity to think and act positively as we interact with patients, peers, and our communities.
This does not mean that everything is perfect in our profession and society. Indeed, it is hard to say nice things about such daily irritants as overloaded schedules, prior authorizations, and uncooperative EMRs. It is also hard to excuse bureaucratic overreach, insurance non-payment, and pushy coworkers.
Yet, I believe that we are at our best as individual physicians and a medical profession when we dwell on the positive. Our actions and attitudes should set a good example and lead to beneficial results. As a long time Rotarian, I have come to appreciate and utilize the Rotary 4 Way Test of what we say and do: 1) Is it the truth? 2) Is it fair to all concerned 3) Will it build goodwill and better friendships? 4) Will it be beneficial to all concerned?
Let me give some examples of the helpfulness of the 4 Way Test from a physician’s perspective.
How we approach patients: I always try to tell my patients the truth, even if it hurts. I believe this is fair to the patient and me. Sometimes I get push-back, but this is when a Presbyterian adage is helpful. We “agree to disagree agreeably.” Hopefully, my patients know that they can trust me as we seek their benefit when discussing appropriate therapy and interventions.
Dr. Johar hands over the reigns of MSMA to Dr. lovinger.
How we interact with coworkers: We, as physicians, should be depended on to promote the truth. We should be “evidence based.” This usually allows us to complement and encourage our coworkers, but sometimes requires gentle correction. This is ultimately fair to all, and promotes goodwill and friendship in the form of stronger care teams.
Of course, intellectual honesty and professionalism always benefits the patients we care for.
Transparency: Patients deserve to be told the truth about expected costs, benefits, and side effects of medications, diagnostic procedures, and episodes of care— whether in the office or hospital. This is fair to them and their families as they weigh the value of a health service. This type of advocacy builds goodwill and trust, while benefiting all of us as caregivers and receivers. This is not unique to the healthcare industry. I recently saw a paper napkin from Southwest Airlines that defined “Transfarency” as their corporate goal.
As physicians, we are enormously blessed with the opportunity and mandate to help others. We should be advocates for our patients, our communities, and our profession. We have the privilege of doing this in our offices, our hospitals, and other places we practice. The Missouri State Medical Association is made up of caring physicians who strive for the common good and societal benefit.
Dr. Lovinger and his family at the Presidential Inauguration.
Our organizational advocacy includes such important current issues as: 1) Healthcare access for all Missourians, 2) Continued availability of affordable insurance coverage, 3) Confronting the opioid epidemic with needed tools such as an effective PDMP, 4) Advocating for appropriate scopes of practice among allied health providers, 5) Advancing our youngest colleagues—medical students and residents— through a program of mentoring. I hope that all of you here this evening will participate as mentors to medical students in a pilot program that MSMA and the University of Missouri-Columbia will be initiating this summer.
We live in exciting but also uncertain times for our profession. The advent of an Obama-care replacement, the MACRA system of outcome based physician compensation, consolidation within healthcare systems, and the inexorable trend toward physicians begin employees—all present many challenges to us as individuals and for organized medicine. Yet, I believe that when all else fails, we do best by maintaining professionalism, telling the truth, promoting goodwill, and striving for solutions that benefit all involved.
As most of you know, I have lived and practiced solo Internal Medicine for over 35 years in a rural Missouri community of 8400 one hundred miles south of here— Nevada. Other than Dr. Dave Barbe, I am the most rural President that MSMA has had for many years. Places like Nevada are well kept secrets, as they truly promote quality of life, sense of community, and opportunities for leadership. But, it can be lonely as a rural physician. Community expectations are very high—often with limited access to medical peers and support mechanisms that would be taken for granted in urban and suburban medical communities.
I think it is important that we in the Missouri State Medical Association do all that we can to reach out to our rural colleagues who have often been serving their communities for many years in relative isolation. Missouri is a vast and diverse state-stretching more than 500 miles from Maryville in the northwest to Kennett in the boot heel.
I have an ambitious goal for my year as MSMA President to visit all 114 counties and the city of St. Louis—hopefully meeting with practicing physicians and MSMA members while there. You can just call me the “Traveling Doc.” Hopefully, Marilyn will be able to accompany me on most of my travels, and I will keep you informed of our progress in Missouri Medicine.
I want to again thank all of you for being here tonight as friends, family, and fellow members of the Missouri State Medical Association. I am truly honored by the opportunity to represent you and work with our great MSMA staff as we dwell on the positive in promoting the medical profession of our state.