Leading with Enthusiasm 2017 Goals to Manage Change

I am incredibly honored and humbled to become the 111th President of the Washoe County Medical Society. In the words of Jack Harbaugh, father of football coaches Jim and John Harbaugh, I will attack this next year with an “enthusiasm unknown to mankind.”

Please indulge me as I recognize two physicians who have been incredibly influential to me. First is Dr. Tom Schwenk who was chairman of family medicine when I was fortunate to attend the University of Michigan Medical School. As a young medical student, awash in a sea of esoteric diseases and tertiary care specialists, Dr. Schwenk and the faculty and staff in his department enlightened me about the importance of family medicine and of community. At a school like Michigan, one of the largest public institutions in the country, that was an extremely challenging task.

When I was deciding if I should go into family medicine, I vividly remember Dr. Schwenk taking the time to meet with me. When I walked out of that office, I knew with certainty that family medicine was for me. I was a tuba player in school and I see family medicine docs as sort of the tuba players of the medical field: we may not get the fanfare of the soloist but we are the foundation, the base that is needed for everything else to work in synchronicity.

The second physician is my dad. When people find out my dad is a child psychiatrist, they often ask what it was like being the child of a child psychiatrist. Like those of you who grew up in a medical household, it never occurred to me that it was any different from any other family. Phone calls in the middle of the night, or my dad getting paged and having to stop at payphones in some very sketchy areas of Detroit just seemed kind of normal. It’s only years later that I fully realized how much his dedication to his patients, and the importance of continuity with his patients, rubbed off on me.

So, Dr. Schwenk and Padre, thank you.

Change is the One Constant

As we start 2017, change remains the constant. At our local level, WCMS continues to change. After 25 years of service, our incredible executive director Jeanie Catterson has stepped down. We certainly are going to miss Jeanie’s hard work, talent and dedication. Our board is working closely with our new executive director, Mary Ann McCauley to ensure a smooth transition.

In partnership with NSMA and the great leadership of Dr. Don Havins and Catherine O’Mara, we’re excited about developing new programs to help physicians care for our patients and our community. We’re also gearing up for the upcoming state legislative session. We are anticipating the legislation that will affect how we practice medicine, and this includes Gov. Brian Sandoval’s task force on prescription narcotics.

At the national level, in light of the presidential elections, the medical community will once again be facing uncertainty. The Affordable Care Act is going to be changed or repealed or replaced. When and how and with what is still an unknown. How these changes will affect us, and more importantly, how these changes will affect our patients and the health of our community, is also unknown.

So how do we face these challenges? As many of you know, as part of my practice, I am fortunate to work with some incredible athletes and coaches. It’s a very rewarding part of my work because we all learn from each other. One concept I’ve heard over and over from coaches and athletes, is that when the game or the race gets to crunch time, that’s when it’s most important to focus on the fundamentals.

Because what I’ve learned from my dad, Dr. Schwenk, my mentors and from all of you, my fellow WCMS physicians, I feel we have three fundamental guiding principles as physicians. I am going to paste these to my wall to ensure anything WCMS does improves one or more of these principles.

1. Caring directly for our patients. WCMS physicians and our staff are incredible. I’d put the care we provide our patients up against any other community and I’m confident that we will continue to look for ways to continue to improve.
2. Improving the health of our community. I’ve borrowed this from a number of talks I’ve heard, but what good is it to “fix” an illness or injury in our office or in the hospital, only to have our patient return to the environment that created the problem? Have we really fixed the medical condition? What can we do to improve conditions in our community so our patients stay healthy and don’t need our care?
3. Advancing the art, craft and science of medicine and passing this knowledge on to the next generation of physicians.

2017 Goals

So how do we go about doing this?
Specific goals I have for 2017 include:

• Work with the state medical society to update our website, membership database and social media presence. We need to create means for providers and practices to learn from each other even when we can’t be face-to-face. We also need to continue communicating to physicians and the community about what WCMS and NSMA are doing to improve working conditions for physicians in Nevada and in turn, improving patient care.
• Create public seminars to address the medical issues our community feels are important to them. With social media and “Dr. Google”, our patients are often getting pretty bad advice from untrustworthy non-scientific sources. Our community knows and trusts our physicians when we see them in our offices and hospitals. That’s a start but we need to reach out at public events and through social media to showcase our expertise and promote medicine based on the most up to date scientific literature.
• Continue to get more employed physicians involved with WCMS and create forums to address the issues they specifically face. We are very excited about having all of the physicians from Saint Mary’s Medical Group join WCMS this year. We want to continue our dialog with Renown, Northern Nevada and the University of Nevada Reno School of Medicine to increase membership for employed physicians and make sure the voices of employed physicians are heard at the county, state and federal levels.
• Continue recognizing the importance of independent practices. Independent practices, which provide a considerable amount of care, have the ability to quickly adjust and adapt. Many of these practices, including my own, are going to need to learn how to partner with ACOs and other larger organizations to take on the challenges of MIPS and MACRA. WCMS and NSMA are working hard, as evidenced by our recent seminar that Dr. Steve Phillips helped organized, to make sure this happens.
• Work closely with Dr. Schwenk and University of Nevada Reno School of Medicine. It’s not often that you have an opportunity to pay back an incredible teacher. With the changes happening at the School of Medicine, the next few years are critical for increasing clinical teaching capacity. WCMS has an incredible pool of talented, knowledgeable physicians with a wealth of clinical experience. The medical school needs our help and we need to increase the pipeline of providers for our practices. As president, I look forward to seeing how WCMS can partner with the University to teach the next generation of physicians and physician assistants.

In addition, I’d also like for us to work with the School of Medicine to expand clinical research capacity in our community. In a seminal paper by Dr. Kerr White, and replicated years later by Dr. Larry Green, out of a population of 1,000 people, only 1 person will end up at a tertiary care center for care. Yet, much of our medical research traditionally has been done at tertiary care centers. This is why we need to continue to push to get research out of the ivory towers and into the community, like Northern Nevada, where most people get their care.

Last and certainly not least, I want to reach out to many of the incredible community organizations that are already doing great work in Washoe County and see how we can work hand-in-hand with them for the benefit of our community. Many of these organizations help our most vulnerable populations and particularly right now, they need our support.

In closing, a moment like our recent inaugural dinner not only makes me excited for the future, it also presents an opportunity to take a quick look back and see what lessons I’ve learned. My first real leadership position was being chosen as the drum major of the Rochester Adams Highlander Marching Band. I learned a lot of lessons, the first being how to have a good sense of humor: As a 16 year old Polish kid wearing a kilt, I got a lot of ribbing!

More importantly, I learned that the drum major had to create an environment where my fellow students could have pride in their band, have fun, and know that their hard work was paying off for the good of the band. I also quickly discovered that to be an effective leader, I sometimes had to put the goals of the band ahead my own personal goals. Or as legendary Michigan Football coach Bo Schembechler so succinctly put it, “The Team, the Team, the Team.” I know what an incredibly hard-working, intelligent and dedicated medical community we have in Northern Nevada. I will humbly do my best to represent the team ...the team ...the
team ...in the upcoming year.