Annual Report 2016 - 2017

President’s Report 2017 
Membership Report
Treasurer's Report
The Leadership 2016 - 2017

President’s Report 2017 

Outgoing President Michael T. Goldstein, MD, JD, and incoming President Scot B. Glasberg, MD, at the New York County Medical Society’s 2017 Annual Meeting, June 22, 2017Photo by Mervyn Bamby

The following are remarks from outgoing president, Michael T. Goldstein, MD, JD, at the Society’s 2017 Annual Meeting. 

Having been the only president of the Society in over one hundred years to serve two years instead of one I have been grateful for that special opportunity to lead the medical society through a difficult period. I would like to thank our executive director Cheryl Malone for all the hard work she has done for the Society. I would like to thank Susan Tucker for staying on top of our legislative issues and other related issues and Lisa Joseph who plays an active role in all our meetings and Sony Hilado who works behind the scenes in Membership. I would like to thank my wife Doctor Belle Goldstein for her support,  encouragement, input, and for arranging the tour of the One World Observatory this evening,  all of which has made this job easier.

Almost three years ago we had to leave our long–time location due to major increases in our monthly rent. On a temporary basis we rented shared office space with the Cardiology Society as our subtenant. The search began for a new space and there were some false starts but I am pleased to announce that we have signed a new lease at  261 West 35th Street Suite 504,  that will provide us with sufficient space for our offices, equipment and the ability to hold small conferences. This space is more affordable then our previous arrangement and we will be there for at least the next five years and possibly longer.

During my presidency there have been huge upheavals in healthcare. With the help of the presidents of the other counties in New York City the counties united to solve common problems. The first was the removal of approximately 800 physicians from the HIP plan. We along with several other downstate counties became the tail that wagged the dog and elicited a rapid response from MSSNY. I have worked for expanding the role of the First District Branch as a spearhead for innovation and cooperation among the five counties of New York City. Because we are a smaller group than MSSNY we can experiment and respond rapidly to pressing issues.

I wrote a resolution that was passed by the MSSNY House of Delegates regarding the creation of a task force for the preservation of independent practice in New York. The first version of the task force met with limited success and I am hopeful that our MSSNY President Charles Rothberg will revitalize and expand the role of that task force.

I also wrote and the MSSNY House of Delegates passed two resolutions regarding collective bargaining for both employed and independent physicians. Our colleagues in Queens drafted and we supported a resolution regarding entering into discussions with a union to further that goal. That has gotten off to a bumpy start but interested members of New York City county leadership will be meeting again with this Union next week. 

The process of instituting change is never fast enough especially in a rapidly changing world. Yet the concept of employed physicians forming a union and independent physicians forming a guild with the same organization is new and the needs of all concerned need to be expressed and a strategy to transform that into a viable plan can be a slow process. Patience and determination are necessary for success. If this first attempt fails we can seek other options but physicians both in the independent and employed situations need to level the playing field with whoever pays them. In fact the lack of bargaining power by independent physicians has been the strongest driving force in shifting physicians from independent practice to institutional employment. From a public policy perspective consolidation has limited choices for patients and has raised healthcare costs. Rebalancing the system and preserving choices of healthcare delivery is necessary to preserve quality and cost effective healthcare in New York.

My road to leadership in the Medical Society began about 30 years ago. At the time I was a young physician with a growing practice and a young family. In medical school I was the president of the student council and the medical society should have been a place where I could use my leadership skills to benefit the profession. I was a member of the economics and governmental affairs committees for several years. At that time managed care, with low reimbursement, narrow networks,  and  huge hassle factors was expanding because of supposed cost savings benefits. At the appropriate committee meeting I had suggested something that is so commonplace today but almost unheard of then, the idea of rating businesses. I suggested that the Medical Society survey its member and use that information to rate the various insurance companies that they did business with. The Medical Society should then publicize the ratings with the employers that were contracting with the insurance companies. The idea was that if there were similarly priced products that the employers would choose the higher rated companies and the poorer rated companies would change to improve their ratings. Everybody today knows that people pay attention to ratings. At that time I was only person in the room of approximately thirty colleagues who thought rating insurance companies was a good idea. All I heard was that it was bad idea, could not work, and that nobody cared about how the insurance companies were rated. Sadly I was right and I realized that my ideas were so different from those of my colleagues that I was the wrong fish in the wrong fish in the wrong pond. I decided to leave and devote my efforts to my family and my practice. Time has proven that I the lone voice in the room with a new and a different perspective was right and an opportunity to change healthcare was lost. Imagine how different things would be had they embraced my ideas. Insurance companies would have had to change to keep good ratings and the lot of every physician in this room would have been better.

