A MESSAGE FROM OUR PRESIDENT

We cannot afford to wait

ABOUT THE AUTHOR Cyrus Fram Buhari, DO is the current president of the San Joaquin Medical Society and practices at the San Joaquin Cardiology Medical Group Every other year it seems as if we go through a political cycle. One party is up and the other party is down. It’s so sensational and vapid that many physicians such as myself try very hard to drown it out. But no matter which party is in power, it seems that the voices of physicians go unheard unless there is political gain from some legislative action. I am hopeful that this cycle will be different, but I am used to disappointment by now.

For years the physicians of our community have been delivering care to the people of our community at a discount while improving quality and outcomes. There has been no meaningful increase in reimbursement to primary care, specialty, or surgery that can even come close to matching inflation and the cost to deliver this care. Physician practices have long suffered financially under the burdens of the Affordable Care Act as well as draconian Centers for Medicare and Medicaid Services (CMS) cuts that only serve to punish physician practices and reduce access to care. I recognize that these cuts are made through some warped sense of maintaining budget neutrality in order to have the appearance that our legislators are efficient stewards of our tax dollars.

However, despite this we see billions (if not trillions) of dollars being spent on our behalf that do not translate into improvement in the lives of the members of our community. No matter which party you support, or which party is in power, an immense amount of wasteful spending is in every single bill signed into law. Would it be too inflammatory to suggest that for every dollar spent on foreign aid or the military, that a matching dollar be spent on healthcare for the patients of our community? Without impugning the motives of our elected leaders, I respectfully urge them to listen to and take an interest in our concerns.

CMS is poised to enact cuts in 2023 that will result in Medicare payment cuts to over 90% of medical practices. It seems both asinine and punitive at the same

time. If the goals are to increase access to care, improve the quality of that care, and facilitate delivery of care to our community, then how can these cuts be seen as positive toward those ends? The cost of living has risen for us all and every physician practice that I am in touch with has given their employees cost of living increases to the extent that they can financially bear it.

California Medical Association and the San Joaquin Medical Society are working hard to lobby for the delay of these cuts in the CMS Physician Fee Schedule rule. If we can get our elected leaders to listen and act on this, it will be a start. But not only will these cuts send physicians into early retirement, they will serve as a negative incentive to move to underserved areas or areas where the cost of living is oppressive. Not only should these cuts be eliminated, but there should also be a push for increased reimbursement and a cost of living adjustment that matches inflation.

ANY reduction in payments to physicians from CMS (and insurers who will closely follow suit) will reduce access to care and result in harm to the patients of our community. I remain hopeful that common sense and compassion will prevail. We as physicians need to make our voices heard to elected leaders and to our patients whose precious votes they desire. The San Joaquin Medical Society has been speaking with a loud voice at both the local, state, and national level but we cannot push for these changes without the strong support of our membership. I urge all of you to push our friends and colleagues to renew their memberships and join us in the fight ahead. Thank you.