Ladon W. Homer, MD Installation Speech

Friday, May 5, 2006 
George R. Brown Convention Center

Houston, Texas
Ladon W. Homer, MD, President

Fellow physicians, spouses and friends, what a great day to be a physician! What a great day to be a Texas physician! Today I speak from the heart when I say I am proud to be a member of the Tarrant County Medical Society, The Texas Medical Association, and The American Medical Association. It is such a great feeling - such an honor to be a member of this great family of medicine - a family built upon a sense of service to mankind - a family that has deep regard for each other.

I will never forget the feeling I had many years ago when, some time early in my freshman year in medical school, I received a letter from the AMA welcoming me into the fraternity of medicine as a student member. A feeling of elation came over me to think that a farm boy from the red river bottom land of Caddo Parish Louisiana could ever be a part of such an honored profession.  You see, in my boyhood days physicians were looked up to as the community elite and revered as the most learned, trustworthy and honored professionals. Little did I realize what was in store for me as a professional, nor for the profession as a whole for that matter, in the years to come.  All I knew was that I felt a great sense of unexplainable pride just to be a member of this family I had always held in such high esteem.

Everyone knows that no person makes a meaningful achievement totally on his own.  Whenever we reach a significant goal in our lives we can always point to those who have contributed to this success - those who have helped, influenced or provided inspiration.  In this regard I am no exception. It is a great honor for me to follow Dr. Gunby as president and I owe him so many thanks for the mentoring he has provided during my year as president-elect.  And thank you Dr. Plested and Carolyn for making time in your busy schedule to honor me by being here today.

Further, I want to briefly recognize those who have honored me by their presence and who have in some way have contributed to this high honor I now enjoy. First, my colleagues, physicians and alliance members from the Tarrant County Medical Society who gave me that first start in organized medicine!    Your support through the 25 years I have been involved in TMA has been invaluable and I am very appreciative.  I would ask all my fellow members of the Tarrant County Medical Society and Alliance to please stand and to be recognized.

Next, my colleagues both past and present with whom I have practiced and associated during the years.  As I call your name please stand and remain standing.  From my distant past in practice traveling here from Nashville, TN are Dr. W.O.T Smith, an anesthesiologist, and his wife, Bonnie, who were our next door neighbors on Long Hollow Pike in Goodlettsville! Next, a current colleague from Huguley Hospital, Dr. David Engleking, a hospitalist, and his wife, Linda.  The immediate past chair of the board of trustees of the Adventist Health System, Max Trevino and his wife Betty, the CEO and president of the Adventist Health System from Orlando, Florida Tom Werner and his wife Sharon.  Pete Weber the current CEO of Huguley Hospital.  Please help me thank these folk for coming to this event. Next, a special friend, a dental colleague, and our family dentist, Dr. Robert Kelly and his wife, Suzie.  Thank you for coming!

And now, those who have made enormous contributions to my personal life and from whom I have learned not only how to be a professional but what it takes to be a good human being, my immediate family. 

Most people look to their fathers to teach them important life principles but in the absence of a father figure in my life I can honestly say I have been taught many of life's lessons from my own progeny.  And, I am especially proud because our two sons are both physicians in practice in Texas and both TMA and AMA members. 

Our son, Kevin, who joined me in practice some years ago, and for whom I now work, and his wonderful wife. Liz, who works in Kevin's office and sees first hand the ravages thrust upon physicians on the "billing" side of medicine. Our grandchildren who honored me by escorting me to the podium today, Allison and Andrew.  Thank you for honoring me by your presence today. Our other two children could not be here today.  Greg, a radiologist in Denton and his wife, Holly, the current president of the Denton County Medical Society Alliance and their three sons-Ryan, Reid and Rhett! Our youngest child and daughter, Jana Stout, of Simi Valley, California, and her daughter, Andrea.  My family of which I am very proud. 

