President’s Message

By Jesse Moss Jr., MD

2011 GREETINGS to all of the Bexar County Medical Society! As I undertake the presidency of the Bexar County Medical Society (Society), I do so with great humility. We have a long line of outstanding presidents in this society and I am honored to be a part of our organization. Our Society has represented Bexar County citizens and physicians at the local, state and national levels on public-health policy legislations, disaster relief and organized medicine. We are 157 years strong!

Before divulging my views on the SGR, a few public health and community issues, or one aspect of the state of our relationship with Mexico, I would like to recognize and discuss the diversity of our community and Society. I’ll start first with The University of Texas Health Science Center at San Antonio (UTHSCSA) and the military training hospitals at the San Antonio Military Medical Center (SAMMC) which includes both the Brooke Army Medical Center (BAMC, now SAMMC-North) and Wilford Hall (WH, now SAMMC-South).

Our Diverse Medical Community

UTHSCSA provides us with an academic center for teaching medical students and residents; and, it offers opportunities for research. The University, with its range of expert physicians in various medical specialties, provides healthcare to our diverse citizens of Bexar County. Likewise, the military medical complex provides care for the active-duty and retired military personnel and their families. It, too, offers research and advanced treatment of extremity injuries and traumatic brain injury while being known worldwide as one of the finest burn research and care centers (BAMC). These same military personnel serve alongside our enlisted men and women who voluntarily defend and protect our rights and freedom.

The private-practice sector of physicians is equally as diversified in ethnicity and medical expertise as our University and military contemporaries—and we are located in the many areas throughout Bexar County to assure easy access to good healthcare for our sizeable community. Like the academicians, we provide clinical research in many of the private practice environments. There is much discussion currently about “cultural competence” because it typically refers to physicians understanding the culture of and being able to communicate with patients in an acceptable and professional manner. In my northeast corner of San Antonio, there are representatives from at least 10 different countries and at least 12 different cultures. We learn from each other, and this allows us to provide the unique care that may be needed by some of our patients. Therefore, the diversified needs of Bexar County residents is more often than not met by its diversified physicians living in and practicing healthcare within our community.

The Sustainable Growth Rate (SGR)

The ridiculous Sustainable Growth Rate (SGR) mechanism, created in 1997, has continued to be a flawed system that has significantly affected the income of physicians. Both major political parties have treated physicians with total disrespect and this cumbersome, draconian system has done nothing but reap havoc on physicians’ ability to practice medicine. It has directly caused access problems for the Medicare, TRICARE and Medicaid patients. All physicians must unite to replace the Sustainable Growth Rate formula immediately. I am not asking you to give up your political party’s affiliations or your philosophies concerning our government. I am asking you to hold your respective party accountable for the ridiculous situation that we, in medicine, find ourselves. We must all be united on this issue; otherwise, we will continue to be fragmented, disrespected and forced to go out of business. As you well know, many physicians have found themselves in embarrassing financial situations and have found it more beneficial to work for corporate organizations.

What Plagues Our Communities

In three recent articles by Jesse Washington, published in the Washington Post, L. Natalie Carroll, MD pointed out that 72 percent of black children are born to unwed mothers in the United States. Hispanics are at a rate of 66 percent, whites at a rate of 29 percent, and Asians at a rate 17 percent (according to 2008 data). Statistics show that children of unwed mothers are more likely to perform poorly in school, go to prison, use drugs, and have their own children out of wedlock. Worse even, the state of Texas is 50th in US when it comes to the highest neonatal and maternal morbidity and mortality rates.

Some suggest that this is part of a legacy of segregation where blacks are more likely to attend inferior-rated schools. It also involves black men who are disproportionately imprisoned. The workforce shortage has disproportionately affected the black community even more. HIV infection rates affect one in every 22 blacks, one in every 46 Hispanics, and one out of every two whites. More alarming is the fact that most don’t know that they’re infected.

Mexico’s Plague

It is time that we step up to the plate and recognize the atrocities committed to our citizens and fellow physicians in the southern part of Texas—particularly along the border. Innocent people are being traumatized, killed and frightened by drug war thugs. Difficulties are being encountered in recruiting physicians to these areas, causing access problems for the patients living along our border. The drug cartel war that is raging in Mexico would not exist if it weren't for the drug addicts and drug users in the U.S. Those purchasing illegal drugs in the U.S. are directly contributing to the drug cartel wars. This is not just Mexico's problem; it is a United States and Mexico problem. The drug cartels are trying to protect routes for smuggling drugs into the U.S., one of the most lucrative businesses that exists. We need to hold the states’ and federal government’s feet to the fire. They must be held accountable for their omissions and co-missions that are a lack of sufficient actions in controlling these unnecessary deaths. If the state and federal government do not get control of this border problem, the carnage only continue to spread in a northerly direction. We need action now! For detailed information, visit the helpstopborderviolence.com website supported by the Border Health Caucus, the U.S.-Mexico Border Health Commission, HHS Secretary Kathleen Sebelius, and a myriad of physicians and health professionals who not only recognize the problems, but are taking steps to ensure awareness of the problems’ effect on the U.S. and Mexico.

Other Focus Items of Your BCMS President

I will dutifully execute the precepts (instructions/guidelines) given me by the Board of Directors. In view of the fact that real estate prices are depressed, if a unique opportunity were to present itself, we might entertain purchasing a home for our Society. Our first responsibility is to maintain this outstanding organization. We will continue efforts to increase our membership by including our hospitalists and other primarily hospital-based physicians. We would love to increase our membership at the UTHSCSA. We must also maintain and continue to build on our sister city relationships with Kumamoto, Japan and Chennai, India. Currently, delegation members are being actively recruited as well as the 2011 BCMS International Affairs Committee being established anew.