Celebrating our past while preparing for our future
This issue of San Antonio Medicine is dedicated to our city's tricentennial celebration. As I have stated before, it is an honor to be BCMS President. It is an even greater honor to be president during our city's tricentennial celebration. As mentioned by Dr. Fred Olin later in this issue, there will be a symposium on the morning of May 12, 2018 discussing the evolution of health care in San Antonio over the past 300 years. It promises to be a fascinating discussion with a luncheon keynote address by Henry Cisneros. I encourage all to attend.
This issue contains outstanding discussions of how medicine evolved in San Antonio and specific physicians that played key roles. From today's perspective, we look back 200 or 300 years ago and can only view medical treatments from that era as rudimentary and at times barbaric. We have to force ourselves to remember that antibiotics were a product of the 20th century. Prior to this, fever from a bacterial infection was often fatal. If we compare medical care from 300 years ago to our present age of organ transplantation, genetic diagnosis and treatment of previously fatal diseases, laparoscopic and robotic approach to surgery, and the many other advances, it is nothing less than astounding. I recently saw a 2 monthold infant in my practice with a degenerative condition involving spinal muscular atrophy. This condition, known as Werdnig-Hoffman disease, had been uniformly fatal up until the last two or three years. There are now two different genetic approaches to actually repairing the faulty DNA and curing a previously incurable genetic disease. As physicians, we often complain about the weaknesses in our health care system. We complain about managed care, increasing bureaucratic load, maintenance of certification, and many other challenges dealt with on a daily basis. It is easy to forget exactly how much progress has been made during our lifetimes. It is astounding to see how much progress has been made over the past 300 years. It makes one wonder what medicine will be like 300 years into the future.
As a county medical society, we should also be concerned with what our health care system will look like over the following centuries and what role physicians will play in an increasingly complex society. As I mentioned above, there are new genetic treatments available to previously fatal conditions. Their cost is in the hundreds of thousands of dollars. This raises the question of how do we finance these incredible but hugely expensive treatments for a small number of people? Will physicians continue to be the captain of the ship? What role will physician extenders play and how will they fit into the administrative management of health care? These are critical questions that will largely determine the health care environment of the future.
Will we continue to have a pluralistic health care system where people have a cafeteria-style option of plans to choose from? Will we, like other countries, move to a single health care payer system run by the government? There are countless other issues we cannot even imagine that will without question impact our health care delivery in this country.
At the same time that I learn how health care has evolved in San Antonio, I also look to the future and hope that our community will play a major role in health care research, health care delivery, and health care education. I am optimistic about health care and the role of physicians in years to come. As always, I welcome the thoughts and opinions of colleagues in San Antonio with regards to our past, present, and future.
Sheldon Gross, MD
Sheldon G. Gross, MD, is the 2018 president of the Bexar County Medical Society.