And finally, the  one person who has stood by my side for more years than she will allow me to announce publicly.  She truly is the wind beneath my wings and has taught me more about life than any other person.  She is in fact my claim to fame!  As I travel about the state and nation and introduce myself, people will say "Oh I know you, you are Mary Ann's husband."   She is president of the AMA Alliance and I have been privileged to accompany her from time to time throughout this year as the AMA Alliance "first gentleman" as she traveled from coast to coast -my wife, Mary Ann. I am truly blessed to have such a strong support system within the "family of Homer."

My goal for this year is to strengthen our TMA by further unifying our family of medicine and by building strong alliances with helpful entities outside our medical family.  I am confident I can count on the assistance of our more than 41,000 members, the many county and specialty society leaders and our own alliance as we work together to achieve this goal. 

The pessimist says he who ignores history is dooomed to repeat it. The optimist says he who studies history is destined to repeat it. And I say, he who examines our past and builds upon its rich heritage is certain to succeed! Just like our history indicates--There has always been someone in need; and there has always been someone willing to meet that need, to serve mankind -these have been our professional forefathers.  The medicine men ! From Soccrates of old, to Cabeza de Vaca in our early Spanish occupied Texas, to Anson Jones in the early days of the Texas Republic, to the 35 physician founders of the Texas Medical Association meeting in the Austin Methodist Church in 1853, to The modern blend of scientists, medical pioneers and caring physicians that comprise our more than 41,000 TMA members.

Has medicine and its practice changed? Of course it has. Will the practice of medicine continue to change? Of course it will. Must we do everything in our power to keep up with these changes?  Of course we should. Throughout the centuries, honesty, integrity and scientific excellence have bound our profession together.  Honesty, integrity and excellence  will continue to give us the unity of purpose we need.  Honesty, integrity and excellence  will continue to make us the most respected profession on earth. 

In my lifetime, and in the lifetime of most of you seated here today we have seen not only a revolution in scientific accomplishments, but also a revolution in the way medicine is practiced. I remember when there was no Medicare program - when physicians still cared for the elderly and the poor, either gratis or with a payment of only a dollar a month.

 I remember when we as physicians enjoyed a special collegiality, when we got along with each other and respected each other as professionals. When we didn't compete, or when such terms as HMO, SGR, primary care, health care providers, capitation and risk sharing contracts were not even a part of our vocabulary. I remember when we served patients------not "covered lives," and when we were called physicians… not "providers."    I remember when physicians kept up with new scientific advances in medicine because we had a sense of pride and professional motivation not because it was written in our HMO contracts.   I also remember when we gave professional courtesy to our colleagues and their families without fear of litigation or of censure for a breach of ethics.

Even with all these past practices, many of which today, we either fear to do or cannot do we were still regarded as the most respected professionals on earth, why? Because we were unified by and exhibited those professional characteristics of honesty, integrity and excellence .

I am here today to tell you that we are still the trustworthy professionals  we were in those days. We have simply allowed ourselves to become intimidated by a barrage of market forces, government edicts, and payer rules and regulations. No, we cannot turn back the clock - but we can take back the profession!  

No, I am not one of the naysayers who believe the golden age of medicine is past, that it has seen its best days or will never be what it once was.  My two physician sons bear testimony to my faith and confidence in the future of our profession.

Yes, I know that in the course of historical evolution, much has changed for medicine.  We can never turn back the clock but why should we?  It is evident that much lies ahead to be enjoyed-much to be conquered. 

The world looks to our generation and to the generations of physicians who follow to make those intellectual leaps that will: conquer cancer, bring relief from the many debilitating diseases that still plague mankind, and reap a myriad of advancements from the human genome project! Much lies ahead for us-promises to be met, accomplishments to achieve! It is we ; the physicians of today, who can and  will make these things happen. Unity within the family of medicine is  key and is even more important today than in generations past. The issues we face today are  not new. Most are the same as faced by our forefathers only in a different form.  

