I have practiced medicine for more than 40 years, so I have seen many changes--most for the better. And for the past 15 years, I have been involved in leadership at Hoag Memorial Hospital and the Orange County Medical Association. From these endeavors, I have learned that there is much more to medicine than just treating patients, which is, of course, our primary function.

We physicians face many challenges in our healthcare system. The costs of medical care and prescription drugs are rising while access to care for millions of uninsured is decreasing. Flawed Medicare and Medi-Cal reimbursement formulas and numerous problems with health plans and insurers are constant battles for physicians. These represent the biggest and broadest problems that plague medicine today.

No one would dispute wanting a cost-effective healthcare delivery system that would offer universal healthcare, integrated with modern technology and supported by the latest information systems. But the real issue is how this can be achieved. We must focus on solutions.

The one certainty is that solutions will not be delivered to us on a silver platter. Change will only occur if we take the lead to effect the change. Major cultural changes are daunting, but have been accomplished at least twice in the past 50 years in our country.

The first example is the civil rights movement. Five decades ago, a relatively small group of civil rights activists began a movement that effected a significant cultural change that is still evolving. We are all better off today because of their groundbreaking efforts.

The second example is the HIV/AIDS movement. At the outset of the HIV/AIDS epidemic 25 years ago, the medical profession was faced with a new and relentless disease that resulted in the deaths of young Americans in the prime of their lives. The grass-roots activism of AIDS patients, their families, community leaders and healthcare professionals forced the healthcare industry, pharmaceutical companies and the government to find the cause of the disease and fund research and treatments. As we all know, the results of that activism are extraordinary and progress in attacking HIV/AIDS is still ongoing.

The medical profession needs to use the same tools as the grass-roots activists of the civil rights and the HIV/AIDS movements to accomplish the necessary changes to reform our healthcare system. Physicians and other healthcare providers must team up with patients to pressure insurance companies, health plans, pharmaceutical companies, the legal profession, and of course, the government to do the right thing.

Although my term as OCMA president is over this month, I am committed to continuing to pursue change and participating in the community activism that is organized medicine's main strength. Thank you for the opportunity to serve.