This 115th year of the Riverside County Medical Association promises to be a challenging but exciting time. I'm humbled and proud to take my turn at the helm for 2008. Given what many see ahead, this year may look like it will be a long, tiring slog through late-night meetings and countless battles with little to cheer about. Yet, when taken in proper perspective, it's a small, and exciting, slice of our long journey forward, which began in 1893. As this year begins, I am struck by the wit, wisdom, and courage of previous RCMA presidents as they faced the diverse problems of their time.

Our first president, Dr. Cary Judson Gill, was born in New Jersey in 1836. He grew up in Illinois, worked as a school teacher and served in the Civil War. A graduate of Rush Medical College, he established his practice in Riverside (at the corner of 8th and Orange) in 1876. He was the driving force behind the establishment of the RCMA in 1893, and instrumental in organizing Riverside's first hospital in 1905.

Our 50th President in 1942 was Dr. Raymond Johnson. After graduating from the University of Oklahoma's School of Medicine, he began practice in Corona 1932. He served as Medical Staff President at Riverside Community Hospital in 1937 and again at Riverside County General Hospital in 1939. He resigned his presidential duties to serve as Captain in the Army Medical Corps and saw action in North Africa and Italy, and survived to return to practice in Corona.

In 1965 we were guided through the intrusion of a very controversial government healthcare program called "Medicare" by Dr. John Ivanoff. Medicare truly represented a paradigm shift in this country's healthcare and has served to help and haunt us over the years.

In 1975 Dr. Carl Wolnisty led us through another bumpy time that included the California medical malpractice crisis and our "life saving" and still crucially important MICRA legislation. It remains a model of malpractice reform that works, but it is also a constant target of California's trial lawyers who continue to pick away at it, ultimately hoping to bring it down.

I chuckled at the statements of our 100th president, Dr. Harris Kanel, not because they were funny, but because they seemed ripped from today's headlines: threats and promises of healthcare reform, malpractice reform, insurance reform, managed care problems, the increasing number of uninsured patients, loss of autonomy in patient care, physician disillusionment, and the seeds of apathy.

I go through this history lesson to make a point-that we as physicians and especially as physicians in the RCMA- are bonded by location, common interests, those who came before us, and those special rights-of-passage that we all survived to become physicians. We need to treasure these connections, and to remember "who we are". We must strengthen and expand our bonds as we wade into the tumultuous social and healthcare challenges ahead.

We are constantly assaulted by increasing demands, decreasing autonomy in patient care, insufficient time, and ever reducing returns for our labor. Each one of us can personally testify to this. Over the last 50 years, we just worked harder to try to dig ourselves out of the ever deepening hole, but as fewer successes came our way we lost confidence, our motivation ebbed, and morale plummeted. But apathy only ensures our demise.

Despite such a less-than-spectacular recent history for the practice of medicine, I look forward to the challenges of the coming year. Why am I optimistic? I believe we've already started on the comeback trail.
We have the absolute best leadership team in place. Joe Dunn and his outstanding staff in Sacramento, Dr. Richard Frankenstein, Dr. Dev Ganadev, Dr. Brennan Cassidy and countless others in CMA leadership. Our own Dr. Steve Larson is on the CMA Board of Trustees and Dr. Rebecca Patchin is on the AMA Board of Trustees. We're building on an unprecedented year of state legislative successes in 2007 where all the CMA backed bills passed and those we opposed failed. We pushed the 2% physician tax off the bargaining table. In addition, RCMA membership is up 10% from 2 years ago and we have new medical school coming to UC Riverside-the first new medical school in the US in over 40 yrs!
Future successes, however, require physician commitment. I call on all RCMA members to become more involved, and for all non-members to join this winning physician "self-help" organization. It's an investment in your future.

In the words of one of my favorite historical figures, Winston Churchill: "Success is not final, failure is not fatal, what counts is the will to carry on." And that's what we must do in the coming year because together we are stronger!