Members present: Dr. Lisa Barr, Dr. Keith Berger, Dr. Jerome Blackman, Dr. Alexandria Berger, Dr. Greg Warth, Hon. Karen Greenhalgh, State Delegate, 2nd District. Excused absence: Dr. Joel Bundy
Location: Bravo’s Restaurant at Towne Center in Virginia Beach
Time: 6:30 PM
This relatively informal dinner meeting of the CVMS Board began with introductions given by each of the Board members followed quickly by a very lively discussion of many of the various advocacy items on the agenda. We were honored to have Karen Greenhalgh with us.
The salient points of our meeting were as follows:
1. We are now established as a medical society in the state of Virginia representing physicians in Norfolk, Chesapeake, and Virginia Beach. Our name has been changed to Coastal Virginia Medical Society and we are registered with the State Corporation Commission and the Internal Revenue Service as a 501(c)6 non-profit organization. There were no dissenting voices to the approval of the Bylaws, Business Plan, or Articles of Incorporation as previously published.
2. We re-affirmed our two-part mission: Professional advocacy and collegiality.
3. We will be involved in the process of developing new legislation to improve physician and patient-centered concerns related to our current health care system.
4. We will continue to promote the ideals of medical professionalism and high-quality patient-centered care,
We discussed many of our concerns about the current healthcare system and about its effect on physicians and patients. We will focus on the following over the next 1-2 years:
1. Certificate of Need (CON) is our primary concern. The absence of adequate numbers of hospital beds is causing significant deterioration of the quality of healthcare in our area. Current restrictions on the development of more hospital beds, infusion centers, outpatient imaging centers, and outpatient procedural facilities are crushing competitive marketplace incentives that would allow for lower costs and improve access. However, in Virginia, lifting these restrictions has been met with tremendous resistance due to special interests. We need to do a study to prove that CON laws are damaging health care and escalating costs, the exact opposite of what they were intended to do, so that we can show undeniable data that this is the case. This has already been proven in many other states who have subsequently eliminated their CON laws. The public has no idea how these CON laws are adversely affecting them. This must be brought to their attention, so they understand what is happening to them, and to gain support for removal of these laws.
2. Overcrowding of emergency rooms is also extremely unhealthy and needs to be addressed rapidly. Elimination of CON laws would greatly improve this problem. But there are other reasons for this as well including current Medicare laws that incentivize keeping people in the hospital unnecessarily for 3 days before they can go to a rehab facility. A study on why the emergency rooms are overcrowded would reveal many inefficiencies in the system that could be corrected.
3. Mental health problems and the marked absence of adequate psychiatric care, both outpatient and inpatient, also contribute to ER overcrowding and is not being addressed in our area.
4. The current level of physician “burnout” and depression cannot be sustained. We are rapidly losing our healthcare workforce. This is adversely affecting our everyday patient care. Total reliance on physician extenders is not the answer that some thought that it might be. We must pay attention to this, determine the reasons, and correct them quickly.
There are many other concerns, but we would do well to focus on a few of the main ones as listed above. Our goal is not to make enemies of those who wish to maintain the status quo but to work along with them to consider changes to improve health care in the future. We must do the right thing for the benefit of all of us, but mostly for the patients. It may seem externally that the status quo is working fine, but those of us who work directly with patients know that’s not the case.
Also, physicians would like to regain some of the respect that we have lost in prior years, and we want to be part of the decision-making process, and not just in appearance. We need to have some control of our lives and use what we know to make things better. If we can do that, some of our moral dilemma* causing the “burnout” will disappear. Our current overworked, paid-laborer status is unacceptable.
We would like to collaborate our goals in a spirit of cooperation with Sentara, Chesapeake General, EVMS, and ODU, along with other neighboring medical societies and the Medical Society of Virginia as we move forward. But we will forge our own way, not simply follow along. CVMS will become a meaningful, respected institution standing for fairness, equal opportunity, professional strength, the correction of faults, and the betterment of healthcare.
Spreading the Word:
The more people who know and understand these issues, the more likely it is that we can make changes to improve them. Spreading the word to our colleagues and to the public will be paramount to making things happen.
1. The Board is enthusiastic about trying to make a difference in advocating for physicians and better patient care. We plan to meet again soon to continue the conversation. Some of our future meetings will be at physicians’ homes to allow for a better venue for networking and collegiality.
2. We will try to obtain email lists of physicians on the staff of local hospitals to let them know about our new Society, and to notify them of what their Medical Society is doing on their behalf.
The meeting was adjourned at around 9:00 PM.
Gregory J. Warth, MD, FACP
Coastal Virginia Medical Society
“We believe that clinicians are not burned out; instead, they are suffering moral injury. Moral injury occurs when we perpetuate, bear witness to, or fail to prevent an act that transgresses our deeply held moral beliefs. In the healthcare context, this transgression is caused by the need to accomplish the impossible task of satisfying the patient, hospital, insurer, and ourselves all at once. Moral injury locates the source of the distress, appropriately external to the physician and within the business framework of healthcare itself.” Commentary by Wendy Dean, Austin Dean, and Simoon Talbot, Medscape, July 23, 2019.
Stay up to date on issues and news you need to know. The CVMS Bulletin is published monthly and will list concerns that local physicians have expressed about healthcare in Coastal Virginia and how we can make it better. We will provide potential solutions and let you know what is happening behind the scenes to help solve these problems.