by Venu Vadlamudi, MD

Reprinted with Permission by the Author

In October, based on faulty premises and the lure of Federal matching dollars, the Michigan House of Representatives passed the Quality Assurance Assessment Program (QAAP, aka the physician tax) by a tight margin. The bill passed along party lines, after heavy internal pressure from within the Democratic party. The Michigan State Medical Society, along with other groups in organized medicine, acted quickly to rally efforts to oppose this legislation through resources such as its Action Center and by quickly organizing a successful march on the capitol. The march was attended by nearly 1,200 physicians, fellows, residents, medical students, office staff and others. This was an awesome effort, especially considering the short timeline involved, but for me it demonstrated the power, impact, and necessity of organized medicine. The result of this swift action lead to the Michigan Senate voting the bill down, saving each physician up to an estimated 31% of their gross revenues. 

During medical school and often throughout residency and fellowship, we learn about medicine under very ideal conditions. In these settings, medicine is defined by a relationship between the physician and patient and the diagnosis and treatment of the patient’s condition. It is because of this definition of medicine that we enter a long road of education, training, and honing of skills to become competent and compassionate physicians. It is often easy to become fixed in this mindset and remain naïve or indifferent to the realities of medicine that loom at the doorstep of graduation. 

At times in contrast to our more idealistic education in medicine, the realities of “real world” medicine often involve decisions and interference from insurance companies, regulators, lobbyists, politicians, and others who may never know what it means to examine a patient. The rules that govern issues such as patients’ access to care, physician reimbursement, medical school debt forgiveness, and medical scope of practice are not often written by physicians even though it would seem that they would be the most logical choice. It is in these areas and many more that the value of organized medicine is truly evident. 

 So why become involved in organized medicine? You should for your patients; for your colleagues; and for yourselves. The defeat of this physician tax in Michigan is an excellent example of the importance of organized medicine. 

For your patients, had it passed, it would have surely worsened the physician shortage in this state which has already been recognized by the Governor’s own Blue Ribbon Physician Workforce Committee and data from the Michigan Health Council, thus decreasing access to care. For your colleagues, the potential impact on physician retention would have been grim, with newly-trained physicians leaving the state in droves, thus hastening and worsening the aforementioned physician shortages. This would have come at a most inopportune time considering the worsening unemployment rates in the state causing additional tens of thousands to go without adequate health care coverage. This point was very evident in polling of medical students and physicians-in-training by MSMS where respondents overwhelmingly indicated that this proposed tax would negatively influence their decision to stay in Michigan with nearly 88% of these future physicians choosing to leave Michigan after completing their training. Finally, for yourselves, as practicing physicians, the passage of this tax would have meant that your future fiscal bottom line would become tighter and, as indicated by the aforementioned polling data, you would have more difficulty in paying your practice expenses or even attracting a new partner to a busy practice. 

With the current debates regarding health system reform and as the inheritors of whatever product may result, we must be active and engaged in organized medicine at the state and national levels to ensure that we are able to better serve our patients and have successful and meaningful careers. I urge those of you who are medical students, residents, and fellows to join MSMS and the AMA and be involved, and for those of you who teach and mold these young minds, please add a bit of this message and guidance in your morning rounds. 

Venu Vadlamudi, MD is a third year diagnostic radiology resident at the Michigan State University program in Flint and is the Vice Chair and Chair-Elect of the MSMS Resident and Fellow Section and the Resident and Fellow representative on the MSMS Board of Directors.