Sunday, July 27, 2014

ACP, Medicine's Conservative Jews

I'm down to my last medical organizational membership, the Endocrine Society, having let the clock run out on my membership in the American College of Physicians.  Of all the organisations that would regard me as a defector, I think the reasons for departure most parallel what has become widespread voting with one's feet on the organizational arms of Conservative Jewry, outlined in the Pew Research Report on Judaism in America.  In his book Getting Our Groove Back, Scott Shay devotes a chapter to Conservative Judaism's decline in formal affiliation, if not in practice or a reassembling of talent elsewhere.  Talent matters.  My own experience with the Conservative Jewish organizations suggested that at least the places I frequented were rather insensitive to the talent that people possessed when it failed to synch with Rabbi or macher agendas.  They failed to capture what the participants wanted to derive from their membership, resulting in attrition.  A revolving door of suburban families purchasing Bnai Mitzah for their children had become part of the culture, people never really connected.  Then there were the people like myself who either were connected or could have been but some clash of values never quite got smoothed out.

And so we have the ACP divergent path of what the seniormost leadership promotes and what dedicated internal medicine certified physicians might want of their professional organizations.  I want to be a really capable doctor, the best I can be, and receive a due measure of kavod for the work I put into it.  When I or any ACP Fellow requests expert advise, I want it from the specialist, not his or her understudy in the form of noctor.  The ACP should carry Flexner's banner a century after his report enabled the ACP to flourish.  They have not.  I work hard to maintain my skills.  They should never be jeopardized by the blight that Board Certification has become.  When I read a study, it should be somebody's research.  Meta-analysis has its place but not a dominant place.  And as people like me toil in front of the computer screen, watching our tasks trivialized to clicking boxes reminding people who have weighed 300+ pounds for decades to exercise while our contact time to do really useful stuff with these most difficult medical challenges gets tacitly eroded with ACP complicity when our own organization should provide advocacy does not bode well for their future credibility.

Scott Shay regarded the implosion of the Conservative Jewish organizations as one of the disasters for American Judaism.  And failure to advocate for the real interests of the core medical workforce, what should be ACP's unfulfilled mission, can be no less a disaster for American medical care.

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