A Message from the SCMA President
A View from the Cockpit: “The Magenta Line”
March 31, 2023
“It’s all about the patient because we have no other reason to exist.”
~ Roger Litwiller, MD, American Society of Anesthesiologists (ASA) President
It was my privilege to hear this physician leader deliver the above message as he addressed the 2004 ASA House of Delegates. His words simply and elegantly echoed my reasons to enter medicine many years earlier.
“Dr. Yeakel likes to get high”
~ Robert Morgan, MD, MBA in comments to the 2021 SCMA House of Delegates
Please know that Dr. Morgan was referring to my keen interest in aviation! My colleagues on the SCMA BOT, the SCMA staff, and those of you still reading these “View from the Cockpit” (VFTC) thoughts, have had to endure repeated metaphors and stories about aviation. My description of the SCMA as a “Dreamliner” organization, referencing the Boeing 787 aircraft produced in North Charleston, is due to similar approaches in organizational excellence, leadership quality, and integrity.
My interest in anesthesiology reflects my interest in aviation. Aviators and anesthesiologists both have and use checklists, both have a takeoff phase (induction), cruising (maintenance), and landing (emergence). Most anesthetics and flights are straightforward but occasionally you hit some “geese, ” as happened to Captains Sullenberger and Skiles on that January day in 2009 over the Hudson. When that happens, training, judgement, experience, and teamwork drive good outcomes.
In the aviation world, ground-based navigational aids are largely being replaced with Global Positioning System (GPS) technology. With GPS data in the cockpit, even with zero visibility out the windows, pilots have a bold magenta line on their instrument panels revealing positional awareness and course/destination.
Dr. Litwiller is correct. It is a humbling privilege, as a physician, to be a part of the sudden intimacies of patients’ lives. So, my question in this final VFTC to you is “What is our magenta line as physicians in South Carolina?” When we hit turbulence from any direction, following a patient-centered “magenta line” should guide and drive our efforts to support our profession of medicine and improve the health of all South Carolinians.
Recent years have seen unprecedented changes within our profession of medicine, healthcare, and the health of our patients.
- The pendulum of physician employment platforms continues to swing in the majority towards hospitals, health systems, and corporate entities.[1]
- Payment systems (Medicare and Medicaid in particular) are on an unsustainable path that are jeopardizing patient access to physicians. The resulting discrepancy between what it costs to run a physician practice and actual payment, combined with the administrative and financial burdens is incentivizing market consolidation.[2]
- Evidence shows that this trend of physician consolidation under the same hospital, health system, or corporate umbrella leads to higher health care prices, decreased patient satisfaction scoring, and does not necessarily improve patient outcomes.[3],[4]
- In the past few years, the United States has experienced the sharpest decline in life expectancy in more than a century.[5]
What happens to the medical profession and to the physician patient relationship when physicians become employees? What happens when legislative bodies use their statutory and regulatory pens to insert themselves into our profession? The loss of economic independence and external legislative intrusions does not necessarily mean the loss of professional independence, though it might.
Physician independence has always meant more than an economic status. It has been the foundation of a professional ethos that inspires a dedication to science, a devotion to patient welfare, and a broad commitment to the health of the public.
The SCMA has been and remains an invaluable resource in my experience. Its mission and vision to serve and support the physicians of South Carolina and to improve the health of all citizens in this state has been integral in providing resources to support and maintain my “magenta line."
On April 27, the SCMA Dreamliner will pull into the gate at the Marriott – Grand Dunes Myrtle Beach, SC for the SCMA Annual Meeting which offers unique opportunities:
- Gather for CME.
- Participate in the House of Delegates debating and establishing policies that impact our practice of medicine and the delivery of patient care in our state.
- Celebrate Dr. Helen Stockinger’s Inauguration as the 162nd SCMA President.
It has been a privilege, an honor, and yes, fun, to be in the cockpit of this Dreamliner this past year. Many thanks to all of you who have shared valuable support and insights during these months. As always, your comments are welcome at scmayeakel@gmail.com.
References:
[1] https://jamanetwork.com › journals › jama › article-abstract › 2794951
[3] https://www.ahip.org › news › articles › hospital-acquisition-of-physician-practices-drives-up-cos
[5] https://publichealth.jhu.edu/2022/life-expectancy-is-declining-in-the-us
A View from the Cockpit Archives
February 2023: "It Should Not Be This Difficult"
January 2023: "Well, that wasn't as bad as I thought."
November 2022: "Primum Non Nocere"
October 2022: "Dr. Yeakel, can you meet the ambulance at Wounded Knee?"
September 2022: Not interested in politics? Politics is interested in you!
August 2022: "We're Going into the Hudson!"
July 2022: The Elephant in the Room
June 2022: Standing on the Shoulders of Giants
