The seasons of life are seasons of opportunity

AMA Leader Commentary. By Duane M. Cady, MD, May 1, 2006.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all physicians from the chair of the AMA Board of Trustees, Duane M. Cady, MD.

Last month I had the privilege of returning to my alma mater to receive an award and talk with students, faculty and alumni about the changes and challenges we all share.

I quickly realized that, as a member of the Class of 1955 at Atlantic Union College, had I heard a comparable talk from someone my age as a freshman (in 1951); that speaker would have been a member of the Class of 1901.

Kind of humbling in one sense. But it was a special reminder to me of the rapidity of life, of the speed with which we travel through the seasons of life.

We talked about that and about the changes the college has experienced in a recent renaissance inspired by financial straits of a few years ago. The college has rebounded from hard times -- financially and in terms of its accreditation -- through a combination of hard work, teamwork and focus on the basics.

As a consequence, those challenges proved a powerful stimulus to increase significantly the value of an Atlantic Union College degree.

When King Solomon spoke of the various seasons of life, he spoke of a time to plant and a time to uproot, a time to tear down and a time to build up. For the college, the building-up period continues as it prepares students for their roles of service in the decades ahead.

This seems to me to be a worthwhile observation on the role of medicine in society today as well. All of the challenges we face -- from medical liability issues to physician payment snarls to our work to consistently improve the quality of care and patient safety -- are positive inspirations. And the beneficiaries are our patients.

When my freshman year opened, the average life expectancy of Americans was 68 years, 5 months. Today it's 77 years, 7 months.

No one can put a dollar or a human interest value on the 13% increase in life expectancy, on the increased quality of life nine additional years makes, especially when preventive medicine and better treatment for chronic illnesses among our seniors makes those advanced years healthier years.

In our discussions with policy-makers, lawmakers, business leaders and the general public, we consistently point out the enormous value the U.S. health care system delivers day in and day out, year in and year out.

Our critics point out that one out of every six dollars of the gross domestic product goes for health care, highest among the nations of the world. They point out that our health indices aren't the best in the world (ignoring discrepancies in the ways other countries gather their data). They focus on the glass being half empty.

My response: What about the alternative viewpoint? What about the fact that individuals prize their health as the most personal of private properties? That they choose to spend one-sixth of their product on health care? That trust levels patients hold for their physicians consistently run in the 85-90 percentage range?

So there is a season for criticizing and for appreciating as well.

As we struggle to modify and fine-tune a $1.9-trillion-a-year industry, we ought never to lose sight of the enormous good the system delivers, the enormous changes it routinely adapts to and the enormous, unquantified dedication of professionals at every level of the system.

Ours is the envy of the world. Warts and all, American medicine sets a pace unequalled worldwide and unequalled in the history of medicine.

We will find solutions to the nagging issues of our day. My hope is that we have the foresight to resolve issues in such ways that unintended consequences won't come to haunt or distract us, in the days to come.

In many ways, today's fledgling medical students are on the threshold of incredible change and incredible service to their fellow Americans.

And it is incumbent on each of us to attract into medicine the brightest minds and greatest achievers among our young men and women.

I also had the opportunity last month to talk to a group of gifted high school chemistry students. I was honored to be invited and used the opportunity to point out that a premed curriculum might not lead each of them into medicine. But, at the very least, it would sharpen their minds, provide a focus for their studies and improve their study habits.

And, should a medical career prove right for them, they would be entering the most challenging and rewarding, most scientific and humanitarian career possible with rewards in the 21st century that will doubtless exceed those my generation found in the 20th.

I encourage you to seek and accept opportunities to talk with students of all sorts. They not only are the bright hope for the future but also the rank and file of our patient activism in the days ahead.

Dr. Cady, a general surgeon who was in private practice for 35 years in Syracuse, N.Y., was chair of the AMA Board of Trustees during 2005-06.