Dr. Paul DeHaan, MD-11th District Trustee, Illinois State Medical Society
Herd Immunity and Organized Medicine
I’d like to talk with you about a concept that is familiar to us from our work, but also applies to the big picture view of medicine. We all understand the idea of herd immunity, in which threats to a group can be minimized if the majority of its members are protected, thereby conferring passive protection to the otherwise unprotected members. We know how important it is in an immunization program to maintain the participation of as many members of the community as possible, and that the inevitable few outliers will still benefit from the responsible behavior of the majority.
There is a striking parallel between getting your flu shot and participating in advocacy for our profession. As long as a majority of physicians support their professional organizations, those advocacy efforts can be successful, and those who choose not to participate still benefit from the good work of their peers. When resources are robust, positive legislative efforts like the Prescription Monitoring Program succeed, and bad ideas, such as periodic sweeps of the Medical Disciplinary Fund, can be resisted.
For years, you have listened to us talk in this time slot about a litany of issues that are critical to the wellbeing of our patients and our profession. The details of the day change, but the message stays the same. There must be organized, effective representation from physicians, the leaders of the health care delivery system, to help direct health care policy and legislation in our state. Surely our specialty organizations play a role in this, but none have the resources, the reputation, and the scope of a statewide organization that represents all physicians, all specialties, all demographics, and all practice types. That organization is the Illinois State Medical Society.
The herd immunity we have built up provides great passive benefit to the individual doctor who chooses to withhold his or her support for this effort. As long as enough colleagues participate, the work goes on, and threats from the multitudes of other stakeholders in the world of healthcare are kept reasonably at bay. But this only works if the resources for our advocacy remain strong.
As our profession is changing, physician participation is also changing. The majority of Illinois physicians are now employed, and their outlook and priorities have shifted. I, like most of you, have chosen to leave the onerous aspects of business management to others, in order to focus on the more attractive components of medicine.
The downside of this is that it is easy to delude ourselves into thinking that the challenges facing our profession are now someone else’s problem. Our liability insurance premiums, license renewal fees, and many other thorns in our sides seem to be relieved. It feels as if we can now put in our time at work, and when our shift ends, our cares and concerns end, and somebody else can deal with those other unpleasant realities.
This is where our herd immunity concept fails. Far too many physicians have chosen not to support organized medicine. Membership and dues income are falling, and the resources to push for necessary policy changes – and to resist counterproductive initiatives – are at risk. Just recently, we prevailed when the psychologists wanted to prescribe psychotropic medications with only minimal instruction in pharmacology, and when minimally trained lay midwives wanted to offer home birth services. But both were close calls, and both groups will continue to try to work the system, to obtain by legislation what they have not achieved by education.
Our challenge, it seems, is to connect with today’s physicians and their employers and communicate the value message of advocacy. Although it is impossible for all of us to agree on each and every detail of our work, we must remember that our interests are vastly more parallel than divergent, and membership dues money is an excellent investment. Our medical staff leadership has shown the foresight to support ISMS by offering us this opportunity to reach out to you at quarterly staff meetings, and by supporting our Illinois Medical PAC. We are profoundly grateful for this demonstration of leadership, and we will continue to earn their confidence.
The work of our Society depends on the involvement of members, and on new ideas and new perspectives. Each of us has something to offer, and we need only very little of your time. Becoming involved is easy, and I have found it to be a very rewarding experience. Thanks for your support!