President’s Message
By Frank Randolph, M.D.

A New Perspective

I have developed a new perspective. In trying to serve my constituents I have studied the roots of growing physician dissatisfaction in California, so that I could participate effectively in attempts by organized medicine to address the problems that threaten the success of the profession. I have always believed that a strong profession could accomplish our primary goal-the best care of our patients. Some problems are recurrent-the professional liability crisis, the uninsured, inadequate or unfair funding practices, laws, regulations, or managed care models that undermine physician scope of practice, and so on. Newer problems have been emerging such as an emergency care system on the verge of collapse, the threat of bioterrorism, physician medical group insolvency, and unfair intrusions upon physician rights by the Medical Board. When Governor Davis spoke to the CMA on April 2nd of this year, he admitted the words “healthcare and crisis” have become inseparable over the past 20 years, he confirmed that California physicians have suffered a loss of autonomy and income, and he communicated his intent to create a Bill of Rights for physicians.

He helped me to conclude the obvious. For the next several years and into the next decade, our patient care-related income and sense of autonomy has and will continue to erode, lagging behind with no immediate hope of repair-the public and the government feel we should shoulder much of the burden created by the crisis.

From this simple acceptance I took stock of my resources-a loving wife and son, caring friends, loyal patients, and an involved and effective local professional community. My profession has been successful. We have realized many of the goals we began with in medical school. We have been successful in improving health care, albeit adjusting continuously to the new problems we face. We continue to develop new ideas and to apply these ideas to our profession, be it a fluoroquinolones, the internet, personal digital assistants, the Human Genome project, cell phones, or contacts lens implants.

When I talk to many of my colleagues, I find that they are still imbued with the desire to serve their patients. A better income and personal autonomy, both acceptable goals, were never the key measures of success. On a steady basis, we continue to see improvements in life span, quality of life, improvements in functional capacity, and reductions in suffering. In California we have created a patient’s bill of rights, we have championed HMO reform, and we have expanded care to the indigent significantly. Since 1975 we have held back the professional liability crisis and inspired other states by developing the MICRA legislation and maintaining it. We are succeeding because the care of our patients, which was always our primary charge, is in good shape. Problems do exist. Thousands of uninsured Californians, a growing population of older Californians with health problems, continue to challenge us. But what is clear is that our patients need us now more than ever. We will be paid less, hampered, and compelled to provide more and better health care than ever before. In consideration of these challenges, I am inspired more than ever to call upon other California physicians to unite for this common purpose.

Frank Randolph, MD