Greetings to Dr. Olesnicky, Dr. Bonder, to the members of our State and County medical societies and to all of my family and friends. I am honored and privileged to stand before you all as the new, 161st President of the Morris County Medical Society . Irv did a great job this past year- his shoes are truly “big” ones to fill but I’m sure I will do my best to fill them in the year ahead.

We are all in the midst of a whirlwind of activity in the field of medicine. New research advances double our knowledge base every seven years. Technology has permitted the use of information systems to harness the Internet and utilize computer systems as a part of the every day practice of medicine. Bioterrorism news and HIV and SARS research gain new advances day-to-day that now can be disseminated to physicians in hours not in weeks. And more recently now, we are caught within a political fight for our lives over tort reform and other reimbursement based issues that threaten to reshape and possibly limit the longstanding and time-proven way in which we serve all of our patients.

Are these the best of times or the worst? Regrettably, the practice of medicine today appears to be deeply troubled but I stand before you as your newly elected County President and ask us all to take a more positive outlook on the ever-changing medical landscape; seek out the parts of medicine that attracted us all to become physicians in the first place. To view medicine, however, as anything but a reflection of our society as a whole is basically naïve. For years, we have served as the Shaman or “wise men and women” of society. Doctors provide needed decision-making input on worker’s compensation, disability and other legal issues for our patients. Our training process has continued to be the most rigorous of all professions, among the most competitive for college graduates to seek out. Yet, many of us fear disclosing to our patients and professional colleagues alike about the increasingly intolerable state of affairs for our beleaguered, though beloved profession.

During this past year, our state and county medical societies have been in the forefront of battles in Trenton for significant and real tort reform. We have been able to bring this previously hidden issue into the headlines of state and local news. Our patients support us overwhelming (by most accounts at greater than 70 % of those surveyed) and we have made national headlines as well. While the issue remains controversial and is caught up in conference in the state assembly, it is clear that those of us who attended any of the rallies in Trenton that these were days of strong feelings of release and empowerment which many of us have not experienced for decades. I too am personally affected by the malpractice crisis, my partner and I are strongly considering stopping delivering babies as a part of our practice of family medicine for nearly 20 years, and not because we do not enjoy obstetrics but because of the ripple effect it has on all practitioners. We must unite across specialty lines to defeat those who do not understand the full extent of this crisis in medicine in our state. I was fortunate, then, to speak out on behalf of my specialty of Family Practice at the last rally in May. In fact, I have just this past weekend completed a two-year term as President and Board Chair of the New Jersey Academy of Family Physicians.

So, I stand before you now poised to tackle new and further obstacles to our profession as a whole having been most recently focused only on issues relevant to primary care. The experiences and leadership activities that I was fortunate to gain these last few years should serve me well in the next year as I represent the physician membership of the proud and storied 187-year-old Morris County Medical Society. I look forward to providing input also into our state Medical society’s governance system.

I seek out inclusion within our county society as opposed to divisiveness, so that surgeon and medical doctor and psychiatrist all can attempt to work in unison on the commonality in medical practice while still remaining aware of the smaller issues that set us apart. Those differences need not divide us when facing the insurance or legal worlds nor when we interact with the general public. We must now more than ever, get out of our offices and stand up and be counted.

Physicians can no longer practice in isolation; standing alone in sad silence over a malpractice suit, especially when the cause and nature of the case are suspect or judgment calls too complex for the lay public to make. We can no longer continue to be victimized by the legal system or by well intentioned but misguided governmental regulators if we are to continue to act as the good agents or “wise men” of our society that I spoke of earlier. This week’s cover story of Time magazine chronicles our profession’s plight. Philip Howard, a reform lawyer and founder of Common Good is quoted in favor of a new special medical courts system and I applaud his group’s candor.

We must, of course, be vigilant in cleaning up our own ranks and in weeding out bad doctors. In fact, the Morris County Medical Society Peer Review committee is a wonderful vehicle for patients with complaints that need not enter the overburdened legal system. We can all benefit from peer to patient interactions there to efficiently settle disputes between parties without needless legal interference. We might do well now to publicize this alternative remedy for patients in order to limit the unnecessary litiginous nature of our public in Morris County and throughout the state.

I also want to make our County society more responsive to the needs of ALL its members whatever the specialty or practice size. I stand before you all as a new breed of member. I am not a current American Medical Association member though I support my colleagues who choose to join its ranks. I know that we must make our county and state society more responsive and less intimidating, not your grandfather’s medical society, but something that inspires more support and cohesiveness than does the sometimes isolated and indifferent sense that many of us perceive of the national American Medical Association. The national society membership of the four major primary care providers, Internal Medicine, Pediatrics, Obstetrics and Family Practice all told , comprise more than twice the membership of the American Medical Association as a whole. So, it is clear that we must work more closely with our own specialty societies and also with other closely aligned groups such as the state and county osteopathic societies, on areas of overlap and similar viewpoints so that the bureaucrats and legislators in Trenton and Morristown will hear us speak out as one whenever possible.

