Come gather ’round people…
…If your time to you’s worth savin’
Then you better start swimmin’ or you’ll sink like a stone
For the times they are a-changin’ ~Bob Dylan
I began my ACOG Presidency this past Wednesday by reciting some of Bob Dylan’s famous verse from the 1960’s. It rings true today, especially in medicine and our specialty as obstetrician-gynecologists.
As the times change I thank our now past-president, Dr. John Jennings, for his leadership and friendship during this past year. With the counsel of his past president, Dr. Jeanne Conry, John tackled some of the very difficult issues facing our practices and our workforce. I will continue his fine work and advance it on behalf of our patients, our specialty and our organization, ACOG.
When I chose the ob-gyn specialty some 35 years ago, it was in part because of the ability to provide a continuity of care over the course of a woman’s life and also the privilege of witnessing the birth of a new family. But now I worry that the excitement and enthusiasm that I felt then are being thwarted by many external forces, resulting in physician dissatisfaction. My concern is that unhappy physicians cannot provide high quality care.
The health care world talks about the “Triple Aim” of providing higher quality care, at lower cost, while at the same time enhancing patient satisfaction. We need to expand the “Triple Aim” to the “Triple Aim Plus One” and include physician satisfaction as an important metric.
My two immediate predecessors began addressing how we can provide more care for more people. Dr. Conry’s landmark task force on Well Woman Care defined the important elements of women’s health care, and Dr. Jennings encouraged us to team up with collaborative health care professionals to provide more care more efficiently. Now, it is time to really take charge of health care and focus on two problems which together contribute more to morbidity and mortality in this country than all of the cancers and specific diseases for which we routinely screen and treat: smoking and obesity.
Oftentimes, ob-gyns are the only regular contact many of our patients have with the health care system. We meet many of our patients when they are very young, often before they become obese and certainly before they build up 20 or 30 or more pack-years. We should not let this happen on our watch!
To help you help your patients, I will ask ACOG’s standing committees to develop a toolkit specifically designed for obstetrician-gynecologists to address obesity and cigarette smoking in their daily practice. First do no harm? Let’s go way beyond that: let’s do even more good than we do right now!
Along with our patients, we must always be the ones making the health care decisions — not the administrators and certainly, not the politicians. So let’s take charge of health care. Let’s step outside of our comfort zone of Pap smears and pelvic exams and provide care for the whole patient… For the times, they are a-changin’.