Open Letter to BCMA Membership

Re: The value of the BCMA:

In the 1990, we led the charge against special licensing for the Mayo Clinic and Cleveland Clinic to establish branches in Florida.

In the 1990, we had an active managed care committee where we took cases of poor care and non-payment and met with the AHCA and argued each one (successfully.)  We met with the VP of insurance companies and resolved many of these issues (until they created a new strategy to deny care and reimbursement.)

In 2001, we started tort reform in Florida, holding a well-publicized town hall meeting that received extensive coverage.  In 2002, we organized a fly-in to Tallahassee (to the displeasure of the FMA and Gov. Bush.)  However, the ball was rolling and in 2003 we passed tort reform legislation.  In 2004, we assisted passage of a constitutional amendment that limited the amount of money a lawyer could make from a lawsuit.

Over the years, we were successful in protecting physicians and their right to practice, especially in medical staff issues when doctors were inappropriately vilified by hospital administrations.  The most recent case was at Holy Cross Hospital when they attempted to require all their cardiac surgeons become employees or lose their privileges.

We were not successful but helped the Chief of Staff at Coral Springs retain his position for a successive term, against the will of the administration.  We provided legal support but the administration was forced to recognize us as an vocal entity.

More recently, the Broward County Medical Association filed an Amicus Curie brief opposing a state law that prevents doctors from talking to their patients about gun safety.  We opposed the FMA and we helped win an injunction.  The case is still in the process of resolution in Federal Court.

Concerning Medicaid Reform, which would place all Medicaid patients into for-profit HMOs, the BCMA took a leadership role in stopping its expansion beyond the current 5 states.  We still have the ear of CMS.  Concerning the implementation of PPACA (expanding Medicaid), Sec. Sibelius refused to allow states to enroll all patients into HMOs.  She would not grant the states a waiver.

The bigger problem is how the BCMA can help physicians in the future because so many young physicians prefer employment over private practice.  Since young doctors are not confrontational, many are quite happy accepting the dictates of their employers even when it compromises patient care and increases health care expenditures.  There may be a time when a physician is inappropriately fired and we can lend assistance but usually the employment contracts are so written that there is little we can do. 

There are other hospital strategies that impede physicians from practicing and perhaps we can lend a hand, but that remains to be seen. We might be able to create a forum to register these complaints (even electronically and anonymously.)

Warmest regards

Arthur Palamara, MD Past-President BCMA