President’s letter: Awash in a sea of complexity

Friday, May 01, 2015 12:05 PM

by Tamaan Osbourne-Roberts, MD, President, Colorado Medical Society

I tend to take great pride in the many innovations now moving through Colorado’s medical policy world, and even greater pride in Colorado Medical Society’s involvement in so many of them.

Some of these current initiatives include the State Innovation Model, which promises to revolutionize behavioral health care for all Coloradans; the Medicaid expansion, bringing health care coverage to an unprecedented number of the state’s most needy citizens; the All-Payer Claims Database, a unique collaboration designed to bring cost and quality data to the clinical level; the Commission on Affordable Health Care, one of Sen. Irene Aguilar’s signature initiatives, and natural successor to the 208 Commission; and most recently, an interim study on network adequacy, CMS’ own forward-looking brainchild to examine the nature of health insurance networks in Colorado, arising out of events this legislative session. We are rapidly working with others to build the future health care system of Colorado.

Perhaps understandably, I mention the headaches that go along with such change less frequently, particularly for practicing physicians on the ground. As health care systems change and offer more capacity to bring better care to more patients, the burden of delivering that care often falls on the shoulders of physicians. As the business environment changes, and as massive hospital systems and payers square off, doctors often get caught in the middle, sometimes negotiating for better reimbursement, sometimes taking collateral damage. As data becomes more accessible and more robust, physicians will be able to use that data to improve care and design better practices, but worry more and more about whether that data will be used in meaningful and ethical ways.

After a while, the landscape starts to look a bit like this month’s front cover: full of icebergs. These beautiful peaks, ready for exploration and harvest, bring much-needed refreshment to the ship of our profession, but much is looming under the surface and threatening to capsize us. We are floating in an ocean of unpredictable winds that will either clear the way for our journey or force the smaller bits of ice together, trapping us in for a long winter.

It is a veritable sea of complexity, needing a skilled team at the front of the ship, charting a safe course forward, avoiding hazard and seeking opportunity. Thankfully the physicians of Colorado have that in their team at CMS.

Much has been made of the increasingly fractured nature of the modern physician’s life. The trend toward physician employment increasingly takes us away from one another. Expanding practice requirements give us less time to band together and protect our profession and our patients. The changing nature of the American career and family places additional demands on our time. And the business environment means we spend more time supporting the care we give, rather than supporting each other.

In this increasingly lonely environment, CMS shines as a place where physicians come together. Serving as the convener for all physician interests in the state, CMS helps to focus our profession’s voice in the legislature and in other halls of policy. Through our work on physician wellness, CMS seeks to remove the things separating physicians from health and happiness, as was recently highlighted by CMS President-elect Mike Volz’s topic for the Spring Conference, “Breaking Barriers.”  And county medical societies provide much-needed social and networking space for physicians in their local communities.

All careers come with headaches.  The question is: How do we respond? And how do we get through?

My own answer has always been that we succeed in the face of adversity with the help of other people. CMS stands ready to serve as the place where you can connect with your colleagues, to meet these challenges head on.

(And maybe hand you a little ibuprofen).

Until next time.