Nearly 20 years ago, Bruce A. MacLeod demonstrated that he is, indeed, a full-service emergency physician.
Dr. MacLeod, who will be sworn in at the 164th president of the Pennsylvania Medical Society next month, happened to be driving through the Liberty Tunnel one cold morning in January 1994, headed for a meeting, when a Port Authority bus up ahead caught fire.
With a wall of smoke bearing down on him, Dr. MacLeod abandoned his car and made his way to one of the tunnel's emergency doors. And as the smoke overtook fellow commuters, he stayed by the door yelling to the other drivers to follow his voice.
"If it weren't for Dr. MacLeod," said one witness later, "they may not have even found that hole to go through."
Once all were safely out, he reported for duty at Mercy Hospital, where, after washing the soot from his face and hands, he proceeded to treat the people he had guided to safety moments earlier.
Dr. MacLeod, 52, of Mt. Lebanon is not likely to face such unexpected life-threatening episodes in his new post overseeing the near 17,000-member statewide physician's group that advocates for doctors and medical students on various issues at all levels of government. Officers are chosen by a House of Delegates, with individuals serving a year as vice president then president-elect before becoming president.
It seems safe to say, though, that he could be navigating his share of crises, between the ongoing Highmark-UPMC contract dispute and the launch of health exchanges, as well as other still-unfolding implications of the federal Affordable Care Act.
"Bruce is just a really great guy," said John Krah, executive director of the Allegheny County Medical Society who first met Dr. MacLeod 15 years ago when they served on a task force to address the issue of women threatened by domestic violence.
"He is willing to speak up on controversial issues. He falls in the category of, 'We should speak up and represent the concerns of patients.' "
In the war of words between Highmark/Allegheny Health Network and UPMC, few know the combatants as well as Dr. MacLeod.
He chaired the Department of Emergency Medicine at Mercy Hospital from 1993 to 2010, the last two years as part of UPMC after the Pittsburgh health system bought the financially ailing hospital.
He left two years later, he said, because he could not pass up the chance to oversee the reopening of West Penn Hospital's emergency department. But he still talks, and golfs, with his former UPMC colleagues.
Of the two health giants' marketing slugfest, Dr. MacLeod's impression is that physicians on both sides "just wish it wasn't there."
Physicians want to be able to refer patients to physicians based on what's best for the patient, he said, regardless of which system that physician works in or what insurance care the patient carries. And he believes patients want to keep their physician even if the doctor moves to a different health system.
"I think it is obscene how much money is being spent on advertising, by both sides, that could be spent on patient care. It just seems almost petulant."
He added: "I think they both need each other and eventually there will be some agreement worked out.
"There are really smart people in both organizations and I think they hear what's going on, that patients are not pleased with this sort of situation. There are so many people who want this to happen for this not to happen in the long run."
A more intractable concern may be the continuing trend of independent physicians -- estimates now range for 50 to 70 percent of practicing physicians statewide -- who are signing employment contracts with health care organizations, even though he understands why they are doing it.
"The cost of running a private practice has been increasing, while reimbursement over the last 30 years has never kept up with inflation. It doesn't take long for you to realize that this is not sustainable."
But he worries what impact it can have on the physician-patient relationship when physicians have a dual allegiance to the patient and the hospital that employs them.
"Patients want physicians to be independent, to be their health care advocate as they're suffering with their disease," he said. "You want to make sure your physician is making decisions independent of anything other than what is the best thing for the patient."
Steve Twedt: firstname.lastname@example.org or 412-263-1963. First Published September 22, 2013 4:00 AM