Year’s End Report

Robert P. Roca, M.D.

At the Board of Governor’s dinner last week Gary Pushkin referred to how much he had enjoyed being president, and I knew what he was talking about.  Part of the fun is having the presidential cane in your possession and thinking about where it has been and whose has held it during the past 60 years.  Part of it is the privilege of being the official face of medicine in our county and meeting people who respect what and whom you represent.  A big part of it of course is having a chance to break some new ground and plant a few seeds of your own choosing.   

And we did plant a few seeds.  Last spring, we worked with MedChi to produce the first survey of senior residents leaving training to find out if they were staying in Maryland and, if not, why not.  We got about one hundred responses and learned that the current crop of residents was overwhelmingly seeking employed arrangements with hospitals or group practices; very few were opting for solo private practice.  We also learned that half of our residents were leaving Maryland, often because they found better financial opportunities elsewhere.  We told this story numerous times and got the attention of state legislators and county officials.  Hopefully this will bear fruit in the near future, perhaps in the form of support for student loan repayment assistance programs for young physicians who make the choice to stay in Maryland.  We are doing the survey again this year and plan to carry the message once again to Annapolis.  

During the summer we hosted a dinner gathering with colleagues in the component leadership from Baltimore City, Anne Arundel, Harford County, and Howard Counties, and at this dinner we agreed that we should help MedChi reconfigure the leadership succession process so that younger members would have a shot at getting involved.  We were able to come up with several ideas which were put into a resolution for the April House of Delegates.  The ideas embodied in the resolution have been referred to the MedChi Membership Committee, of which Dick is a member.   We’ll be very interested to see how this plays out over the year to come.   

Of great interest to me at the beginning of my tenure was the enhancement of communication and coordination among physicians.  This is a big issue that will require big solutions.  But this spring we are taking a small step in the right direction by setting up what we are calling the Primary Care Physician Help Line.  This is a listserv linking primary care physicians who are members of the BCMA with psychiatrists who are members of the Maryland Psychiatric Society.   Primary care physicians are often the only source of care for people with psychiatric disorders - because there are simply not enough psychiatrists.   Similarly, psychiatrists may be the only physicians who are seen by some people with serious mental illness – because such patients may have trouble navigating the health care system.  The purpose of the new listserv is to make psychiatrists and primary care physicians rapidly available to each other for mutual support, education and advice, for our sake and the sake of our patients.  If this listserv proves useful, we will consider opening it to a wider group of physician members.    

At the beginning of my tenure I also was interested in trying to enhance our ability to help colleagues in distress.  I took this up in one newsletter article called “Breaking the Silence” and had the privilege of joining a panel discussing related issues under the auspices of the Center for Healthy Maryland at the invitation of Michael Llufrio and Tom Allen.  This experience reinforced for me what a great resource we have in the Physician Health Program and I hope in the next year to see what might be done to extend its reach and increase its availability to colleagues in need. 

When I think back on this year I’ll remember these projects.  But I will also remember a few personal milestones.  I will remember last year’s annual meeting at the Forbush School in the frozen reaches of northern Baltimore County on a night when the local water main failed.  This was also the occasion on which my son and his fiancée asked me to officiate at their wedding scheduled for October 2010.  So this was the year I was ordained on-line by American Marriage Ministries, and with my son and daughter–in–law, wrote a wedding service that was played out in the dark under the starry dome of the planetarium in the Science Center. 

This was also the year I developed an acute abdomen, took a bumpy ride to the ER in my wife’s Mini, and had an emergency appendectomy.  As many of you know, I was very successfully treated at a hospital in Baltimore County.  I emerged from that experience proud and happy to be a physician in this county.  And of course very thankful for the quality of the care I received.    

I would like to close on this theme of gratitude.  Thanks to all of you for the privilege of being president of this Association.  Thanks to Gary for handing the Association to me in good shape and thanks for his leadership of the BCMA Board.  I look forward to working with Gary next year in his capacity as BCMA Trustee to the MedChi Board.  Thanks to my wife, Breon, for her companionship and her astute counsel.  

Finally, thanks to the staff.   Thanks to Josette for her able assistance throughout the year.  And of course thanks to our executive director, Neilson Andrews.  I don’t know where to begin thanking you because you do so much.  But a special thanks for your work on the Newsletter, and in particular thank you for your help producing the President’s letter.  You were invaluable as an editor but also as a source of ideas and inspiration.  In fact when I think of you in this role, the image that comes to mind is that of a MUSE.  You are the Muse of the BCMA.  As you recall, the original 9 Muses were daughters of Zeus, conceived on nine consecutive nights. They were seen as sources of creative inspiration to musicians, visual artists, and writers.  They are often portrayed in classical art as lovely women in diaphanous gowns plucking a lyre or carrying rolls of parchment.  I didn’t know where to go to find a lyre, but I did have access to parchment.  So Neilson I have something for you here in parchment.   Here is a folder; on the cover it says To Neilson, the Tenth Muse.  Inside are two parchment documents.  On the left is a poem by the great poet William Blake entitled “To the Muses.”  It’s rather long, so I won’t read it.  It’s a lament by someone who has lost touch with his Muse and has lost his creative spark.  On the right is a short poem by an anonymous poet, and I will read this.  It is entitled, “To Neilson, the tenth muse.” 

With artful plucking of the ancient lyre

Many a President’s letter did you inspire. 

Your sweet voice and editorial imagination 

Always overcame presidential procrastination.

Heaven help whoever’s President when you retire.