In her editorial, Nancy S. Reau, MD, FAASLD, AGAF, provides an impassioned plea for us to engage in activities that re-establish control of our profession and our practices. Her instructions are simple: Become informed; become involved. Most of us struggle daily with finding time to balance the flood of demands on our time at work and at home. Adding yet another set of activities to the mix likely feels overwhelming.
Yet, on our part, a collective failure to act virtually assures the trends of the last 3 decades will continue. The loss of control over our practices, the uncertainty regarding reimbursements for our professional activities, the opaque nature of drug pricing and the inability to predict when we will encounter the next ‘prior authorization’ request (or not) are all the result of a chaotic system that is only becoming more fragmented and chaotic.
The beneficiaries of the chaos do not want the system to change, and certainly do not welcome the thought of our involvement. Indeed, the reason the current system evolved the way it has is precisely because we, as providers, were consumed with our day-to-day practices and did not carve out time to engage in the dialog. As a result, we have lost our collective voice. And in the vacuum of our silence has emerged a system that serves those beneficiaries of chaos, certainly not the patients nor the providers.
Whether we like it or not, we need to become engaged. Now. As individuals, we can readily become informed, with help from our respective professional societies and/or through visits to reputable websites (e.g., Kaiser Family Foundation). Once informed, we need to become actively involved in efforts to communicate our vision of how the chaotic system should be reformed to serve patients first. That is truly a way to put “America First.” If we place patients first, everyone benefits: Patients, their families and, for sure, their providers. And after all, at some time in our lives, we are all patients, too.
During the early days of the AIDS epidemic, amidst the death and dying and hopelessness, the activists coined a phrase: “Silence = Death.” In my mind, this refrain applies to all of us as providers. Continued silence from us perpetrates the chaos that does not serve the patients nor us. We all need to, collectively, become active in this cause. Become activists. End the silence and make sure our collective voice is heard.
Michael S. Saag, MD
Co-Chief Medical Editor
Disclosure: Saag reports no relevant financial disclosures.