By George Trajtenberg, M.D.

President of the Chester County Medical Society

• Introduction
• Physician Unions
• Physician Organizations
• Physician-Owned Insurers
• National Health Insurance

• React to this article in the Discussion Forum.

It is ironic that with all this tremendous frenzy for controlling costs and managing care, we have not reduced the cost of medicine or improved it. We just have created a brand new industry of managed care for unemployed MBAs, administrators, attorneys, nurses, and some docs, but the patients have suffered the financial cuts together with physicians and hospitals.

No one but physicians can practice medicine, treat patients or prescribe medications, and they should be the leaders of any changes. We are the ultimate patient advocates, we are the most trusted part of the equation. Maybe it was necessary to get to this point in order for physicians to wake up.

Unfortunately some physicians panicked and sold their practices to hospital groups or to Wall Street, and it will be very difficult for them to lead or be part of the change, unless their employers let them do so. In reality they have sold more than their practices, they have sold their choices for the future. Some of them went for the big dollar sign and suffered from "mural dyslexia" or the inability to read the writing on the wall.

So the future of medicine in our area resides on the independent practitioners, physicians must get together, remain independent and develop a physician-driven enterprise, they must negotiate from strength, be payors neutral, systems neutral, and be able to provide the best medical care that our communities deserve.

Physicians can do it, combining what we have learned from managed care with our intellectual skills, high ethical standards, and public support we can turn this situation around for the benefit of all.