But it’s the worst of times in that it’s a period of extraordinary frustration for physicians. [They are] trying to not only keep on top of what is going on with these dramatic changes and with what’s happening to providers, but also trying to make a difference and to help shape it so that patients get the best possible care. We find ourselves between government’s antitrust regulations and between labor laws that have become outmoded. With the new structure of delivery of care, we are relatively disenfranchised, despite excellent membership in our organization.

This frustration is at all levels. We are finding our most experienced physicians, whether they be academic or in private practice, seeking early retirement, cutting back on their work, looking for a way out. It is discouraging young college students from going into the field, which if this continues, will lower the intellectual and talent pool of the physician population. To those who are just coming into this field, some of their idealism about spending plenty of time with patients and doing what is best for the patient is being rubbed off very quickly by some of the business principles that are difficult to understand from a physician point of view.

We’d like to think, like everyone else here, that we are the last denominator of advocate of patients. No one else at this table feels otherwise, I am sure. But when we have sick and ill patients, we are the ones who are there talking to them, who take responsibility, who wish to make them better and who keep them well.