Who Do You Call? The Champion in Our Exam Room

“If you do not take an interest in the affairs of your government, then you are doomed to live under the rule of fools.”

—Plato

As I reflect on my travels this year throughout the state, I’m amazed at how resilient we’ve been as a profession in the past year. Despite many major affronts, we have undeservingly taken a lot of the blame through misinformation. In lieu of our evidence–based recommendations, we continue to confront false claims such as physician profiteering from the pandemic.

Missouri physicians simply aren’t to blame. As a result, greater than 6 of 10 physicians are experiencing burnout, and 20% intend or have expressed a desire to retire in the next year. If our current time doesn’t cry “crisis,” tell me anytime in the past two centuries when physicians in Missouri and our profession have been more at risk.

The only consistent stalwart support through it all has been the MSMA, unending even after 172 years, yet still relevant for us and our patients. While we can’t fix the all the upheaval alone and look to our big fortresses of industry, don’t expect handholding from the insurance industry, the pharmaceutical companies, or even our network of hospitals in which we work.

MSMA embraces the diversity in each of us whether it be by our indicated specialty disciplines, the side of the aisle on which we vote, our ethnic and gender identities, geographic locale, and regardless of who directly employs us. This diversity has truly produced unity and a cause for justice. It’s never been clearer how to best face our target audience at the Capitol but through our advocates at MSMA. Aligning the profession provides the positive interaction of emotion with a team as opposed to the personal degradation of isolation. If we don’t look after ourselves as a group of professionals, we can’t reclaim the support and collegiality that sets us apart from an assembly line worker. We need to restore the public reputation of who we are: compassionate, of great intellect, and exuding goodwill.

As physicians imbuing our basic altruistic nature and placing others before ourselves, we never seem to have the time to face all the growing obstacles. The multitude of pertinent scope–of–practice details, needed med–mal insurance reforms, legislative intrusions into our exam rooms, prior authorization battles, and the burden of EHRs cannot be addressed simply or individually but only by our MSMA organization, (and often while we sleep).

MSMA communication comes in five different ways throughout the year, this journal, Missouri Medicine, is the second most rewarded state society journal, only superseded by the New England Journal of Medicine. Weekly e–mail blasts keep us up to date in the house of medicine and Progress Notes keeps us aware of MSMA news, CMS updates, and changes for compliance on a regular basis. Only a minority of Missouri physicians currently utilize our impeccable, doctor–led insurance company, the MSMA Insurance Agency, which offers independent counsel and expertise specific to medical malpractice. This not found in any other broker in the state; truly working for us and not themselves.

In June, the Dobbs Supreme Court decision enacted a trigger law that introduced both civil and criminal liabilities for medical management of essential health care for Missouri women. Legislator’s actions are now in all our exam rooms, not just OB/GYNs but oncologists, surgeons, cardiologists, et al. Such a decision is “reckless and dangerous,” according to AMA President Jack Resnick, MD, in his recent AMA Interim Meeting address. Our patients and their care suddenly don’t fit directly into a new state statute, hampering emergent and essential care, which is far more complex now that the courts and state Attorneys General are tasked with discerning whether something that had been well established and essential healthcare in the recent past is now appropriate. Corrective legislative action is needed to fix such a political intrusion into our practices and patients, and the only immediate approach is action through our MSMA advocates.

Burnout that currently affects most of us isn’t addressed by a simple hospital CEO invite to go to lunch just to talk or mindfulness classes, both of which are ineffective ovations for frustrating conditions that exist, not by our own doing. MSMA, in conjunction with the Missouri Association of Osteopathic Physicians and Surgeons, and Missouri Academy of Family Physicians is sponsoring a weekend retreat in 2023. MSMA also encourages physicians to utilize the Missouri Physician Health Program, which helps struggling medical professionals return to healthy lives, and is available to all Missouri physicians, physicians–in–training, and medical students.

Additionally, a member physician doesn’t have to be without support for grievances, contract disputes, and malpractice claims. Who will you call? Answer: MSMA, who is a physician liaison and has direct relationships with the state’s Board of Healing Arts and the Missouri Department of Health and Senior services.

In sum, MSMA makes us one with each other and addresses our real political issues that are close to home. As is said: “all politics is local,” and to that something our specialty boards and the AMA miss for lack of local involvement. It is only with MSMA that we can get politics out of Missouri physicians exam rooms, amend prior authorization hassles we all face, confront the myriad of Missouri scope–of–practice challenges, help define and control the pharmacy benefit managers, directly address our burdensome EHRs and their vendors, and have someone have our backs daily in the state Capitol.

Corporate pharmaceutical, medical insurers, and hospitals don’t always have your best interest, but MSMA continues to be your champion. Please join me in recruiting a new member, and renewing your pledge today to have an effective voice in Jefferson City. Together we are a choir and will be heard even louder and more resonant in solidarity.