Dr. Blog

Fresh from the Leadership Academy

The OMA's new President, Bud Pierce, MD, and Executive Vice President and CEO Jo Bryson, CAE, just got back from the Physicians Foundation Leadership Academy hosted by Northwest University's Kellogg School of Management in Chicago.

"This is an outstanding leadership course taught by professors who hold endowed chairs in the Kellog School of Business at Northwestern University; if you are ever asked to attend, run, don't walk to this course as it is truly outstanding in content and presentation," said Pierce.

Dr. Pierce (pictured here reading his copy of Leigh Thompson's The Truth About Negotiations from the Leadership Academy) follows in the footsteps of the last three OMA presidents, who attended the Leadership Academy with Jo in the first weeks of their presidency.

Lebanon and Corvallis

By OMA President Carla McKelvey, MD

We left the Burpees with garlic, rhubarb and Jon’s legendary rock art – Jo with bookends and I with beautiful polished rocks, one of them from Whiskey Run Beach in my area. They were so gracious.

Our first stop was the new medical school in Lebanon, COMP-NW (College of Osteopathic Medicine of the Pacific). The school opened this year and is located across from Samaritan Hospital. The new building is amazing with the latest technology. It appears to be the campus of the future.

Jo and I visited the Gross Anatomy lab. That smell brings back memories of where a significant portion of your first year in medical school was spent. The lab is outfitted with monitors where x-rays and CT scans can be displayed so that radiographic findings can be matched.

Lunch was at The Corvallis Clinic. The concerns expressed mirrored what we had heard across the state, especially regarding the implementation of CCOs.

The day ended in Portland with more meetings. It was a whirlwind tour.

Once again, I am impressed with the diversity of situations across the state and thus the importance to keep sending the message of the need of flexibility and respect for local issues as health system transformation is created and implemented. Our physician communities will be able to continue to provide good patient care if they are given the leverage to do so and are not be hampered with regulations and rules that take their time away from their patients.

Grants Pass and Roseburg

By OMA President Carla McKelvey, MD

Jo and I drove from Klamath Falls to Grants Pass last night. We got here at 11 pm and went right to bed. It was a pleasure to wake up this morning and look outside to see the Rogue River off the hotel balcony.

Coos Bay and Grants Pass have much in common. Kim Kozak, DO, an ENT moved from Coos Bay to Grants Pass, and Laurie Hamilton, DO, an OB/Gyn moved from Grants Pass to Coos Bay. The CEO of Bay Area Hospital moved from Grants Pass to Coos Bay. Grants Pass has the amazing Rogue River and we have the powerful Pacific Ocean.

The morning was lovely and we walked along the river from the hotel to where the breakfast was. We had a good turnout of physicians and a good conversation primarily regarding the health transformation that is occurring in Oregon. As in most communities, there are many questions about how the process will work. The legislation that passed is a skeleton and the current workgroups are putting the meat on the bones. It won’t be until the final rules are passed in February that we will know the nuts and bolts of the transformation.

We also talked about the Patient Centered Primary Care Home (PCPCH). In general, the physicians are supportive of the PCPCH, but as one physician put it, “I am about initiatived out!” There are many concerns that while many of these items are well worth the change that it will require more paperwork and the amount of new documentation required will not be worth the financial incentives.

The physicians in Grants Pass seem confident about their ability to approach the future even though there is so little known. It is always great to see doctors who see opportunities in the challenges that we may face.

We moved on to Roseburg for lunch at DCIPA. Once again, there was a good turnout of physicians.

There seemed to be more of a focus on recruiting physicians. This has been a concern in most of the communities that we have visited. One physician stated, “Tell me who will take care of me when I retire.” They indicated that none of the physicians in Roseburg are currently taking new Medicare patients.

We had a good discussion about what motivates medical students to choose their future specialty. Is it the debt that makes them choose a higher paying specialty or is it lifestyle? Is there a belief that primary care has less respect or standing then a specialty field? There is no simple answer but we agree that mentoring and being role models for future doctors is important.

Our next meeting was at Marie Stoddard’s home with her and other Alliance members. The Alliance faces many of the same challenges that the OMA does – a changing demographic. Like the OMA, the Alliance is looking at how to update their structure to reflect their changing membership. The OMA and the OMAA are looking at ways to maintain relevance and vitality as well as reflect the needs of our members.

We spent a lovely evening with Jon and Jeannie Burpee. Jon is a retired ophthalmologist. For dinner we had fresh King Salmon, corn and broccoli from their garden. Fresh food tastes amazing, especially accompanied by the hospitality of the Burpees.

Klamath Falls Road Trip

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.