PULSE 11/22/2024: Presidents Corner

Colleagues:

Last week, my Pulse Message generated heated responses from members on both sides of the political aisle. Some emails expressed dismay that by being bipartisan, MSSNY is failing to confront what could be significant public health threats by the failure to protest the incoming presidential nomination for HHS Secretary. Other emails expressed displeasure over any expression of concern for those who are upset about the election results when there are MSSNY members who are extremely concerned over Medicare cuts and other threats that are making it impossible to meet their office payroll. All these emails express cries from the heart and deserve a response.

Our organization’s greatest strength is our respect of divergent opinions. I implore our members to come together to work on the mutually agreed upon issues that are most important to physicians.

First of all, MSSNY policy is set by the House of Delegates, a democratic organization that gathers and debates yearly each spring. When the House is not in session, MSSNY Council acts in its place. The Council meets every other month, and sometimes more for emergency sessions. Your President does not make policy. Your Delegates do. Those who wish to influence MSSNY policy will be most effective if they attend their County medical society meetings and the meetings of the MSSNY Sections.

Second, it is the collective wisdom of the House of Delegates that MSSNY advocates for policies, not for political parties, and this is reinforced by IRS regulations that establish the parameters of our tax-exempt status.

Third, our policies are all geared toward improving our practice environment and helping our patients. Our advocacy is most effective when we put our patients first. Here is an example.  Many politicians do not care that 20 years of Medicare cuts have hurt physicians.  But the politicians do take notice when we tell them how patients have been hurt by this, too. Surveys show that 95% of patients want access to a physician when they are ill. Medicare cuts have forced physician offices to close or merge with a hospital chain. This limits patient choice and patient access. This also results in higher costs for the Medicare Program because the hospital chains charge much more than the private offices did. Also, patient safety is affected as for example when rural ERs are forced to close for lack of physicians to hire. The point I am making is that our politicians take notice when our patients are suffering, and not so much when we are suffering.

When I write that MSSNY advocates for patient safety, I do so proudly knowing that putting our patients first is right and proper. I believe this to be a unifying principle for all physicians regardless of political beliefs.

That being said, MSSNY also is raising the alarm that Medicare cuts have reached a critical point. Many physician offices have already closed for inability to meet payroll, and many more are on the brink of closing within a year. In NYS, more than 70% of physicians are now employed instead of owning their own offices. Even for the employed physicians, Medicare cuts eventually result in pay cuts and pressures to produce more RVUs in less time. MSSNY and our AMA are laser focused on Medicare inflation update reform being our top priority. That is why I was with our EVP Tom Lee in Senator Schumer’s DC office in September, where we plan to return in larger numbers in February.

Now since Medicare reform is our top priority, this also means that all other advocacy items are a lower priority. We must choose our battles. Issues that generate bipartisan support have the greatest chance of winning. We are trying extremely hard to make Medicare reform an issue that has support from both sides of the political aisle. In this context, taking on other battles that already have a sharp political divide will lose us critical allies in our fight for Medicare reform.

The Medicare inflation update reform is MSSNY’s top priority. This is a patient safety and health care access issue. This issue affects all MSSNY members in practice, training to enter practice, and retired from practice who are now Medicare patients themselves. This issue crosses all political divides. This issue needs the support of both Republicans and Democrats for success. MSSNY members who are either registered Republicans or Democrats have an opportunity to reach out to their respective friends in either party, to advance this initiative which benefits us all.

Now, does this mean that MSSNY is a bipartisan organization insofar as we advocate our issues with all politicians in office? Or is MSSNY non-partisan insofar as we have members who happen to be from either political party, but our organization does not take political sides? I do not think the semantic answer matters, as long as we share the same goals and work together for the betterment of us all.

I thank you all for your emails, for they show me that you are not apathetic but indeed concerned about issues that I raise. I get to hear what you are thinking, and it is my privilege to respond and engage with you in this column.

All the best,

Jerome C. Cohen, MD
MSSNY President

Please join your colleagues in our effort to obtain needed Medicare payment increases by sending a communication to your member of Congress here: Be Heard | Physicians Grassroots Network