Dr. Perloff's Presidential Initiative

DAVID E. PERLOFF, M.D.

PRESIDENT’S MESSAGE

Esteemed Colleagues and Guests – I am honored and humbled to be elected the 89th President of the

Broward County Medical Association (BCMA). I launched a unique pathway to this profession. My

father actually chose medicine as his second career. So he went to medical school when I was eleven,

and he was about 40. I had the privilege of watching him go through medical school and residency

training. I will never forget him taking my brother and me to the cadaver lab. I was completely

fascinated, while my brother struggled unsuccessfully to avoid passing out. Needless to say, I became

a physician and my brother became an attorney. I have to admit that I was drawn to medicine

because it is such an amazing fusion of science, technology and human intimacy, that I really could not

see myself doing anything else. Even on those really challenging days that we all have, I am still

grateful to be a physician and could not imagine having any other profession.

After finishing my residency training in cardiology, I chose to come to Broward County. I was

particularly drawn to the fact that Broward General had a residency training program that I could get

involved with. I immediately started teaching the residents and have been an integral part of

graduate medical education since. I am very proud of the fact that I have participated in its growth

from a handful of family practice residents to now over 100 residents yearly with 10 residency and

fellowship programs. We have recently been designated a statutory teaching hospital by the Florida

Agency for Health Care Administration. It is an honor to have been a faculty partner and I plan to

continue to mentor young physicians throughout their training. It is so rewarding to receive a referral

from one of our prior residents for a patient with aortic insufficiency (without an echo) and remember

back to the day I taught this resident to hear and identify that particular murmur.

I have felt so fortunate in my career to be able to build a large and successful practice. But what I feel

most proud of are the relationships I have been able to share with my patients. I will never forget a

patient who had severe Mitral Regurgitation. Unfortunately, she suffered a large perioperative

myocardial infarction.

I personally spent several days and nights managing her pressors and Intra-Aortic Balloon Pump

during the critical time period for her to recover. Fifteen years later despite an ejection fraction of

only 20%, she comes to me every three months without signs or symptoms of congestive heart failure

and always thanks me for being by her bedside. She is only one of countless patients that I have had

the privilege of making a difference in their lives. Out of everything I love about medicine, that is

what brings me the most passion.

It is for this reason that I am so grateful to my friend, colleague, and a past BCMA President, Dr. Aaron

Elkin for pushing me to get involved in the BCMA. I have always sought opportunities to make an

impact on our profession and make a difference in our community. The BCMA offers an amazing

opportunity to do just that. A good example of what I am talking about is the issue of Medicaid

Expansion. As you know, our legislature has refused to accept Federal funds to expand the Medicaid

program. The consequence of this to Floridians is a loss of over 51 Billion Dollars in Federal money

and leaving hundreds of thousands of our states most vulnerable citizens at risk. They face not only

serious illness, but potential financial ruin if they are unlucky enough to require significant medical

care.

I have to admit that I have been extremely perplexed by the irresponsibility of the Florida Legislature.

On one hand, they tell us they want to cut taxes, but by refusing to expand Medicaid, they have done

the exact opposite. I pay my taxes to the Federal Government who then sends my money to subsidize

states that have expanded Medicaid. Since we have not done so, we do not have a safety net

healthcare and need to perpetuate a county hospital system where we are charged an Ad Valorem

Tax on our property taxes to fund indigent healthcare. So essentially, we are forced to pay for

healthcare twice once for other states and once for ourselves. I simply cannot understand why every

individual in the State of Florida, regardless of political ideology, is not incensed by this tragic and

unnecessary waste of our taxpayer dollars.

For the last several years, we at the BCMA have sent a consistent message to the FMA. Finally, this

last year Dr. Elkin’s resolution to expand Medicaid was adopted by the leadership of the FMA.

It is accomplishments such as this that make me proud to be part of the BCMA. More times that I can

count, we have taken “the road less traveled” and stood up for the needs of our physicians, our

patients, and our community.

When I ask myself what do I want to accomplish this year, I keep coming back to one important

legacy. I would like the physicians of Broward County to reconnect with the BCMA and see the value

we offer as an organization. It is clear that Medicine is changing. Physicians are increasingly

becoming employed. Nationwide, the percentage of physicians who are independent fell from 57% in

2000 to 36% in 2013. Employed physicians have some very different concerns and needs than private

practice physicians.

We also have a change in the demographics of our physician workforce. Here in Florida, 30% of

doctors are older than 60 years of age and less than 10% are younger than 35. So approximately, 5-

6,000 will be retiring the next five years. Couple this with the fact that we are the third most populous

state and have the largest proportion of elderly individuals, we are projected to have a nearly 7,000

physician shortfall by 2025. To combat this, the Governor and legislators have appropriately begun to

fund expansion of Graduate Medical Education (GME) across the state. All this leads to an influx of

young doctors in our workforce. Traditionally, the BCMA has appealed to the older established

private practitioner. I believe this is a reality we need to change. We must learn to be nimble and

appeal to all demographics. The younger physicians are more likely to be seeking an employment

model. They often value an attractive work-life balance, a more casual work environment, and

personal fulfillment over financial reward. These are very different individuals than the baby boomer

generation.

I have spent a large amount of time trying to think about how to appeal to this new generation of

young/employed doctors. I wish I had some words of wisdom and an answer, but I don’t……..yet. I

would like to take a page from the playbook of one of our past presidents, Dr. Dana Wallace. She has

been very successful in starting and running a Women Physicians’ Section. This has generated

significant new membership interest into the BCMA. To this end, I plan to put together three focus

groups to reinvigorate the BCMA. I will start with a young physicians group. Secondly, I want to target

employed physicians. Lastly, I will work with residents from to try to understand what their needs are

and how the BCMA can help meet those needs. These doctors are really the generation of our future.

Sometime quite soon, we will be passing the profession and our organization off to their capable

hands. One thing I am completely sure of and that is that physicians of every generation are very

idealistic at their core. We passionately believe in the honor of our profession, we care very deeply

about our patients, and we hope to make a significant positive impact in the world. I firmly believe in

the power of the BCMA to meet these needs for all the MDs of Broward County today and in the

future. Furthermore, I will commit myself to delivering that message