Unfortunately at a recent house of delegates meeting once again I was the lone voice in the room looking a situation from a different perspective regarding the need for more and prompt disclosure on the MLMIC demutualizaion. Hopefully for all our sakes time will prove me wrong.

Time passed I left the Medical Society, raised my family, built my practice and even went to law school. A new leadership had taken over the New York County Medical Society and Eugene Weise as president–elect nominated me to the Board. This was a very different board than existed when I had first become involved. I was very proud to become a member of a board with different opinions, diversity, and open mindedness. Despite our different and varied opinions we always respect each other and we all work for the betterment of our profession. In this new environment I flourished and moved up eventually becoming president.

 In a close vote our county as did MSSNY did not support the Affordable Care Act because of its many flaws and the lack of physician input in writing the bill. We also had different opinions on the linking of Maintenance of Certification and the Maintenance of Licensure issue. Some felt that their boards were reasonable and it was ok. Others felt it was a done deal and nothing could be done. Finally others including myself were strongly opposed. Here too we wrote and had passed a MSSNY resolution opposing MOC linked to MOL. Sadly it is not the progressive state of New York that took the first step in passing legislation preventing the linkage of MOC to MOL —  it was Oklahoma. Recently another red state, Texas ,passed legislation against MOC. New York has not passed any legislation on the subject.

The message is that when doctors fight and unite they can institute change to prevent bad legislation from passing and to advance legislation favorable to the profession. Physician leaders in general medical societies need to continue to advocate for all physicians and not just the physicians in their specialty.

The Board of Directors of the New York County Medical Society. but not the New York County House of Delegates delegation have expressed concerns about the MLMIC demutualization and future of the malpractice marketplace in New York. Our delegation proposed a MSSNY resolution that was adopted calling for the reduction of malpractice premiums across the state. According to a recently published article the volume of malpractice cases has declined over the last decade and premiums have not. I hope that MSSNY will advance the goal of reducing our malpractice premiums consistent with that resolution.  Unfortunately legislation passed during this past legislative session that  may quash premium reductions and instead further escalate our excessive malpractice premiums.

The future of the malpractice marketplace in New York is problematic. Risk Retention Groups, exempt by federal law from New York regulation are flourishing here. Some are underfunded and cannot pay the claims. Yet they attract business because of low premiums. This has resulted in steadily declining MLMIC  premium dollars and PRI has a negative surplus. Medpro a Berkshire Hathaway company that is financially solvent, has expanded in New York. In my opinion, I see three possible scenarios following Berkshire Hathaway’s purchase of MLMIC. These are MLMIC lowering premiums and expanding market share, MLMIC keeping premiums at current levels and continuing to decline with business shifting to Medpro to the point that MLMIC will no longer be profitable, or MLMIC reinventing itself and expanding. I hope that the MLMIC board and leadership steers the ship in the right direction and preserves competition and continues to offer financially sound insurance products to the physician community.

In the new healthcare world physicians and their organizations in order to survive have to be innovative, buck the status quo and force their organizations to quickly adapt to changes.
 I am an ophthalmologist who subspecializes in cornea and I perform corneal transplants. In the 1940s the one of the pioneers in corneal transplants, Doctor Richard Townely Payton, was not permitted to remove the eyes of the deceased to perform corneal transplants because the AMA rules prohibited it.  Apparently there was an exception where if he could obtain the consent of convict who was scheduled to be executed prior to execution it was okay. In order to do corneal transplants he had to drive to Sing Sing before executions, obtain the consent from the condemned prisoner, stay for the execution, remove the eyes afterwards, place them in glass jars, drive home, place them in his refrigerator and take them to the hospital the next day and perform the corneal transplants on two patients. He later went on to found the Eye Bank for Sight Restoration that now provides corneas for transplant surgeons in the metropolitan area. Other eye banks followed throughout the country and tissue banking of other organs followed. It all began with one man finding a way to change the system for the betterment of the society and the medical profession.

There are two lessons from his story, the first being a medical organization that is backward thinking harms the profession and society by hampering positive change. The second lesson is that those who are willing to devote extraordinary effort to institute change despite strong resistance can move the profession forward.

