As I write this valedictory president's letter, I reflect back on a year that is full of transitions and accomplishments for the Los Angeles County Medical Association.

Transitions occur in every organization and LACMA, both unfortunately and fortunately, has seen more than its fair share over the past five years. We are fortunate because LACMA has transitioned to outstanding and enthusiastic leadership with the coming of our new chief executive officer, Dominick Spatafora, who started in February; as you read this, Dominick will have completed his first 120 days in office.

We often read editorial commentary when the president of the United States completes his first 100 days in office, so I believe it's appropriate to reflect on Dominick's accomplishments during his first 100 days in office, as well as LACMA's accomplishments over the year of my presidency.

First, we brought in a new director of governmental relations, Luis Ayala. He took over a department that functioned well and has brought it to another level of excellence. He coordinated extensive candidate interviews and cemented relationships with elected officials. Since he also serves as Mayor of Alhambra, Luis brought with him a valuable perspective on developing relationships with local leaders who become future state legislators. He reinvigorated our relationship with the County Board of Supervisors and continues to ensure that LACMA is a player on the local political stage.

Second, we hired a new publisher and editor for Southern California Physician, Cheryl England. Cheryl is reworking the magazine's editorial content, style and presence, all of which will become apparent in the next few months.

Finally, my commentary on our new CEO, Dominick Spatafora. Dominick has buckled down, analyzing every aspect of LACMA operations and evaluating activities that either no longer contributed to our mission, or failed to return on the energy we were devoting to them. Toward that end, Dominick and his team at LACMA completed a strategic plan, which was presented to the entire board and all the district presidents during an Excellence in Governance retreat held at my home.

This comprehensive three-year strategic and operation plan takes effect at the conclusion of my presidency, and will guide LACMA activities and priorities for the foreseeable future. As a result of this process, there has been a total restructuring of internal LACMA operations, which is ongoing and which has eliminated internal inefficiencies, thus permitting LACMA to become a leaner, more effective organization.

Our communications have received major attention with the initiation of a bi-weekly Friday update that is sent to the board and district presidents, as well as LACMA Pulse, an e-newsletter that is sent to all members to update them on important community and advocacy issues. If you have not received the e-newsletter, please call LACMA and provide us with your preferred e-mail address. We are in the process of totally revising the LACMA website to make it more functional for all of our internal and external needs, and to use it as a marketing tool for LACMA, showcasing our continuing accomplishments.

Our community presence will be enhanced with the brand new Los Angeles Patient Care Foundation, a 501(c3) charitable foundation, which will allow us to partner with corporations and others wanting to direct dollars to meet the current needs of Los Angeles County physicians and the patients we serve.

We established a partnership with the L.A. City Attorney's Office to pursue inappropriate care denials and to keep insurance companies out of the doctor-patient relationship. As part of this effort, LACMA published the "Patients Know Your Healthcare Rights" flier to ensure that patients have resources to turn to when insurance companies trample on their healthcare.

Our economic advocacy department under the leadership of Socorro Perrins has brought the concrete value of membership to hundreds of individual physicians as she goes to bat for them on a daily basis to correct improper reimbursements received by the physicians from insurance carriers and HMOs.

Finally, I want to close this last president's letter by discussing the real value of your LACMA/CMA membership. After a day at my home discussing what benefits we can provide for members, it dawned on me that insurance discounts, credit card discounts, bank benefit programs and a variety of other assorted frippery are not what provides the true value our members seek or need. Our most potent value is the value of representing physicians before legislative and regulatory bodies. The value of membership lies in the advocacy that LACMA and CMA perform on a continuing daily basis in legislators' offices and in the legislature's hallways. The value of membership is the role we play in ensuring that physicians are not further damaged by legislation and rules.

Physicians need to get this message. Without a potent general medical association, there will not be a single group that represents physician interests effectively and powerfully. Then, soon enough, physicians will have no representation and our situation will become much worse. Members must get the word out to their fellow doctors that they are hurting themselves by failing to join LACMA and CMA.

Advocacy is the most important critical benefit of belonging to this organization, and if we don't see a spike in membership soon, then LACMA and ultimately CMA will fail and we will have no one speaking out on our behalf. At that point, we will deserve what we get.

My last words as president, and my charge to each of you, is to recruit one new member each. Just one and the power of our organization will increase immeasurably, and your benefit will be far greater than another rental car discount! Thank you for allowing me to serve as your president this year.