We are facing numerous Scope of Practice legislative initiatives in Trenton; these are dangerous infringements by allied health providers in such areas as optometry, Physical Therapy, pharmacy and Nurse Practitioners who would all seek out prescriptive and also un-supervised practice rights previously granted only to physicians. I urge each and every one of you to speak out on these issues to patients and legislators so that we can maintain the high ideals of practice for the public while still keeping relations with these colleagues on the proper plane and level of professionalism.


Reimbursement is another topic of high prioritization for me as your County leader in this next year. We must forcefully and without embarrassment spell out to the New Jersey Department of Banking & Insurance and to politicos about the dangerous trend for managed care insurance carriers in denying claims that are properly submitted or “clean”. Many of these claims are rejected because of delays out of our control including patient errors or mis-representations or with wrong addresses provided on submission documents. Insurance fraud must be stamped out aggressively, however, no patient who works hard to receive health insurance benefits wants to see his personal physician denied reimbursement despite timely and effective claims processing due to circumstances out of that physician’s control. Today, insurance fraud is being committed most by the insurance carriers themselves rather than by the providers. Extending limits on timely filing to more reasonable time tables up to one year should virtually eliminate such unfair business tactics by managed care systems selling insurance contracts in our state.

Along the same lines, we must strive to attain a state of true responsible universal health care coverage for all of our state’s citizens. The United States spends significantly more on health care per capita than the rest of the world, and yes, our Medical care stands second to none. Yet, 40 million Americans have no coverage at this time and that is something that we all know as practicing Docs does have a powerful impact on the timeliness and ability for these patients to get good medical care and obtain appropriate prescription medications. I believe it is the honorable and correct thing for us as Americans to push for this basic right and it is also good for physicians that our patients all have some kind of general health care benefits available to them so that none of them suffer needlessly from financial constraints upon their care. Naturally, those who can afford to pay or receive higher levels of benefits should be afforded the right to do so as is the case in all other walks of life. This need not be a Republican or Democratic issue. Physicians who are in the front line of health care expenditures are, I believe, best equipped at setting up such a system of basic coverage for the unemployed or part time employees who lack standard health care benefits. And to be sure, it can and must be done in a fiscally solvent way that does not further bankrupt our over-taxed health care delivery system.

So, I have touched upon many areas of importance to us all as practicing physicians in Morris County whether you are a member or not of the state and county societies. This leads me to the last, but possibly most valuable goal of the next year. We must finally gain the trust and support of all our potential physicians in this county. We are a strong and vigorous county of three hospitals and many primary care and specialty providers. With the wake up call of this past year, we must finally all learn to dig in to our pockets just a bit more and either join or rejoin the state and county medical societies. Furthermore, it is time that we all give more of ourselves either with time or monetary contribution to our established Political Actions Committees (MEDAC or JEMPAC ) to finally get the one-on-one time with elected leadership so that they will hear our rightful calls for relief from red tape and unfair financial burdens upon our practices. Speak to your colleagues who are not members and tell them why they must join with us on this difficult crusade to defeat those who do not understand how hard we all really work. Those who oppose us are not available 24/7 as we are and they do not comprehend how we fight to keep our offices open and free from HIPPA, OSHA, and all sorts of other onerous regulations that are rapidly dismantling the wonderful medical system that we once knew so well. Many of these groups that claim to improve healthcare, I feel certain are actually destroying it.

We are physicians, we know how to heal America, we must now heal the system of health care provision so that it remains a proud and noble profession to aspire to, because it has lost much of its luster these past few years. Anyone attending these rallies, however, is able to return home with a renewed sense of vigor in practice. I know that I am, and I will continue to fight for our rights, our virtues and to let the public now know, finally how proud we are to be their physicians and how privileged we are to care for them. They, however, must give us the tools and the means to be freer to practice without constant fear of being sued, not making our staff payrolls or having to spend needless valuable physician time to attain basic rights for our patients. Medical practices caught up in over-regulation can be easily be reviewed retrospectively now with insurance claim data, so that we can finally eliminate the red-tape and needless bureaucratic hoops that we are all subjected to; often by non-physician or non-peer reviewers. All of this is attainable. If and only If we all stand up and say it is time, like the rally cries we started over tort reform but which must now extend to these other broken areas of medicine that I alluded to before.

I am hoping in this next year to reach out to county representatives of the legal community, industry and legislators so that we can have more meaningful and open dialogue on these matters. We must talk to our state’s leaders in all these disciplines as well so that we can seek to end the cross talk and bickering and reach common ground and understanding. That way we ALL can do what is ultimately right and good for the most important people we serve; our patients. Margaret Mead the noted anthropologist once remarked, “Never doubt that a group of thoughtful committed citizens can change the world- indeed it’s the only thing that ever does.” Let us be those citizen leaders to change how medical care is provided and organized in our great nation.

Thanks so much for being here, for listening and for the help you can offer our dedicated Morris County Medical Society Executive Committee and me in this upcoming year as we work for you all at achieving some harmony and civility in our chosen life’s work. Have a great night.

Arnold I. Pallay, M.D.
President,
2003-2004



Click here
to view the previous Pesident's Page