Although I never met Doctor Paton I was fortunate enough to do Corneal Fellowship with his  protégé,  Doctor  Richard Troutman.  He too went against the system and pioneered ophthalmic microsurgery. Following in that tradition I have worked to empower physicians and increase their control of their own destiny and how healthcare is delivered.
We in New York County are fortunate to be located in a county that is the home to four allopathic medical schools and one school of osteopathic medicine.  There are five additional medical schools in the surrounding counties. Within a 50–mile radius from here on the New York Side there are 10 allopathic or ostopathic medical  schools. This is the largest concentration of medical education in the country. We should be the epicenter of healthcare and physicians should consider this to be the best place to practice in the country.

Unfortunately medicine in New York is in trouble we are the lowest–rated state regarding practice environment for physicians. We have a hostile regulatory and malpractice situation. 
To make matters worse on June 21, 2017, a disastrous bill was passed by the New York State Legislature that would extend the statute of limitations from 2 1/2 since the last date of treatment to the date of discovery plus 2 ½ years for a maximum of 7 years since the last date of treatment in medical liability cases involving cancer.  That means that if you stop treating a patient and  seven years later he or she develops cancer ,you can be sued for malpractice for missing the cancer diagnosis. Obviously the facts would have to prove that you in fact did miss the diagnosis to win against you. However, your medical liability  carrier will have to defend you and that translates into higher premiums. In order to protect themselves from being sued for missing a cancer diagnosis, physicians will have to practice more aggressive defensive medicine.  Any time that cancer is even in the differential diagnosis or suggested by any diagnostic testing, the physician will have to make every effort to prove that there is no cancer. This will translate into higher health care costs. 

 Other detriments to practice here include higher living costs, high taxes, and incomes that are not sufficient to offer comparable lifestyles to living elsewhere. The cost of a studio apartment here exceeds the costs of a luxury house in most parts of the country. 

This low rating and unfortunate situation is due to a combination of the failure of the leadership of our societies to advocate sufficiently for the state’s physicians and apathy and lack of support of the medical societies by the majority of physicians in state. 

We need to change by taking an aggressive, progressive and proactive approach to solving this problem. For this to happen there needs to be a huge commitment. We need to put the same effort, determination and perseverance that we needed to succeed as professionals to make our profession succeed. We should follow Doctor  Payton’s lead. If your convictions are strong and you want to change things you have to go forward and persevere despite the skepticism and indifference of your colleagues. In the end if you are right you will achieve your goal. 

One potential ally is the OPEIU, a union we have entered into discussions with. Their first meeting with us was positive and a second meeting took place at the New York County Medical Society.  Our category of members is different than anything they have ever dealt with. Being first to try something is better than our current situation of being last in physician practice environment. They have much stronger lobbying power than us. They represent the workers who pay for healthcare as a wage substitute. Their members are being squeezed by skyrocketing healthcare costs. We as physicians can help.

 Physician–hostile medical liability laws leads to defensive medicine and higher healthcare costs. Obstacles to care harm union  members. They have a stake in curbing the abusive practices by insurance companies that hamper patient care.  Preserving a diverse healthcare marketplace with private and employed practices controls costs and fosters competition which benefits the patients. I believe with their help, a useful physician collective bargaining act would be passed. When it is, they could play a role in doing what they do best —  negotiating terms and conditions of contracts. There is potential for synergy but it will take time and effort to make it happen. If it doesn’t work we can explore other options. If we affiliate and it does not work out, unlike a divorce, there is no alimony. 

We are a great city and a great state with a long history of innovation, and problem solving.  This city leads the way in many industries. It is time for us the physician community to develop and innovate changes in healthcare and partner with groups and organizations that represent patient stakeholders who share our goals.

The New York County Medical Society and its partner societies representing the five counties of New York City need to strengthen their collaboration and their dedication to achieving the goal of making New York the best place rather than the worst place to practice medicine in the United States. If the Chicago Cubs, a team that had not a World Series in over 100 years, can retool and win a World Series, we too can retool and move New York Medicine up the ratings ladder. 

I want to thank all of you for your support of the Medical Society. We all need to encourage our friends and colleagues to join the team and stand up for future of medicine. I have been very proud to serve as president of this Society and I take great comfort in the fact that our new president, Scot B.  Glasberg, will continue the fight for you, the members of our Society and all those who will benefit from our efforts without ever contributing to the cause.

Membership Report

Elected  in  2017
Active 16
Young Physician/Part Time/Paid Retired    24
Resident/Fellow 39

Current  Members in 2017

Active 807
Student 521
Life 764
Reduced Rate 188
TOTAL 2,280

Figures reflect membership as of November 30, 2017. 

