Thank you for the many good wishes and warm welcome back to the Orange County Medical Association. Can you believe it has been five years since I left as your government affairs representative?

This past summer, I spent a lot of time considering whether to pursue the executive director position after Marika Bonner decided to retire. I was very content running my own small corporate consulting firm, working mostly with emergency medicine physicians. I greatly enjoyed lobbying alongside the ER doctors on county reimbursement issues. During my many years in the political arena, I managed high-profile campaigns and staff, and worked under some pretty tight budget restrictions at times. And so after a good deal of soul searching, I decided that change is positive. Hence, my return to the OCMA seemed like a logical choice.

What Is the Future Vision for OCMA?
In the next several months, I will be talking to as many physician members and nonmembers that will allow me a few minutes of their time. Consider this an invitation to share with me your vision for the OCMA.

I have many questions. What are your interests and how can we provide you with additional resources to run your practice, treat your patients and ensure that you have a say in the future of medicine? In your opinion, what are the OCMA's strong points and weaknesses? What kinds of programs would draw you in to participate? Is the association meeting your expectations?

What's at Stake in the Healthcare Reform Debate?
Certainly, the OCMA and the California Medical Association offer many benefits for physicians including legislative advocacy, such as combating the egregious proposal of a 2 percent "fee" on patient revenues. While we commend Gov. Arnold Schwarzenegger for bringing healthcare reform to the forefront of his policy agenda, his proposal is obviously a starting point for discussion. The 2 percent fee is not debatable and we have made that clear.

A dedicated group of OCMA members formed the Orange County Healthcare Reform Committee to request input from local doctors about healthcare reform. Many, many physicians contributed their thoughts and the committee spent hours assimilating the ideas for change. The ideas were then sent to the CMA for further vetting.

In addition to opposing the 2 percent fee, Orange County doctors expressed their strong desire to increase patients' access to insurance, expand mental health benefits, seek cost reductions, and pursue prompt and fair payment to physicians.

The reform committee met locally with Herb Schultz, one of the governor's chief healthcare policy advisors. Schultz admitted he was taken off-guard. He indicated that he had not met with any other group that was so well informed, negating the need for an overview from him to start the discussion. It was a spirited debate and he left, I believe, impressed.

The debate will continue throughout the year. Everyone seems committed to an attempt at real reform this year. The driving force? The upcoming election in 2008. The election will take precedence over any meaningful discussion. So if the issues are not resolved this year, most agree it will end up in the hands of the voters.

To that end, we hope all doctors realize the stakes. This is the first opportunity in a very long time that the issues will be examined to this extent.

The proposed tax alone should convince all nonmembers to join our group. Together, we are stronger. After all, can 1,700 doctors in Orange County be wrong? Of course not, and we can't preach only to the choir, so I hope that all members will speak up to urge their peers to join and participate in the OCMA and CMA.

Thank you for allowing me to work with you!

Michele Revelle is the executive director of the Orange County Medical Association. She can be reached at 714/978-1160 or mrevelle@ocma.org.