During the past few months I have been reflecting on why the nursing association was successful in having its demands met, and why the teachers union was able to get Gov. Schwarzenegger to back down from extensive cuts to the state education budget.

We physicians, on the other hand, cannot seem to get anyone outside of the healthcare community excited about our plight. A UC, Irvine study showed that California's average physician income is among the lowest in the country, raising significant concerns about our ability to recruit young doctors in the future. Between 1978 and 2002, the number of practicing physicians over age 65 tripled in California, and doubled for those over 55. Meanwhile, since 1990 the number of California physicians under 40 has decreased.

When doctors speak in a public forum, we typically--and accurately--maintain that any cut to our fees would negatively affect the healthcare of Californians as a whole. I am concerned, however, that the message we are sending translates to, "it is going to affect my pocketbook, and therefore it is bad for California." I, for one, never saw a sign at a nurses' or teachers' demonstration that mentioned salaries. Instead, they speak about patients, students, education or feeling sick and vulnerable in a hospital bed, lying soiled with no nurse to come to the bedside.

We are in a battle for the future of healthcare in California. It is frightening to think that any of us could be in an automobile accident and experience difficulty in finding an emergency room willing to treat us. We worry about one of our family members having a myocardial infarction and then encountering a prolonged emergency room wait because of overloads exacerbated by threatened and existing Medi-Cal cuts. I believe that our motivations are genuine, fundamentally driven by our desire to provide the best possible care, because we understand that our friends and families and even fellow doctors will all be patients someday, and we naturally want the best for them. We need to project the principle that patients are our central concern, and that appropriate funding will lead to better care for Californians.

My goal in the coming year is to tell the story of our dedication to patient care and how we need to reconnect with the beauty of being a physician. When someone needs an operation, or a sophisticated medical procedure, or a knowledgeable consultation about a difficult health condition, that person won't look to any generic provider. He or she will seek a confident, well-trained, concerned individual--a California physician.

I take this opportunity to invite any member to write about a memorable occasion in which taking care of a patient brought back all those feelings of why we went into medicine in the first place. You can email your story to editor@socalphys.com. I look forward to hearing from you!