Treasurer's Report

June 22, 2017, Annual Meeting of the New York County Medical Society: Eugene E. Weise, MD accepts the Nicholas Romayne MD Award from President Michael T. Goldstein, MD, JD   Photo by Mervyn Bamby

In accord with Article VI, Section 6 of the Bylaws of the New York County Medical Society, I present this statement summarizing the  Society’s  financial records for the fiscal year ending June 30, 2017.  Any active member in good standing may, by appointment, inspect the full and complete statement of our independent accountants at the offices of the Society. 

Dues and Commission 459,976
Grants and Contributions 1,660
Fees 69,985
Royalties and Administrative Fees 52,842
Reimbursements 3,920
Advertising 16,905
Other income 4,432
Total $ 609,720

Salaries and Related Expenses $ 297,230
Occupancy Costs 151,233
Business Expense 1,137
Program Activities and Functions 42,966
Office Management 68,131
Professional Services 69,910
Total   Expenses $630,607

($   20,887)
The Leadership, 2016 – 2017

The Presidents, June 22, 2016, Annual Meeting of the New York County Medical Society:   Back row, left to right: Milton Haynes, MD;  William B. Rosenblatt, MD; Charles Rothberg, MD, President, Medical Society of the State of New York;  Anthony A.  Clemendor, MD; Malcolm D. Reid, MD, MPP; Eugene E. Weise, MD; Zebulon Taintor, MD;  Joshua M. Cohen, MD, MPH; Peter C. Lombardo, MD  Front row, left to right: Paul N. Orloff, MD; Michael T. Goldstein, MD, JD; Scot B. Glasberg, MD; and Sudha Patel, MD    Photo by Mervyn Bamby

Board of Directors,  2016-2017
New York  County Medical Society

Michael T. Goldstein, MD, JD, President
Scot B. Glasberg, MD, President–Elect 
Naheed Van de Walle, MD, Vice President    
Jessica J. Krant, MD, MPH, Secretary
Ami Shah, MD, Assistant Secretary
Wen Dombrowksi, MD,  Treasurer
Jill Baron, MD,  Assistant Treasurer

Board of Medical Ethics
Ksenija Belsley, MD 
Michael Borecky, MD
Mary Ruth Buchness, MD 
Eli Einbinder, MD 
Milton Haynes, MD
Henry Magliato, MD 
Marlin Mattson, MD

Board Members at Large
Conrad Cean, MD
Arthur Cooper, MD
Keyvan Jahanbakhsh, MD 
Anuradha Khilnani, MD 
Keith LaScalea, MD
Mark Milstein, MD
Gabrielle L. Shapiro, MD 
Bijan Safai, MD
Niket Sonpal, MD
MSSNY ex–officio
Joshua M. Cohen, MD, MPH, Councilor
Malcolm D. Reid, MD, MPP, MSSNY  President 
Board of Trustees, New York County Medical Society     
   Board of Directors,  Spingarn Fund, Inc.

Daniel Green, MD, Chair
Peter C. Lombardo, MD 
Paul N. Orloff, MD
Joshua M. Cohen, MD, MPH
Edward W. Powers, III, MD

Committee Chairs, 
New York County Medical Society 2016 –2017

Naheed Van de Walle, MD, Continuing Medical Education
Peter Lombardo, MD, Public Health 
Heskel M. Haddad, MD,  Parking Review 
Milton Haynes, MD, Bylaws
Keyvan Jahanbakhsh, MD, Young Physicians
 Paul N. Orloff, MD, Government Affairs
Scot B. Glasberg, MD, Membership Benefits
Steven Zaretsky, MD, Workers’ Compensation
Michelle Zweifler, MD, Public Relations
Delegation to the Medical Society 
   of the State of New York Leadership

William B. Rosenblatt, MD,  Chair  
Anthony A. Clemendor, MD, Vice Chair
Stuart Orsher, MD, JD, Chair Emeritus
Michael T. Goldstein, MD, JD, Presidential Vice Chair
Robert B. Goldberg, DO, AMA Delegate 
Malcolm D. Reid, MD, MPP,  MSSNY  President  and  AMA Delegate
Joshua M. Cohen, MD, MPH, MSSNY Councilor,  AMA Alternate Delegate
Staff, New York County Medical Society
Cheryl M. Malone, CAE, Executive Director
Susan Tucker, Esq.
Sony Hilado
Lisa Joseph