By OMA President Carla McKelvey, MD
One of my first trips when my family and I moved to Oregon was to Crater Lake. Lodging was full in the park so we decided to stay at what sounded like a lovely place called The Sportsman’s Lodge in Chiloquin, which is near Klamath Falls. Let’s just say we got little sleep with the trucks whizzing by on one side and the trains going by on the other side. It was impossible to close the windows to drown the noise as it was a hot August and the lodge was not air-conditioned. Despite that rough start, I have always found the K Falls area beautiful. Driving in on 140 with the lake right by the road and watching all the waterfowl is inspiring. My family and I have returned to see the eagles in February and to play golf in the fall as well as to return to Crater Lake.
After a five hour drive from Coos Bay, I picked up Jo Bryson, the OMA’s CEO, at the K Falls airport. Klamath Falls has a National Guard unit and the jet planes were taking off as she was arriving. The power and speed of that aircraft is something to behold.
We had dinner with physicians from the Klamath County Medical Society, including Ralph Eccles, the OMA’s vice-speaker. Once again, it is always enlightening to hear what the concerns of physicians are. The conversation immediately launched into CCOs, or Coordinated Care Organizations. There is a sense that the CCO structure will be so complicated that a local group such as Cascade Comprehensive will not be able to achieve it. They have been very successful in managing the local Oregon Health Plan but this new “animal” may be beyond their abilities. They wonder if a larger organization will swoop in and take over and leave the good work they have done behind and they will become mute and just a cog in the wheel.
In addition, they struggle with maintaining collegial and good working relationships between primary care physicians and specialists as the pot of money gets smaller. They understand the importance of working together and that the pressures they feel are from the outside and not within the ranks, but it is hard to feel shared suffering when the roles of the two groups are different in their interactions with patients. They worry that if more funding cuts come down that they will have to bow out of the Oregon Health Plan and leave the patients that they have cared for without access to physicians – both primary care and specialty care. It is hard to provide care with funding cuts when 60% of your practice is Oregon Health Plan.
And finally they wondered if the OMA should help physicians unionize. This is not the first time that we have heard this in our conversations as we visit with physicians throughout the state. Physicians have always been an autonomous, independent minded group but they are feeling more and more that the system is controlling them to the point that they cannot do what they love the most – take care of patients. As newer structures with different names are imposed on them, they believe that, possibly, the only way to regain control is through a union. It is a conversation that I never thought I would hear from so many different physicians in different parts of the state.
We left K Falls at 9 pm to drive on to Grants Pass. I am confident that the physicians there with assistance will continue to be successful in providing care for their patients. They have good leaders who will be able to make the connections needed to create a local CCO. As an organization it continues to be important that we are there to provide the best information we can and the tools that are needed so that physicians can continue to do what they love the best.
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