Louisville Medicine Volume 66, Issue 4 | Page 7

From the President Wayne Tuckson, MD GLMS President | [email protected] YES, WE ARE Still Relevant T hose of you who remember the cortical homunculus will recall the outsized representation for the hand. This representation reflected the amount of corti- cal resources dedicated to maintaining the functions of the hand, which I’m sure our colleagues in hand surgery will say accu- rately reflects the importance of the hands, and them. When I rotated through surgery as a third-year student in the late 1970’s, the in- structor, whose charge was to prepare us for the operating room and its environment, pre- sented us with a variation on the homunculus that was unabashedly skewed towards a sur- gical perspective. This homunculus depicted an operating room in which the surgeon, like Godzilla standing over Tokyo, towered over the operating room, and all others within it. The health care team has traditionally included physicians, nurses, allied health workers, physicians’ assistants, pharmacists, social workers and hospital administrators. It was by virtue of our training and study that we, the physicians, were given authority and responsibility over the development and execution of health care policy and practices. There was a dialogue between physicians and other members of the health care team, but it was more one sided with physicians speaking to the various stakeholders. As Bob Dylan sang, “Times, they are a’changin’.” Now, we find ourselves in a position not too dissimilar to that faced by Bill Clinton in 1995 when he confronted a political land- scape dominated by Newt Gingrich and “The Contract With America.” Clinton faced a threat to his executive power and the im- portance of the presidency. To this threat, Clinton declared, “I am relevant,” and though things had changed, Clinton succeeded in both re-establishing his importance and that of the presidency. The health care team of today is com- posed of the traditional members, but is now dominated by health care economists, big data specialists, an alphabet soup of gov- ernment agencies, health insurers, hospital administrators and practice managers. In addition to the new players, greater authority has been extended to other members of the team, further diminishing the role of the physician. This is not necessarily a bad thing as the unique perspective of these stakehold- ers gives both a broader and more in-depth understanding of the problems and potential solutions that we all face. However, these changes have altered the nature of the con- versation and who controls the dialogue, if one even exists. patients, be it at the bedside, the office, the operating room, the ER, or anywhere else that we interact with people, we can and must influence and inform their health behaviors and attitudes and make them aware of their roles in the health of the community. When interacting with other members of the health care team, it is our deportment that will, either positively or negatively, impact their behaviors and attitudes. The health care landscape has changed, and this has had an impact upon us. How- ever, there is no going back. Now, more than ever, we must stay engaged and not abdicate either our fate, how we interact with our patients, or the responsibility for the health of our community to others. We remain the best suited to respond to changing health care needs, because after all, this is what we do. Dr. Tuckson is a practicing colon and rectal surgeon. So, we are no longer the coach of the team, but we are still the quarterback and the face of the team. Wherever we encounter SEPTEMBER 2018 5