Executive office update: Moving forward with The New CMS

Friday, January 01, 2016 12:07 PM

by Alfred Gilchrist, CEO, Colorado Medical Society

The productivity of a medical society, especially state organizations whose primary mission is to advocate for the profession, is a function of its ability to aggregate and deploy its physician-constituencies’ collective wisdom, clinical expertise and homegrown relationships with public officials and other public policy influencers. The fundamentals – the grassroots connections – that organize and weaponize us in the public affairs space are labor intensive and often referred to as “herding cats.” The logistical challenges of bringing a medical society into communities scattered across a wide array of practice settings and professional priorities is difficult, especially given that discretionary time (the physician’s most valuable volunteer resource) is limited. Physicians tell us that regardless of specialty or practice setting, their patient care day has spilled over into the evening hours.

Medicine’s practice productivity is being stressed to a tipping point. Yet physician engagement must drive the politics and process that set health care policy. The laws and supporting regulatory structure directly influence both the clinical and economic components of medical practice and must not be constructed in a void. Even so, despite grassroots-derived, highly relevant annual meeting programming, most CMS physicians have been voting with their feet to not give up personal or professional time to participate as a delegate in our 145-year-old governance process that used to set medicine’s agenda. Evaluations, statewide physician surveys and focus groups praised the program content and criticized the cumbersome governance model.

The CMS Board of Directors reaffirmed what they intuitively knew: the problem with physician engagement was not inspirational, but structural. We had to adapt to the limited bandwidth of medical practice and make policy idea intake and development more horizontal and interactive. Two years ago a task force was created to reinvent how to connect and mobilize our members, and in 2015 that same governing body overwhelmingly voted to re-engineer the process to allow for real-time connections to a smaller board linked to its local constituencies. As a result, we will strive to assure productivity on behalf of Colorado physicians by making it as easy as a keystroke to influence views in Denver and Washington.

We are reaching out to you right now with a comprehensive survey on the health plan mega-mergers and will share the results with the United States Department of Justice Antitrust Division and state regulators. We will soon be surveying you on end-of-life decisions in anticipation of a renewed legislative debate on the role of a physician. We are organizing physician interests and expertise by issue clusters that can be ongoing and readily mobilized in virtual space as those issues heat up. A work group of your colleagues is meeting to reinvent the annual meeting as a family-friendly event that celebrates the community of medicine and deep-dives into the real-world mechanics and innovations of practice support tools and, of course, public policy debates that steer those innovations.

This in-person/virtual governance interactive model intends to harness the wisdom, experience and insights of Colorado physicians. It will increase our productivity and influence on your behalf. If you want more information, contact me at alfred_gilchrist@cms.org or, even better, call me on my cell phone at (303) 475-0144. I will hear you.