The solutions that made them successful in the past are our solutions today - a unified family exhibiting the principles that have held us together for centuries - honesty, integrity and professional excellence.     

You may have heard the new AMA brand--"together we are stronger." Some may think it trite, some may think it redundant, and some may think it superfluous: But, to me, it expresses a strong message for hope and success - a unity we must have to withstand the external forces we face today and will surely continue to face tomorrow.  

The current state of disarray of our health care system is not our doing.  It is the responsibility of the Wall Street entrepreneurs who have tried to enter our profession just to enrich themselves-without concern for our patients.

Our greatest blame  may be only that we helped develop such a high level of medical science and technology that we now have the greatest medical care in the world!

Our greatest blame  may be only that we have fought diligently to extend care to  all our patients and those we serve!

Our greatest blame  may be only that we sought to preserve the physician-patient relationship rather than allow those we serve to become just another government or payer number at the mercy of the bureaucrats. 

All this has left us caught up in a system of physician-patient isolation, underpayment with government and payers engaged in a shame and blame game at our expense.  If that is our blame-then I am PROUD to be blamed .

Through it all we have maintained our profession's high ethical standards of honesty, integrity, and excellence of practice.  These have been the elements that have held us together in unity throughout the centuries and will today and in our future! But we must continue to build upon our past and take the offensive.

As I have spent time with politicians, bureaucrats and other government employees at the statehouse since our liability reforms,  I have often heard these words "it is time that doctors pay their fair share. " I am telling you today,  we do  every time we see a Medicaid patient and receive less than operating costs for this care,  we are paying our fair share.  

Every time we  administer a vaccine and receive a payment of less than actual cost of the vaccine, we are paying our fair share .

Every time we go   to the emergency room at 2 a.m. to care for a critically ill patient and receive no pay, we are paying our fair share.  

Every time we go  to the emergency room at 2 a.m. to care for, even save the life of a critically ill patient, get no pay for it and end up paying thousands of dollars to defend ourselves in a frivolous lawsuit , we are paying our fair share many times over.   

Our dedication to our profession, to our patients, and our oath compels us to do this not just once, not occasionally, but day in and day out, night in and night out until it becomes a way of life.  Every single day we pay our fair share.  

No other profession exhibits this kind of dedication nor is subject to this kind of risk.  Why do we do it? 

Like our forefathers  we are committed to the service of mankind. 

Like our forefathers  we are dedicated to the principles that have unified and held our profession together for centuries.

Like our forefathers  we not only subscribe to an oath, but we also put it into daily practice everyday.

I do not believe the golden age of medicine is behind us.  Like Ronald Reagan I still see a shining city on a hill - but if we are to reach that shining city we must travel there together - with unity of purpose and unity of action. 

Unity of purpose must extend to  all our profession.  One of the byproducts of the tremendous advance of knowledge, science and technology we have seen has been a highly specialized profession. While this has brought many lifestyle rewards for us and medical benefits for our patients I am afraid it has cost us some of our collegiality, togetherness and unity of purpose.  This specialization has been the catalyst to fracture our unity.  

There are times I feel like we are too much like the wagon train riders who, when seeing an enemy emerging over the horizon, very methodically circle the wagons, turn their guns inward, and fire.

Unity of action  means engagement on the part of every member.  Make no mistake we are engaged in a conflict:

A conflict  for the preservation of the principles upon which this great profession was founded;
A conflict  for the freedom to practice medicine in the best tradition of our profession;
A conflict  to protect and preserve the rights of our patients; and
A conflict  to protect and preserve our rights as free men and women to practice as professionals and a conflict we  should win because right is on our side.

But it will take more than right.  It will take action on the part of each and every member.   We  must have many voices speaking with one message.

Before us looms a growing opportunity to achieve greatness.  Physicians over the years have presided over a profession that has undergone a transition from one based almost exclusively upon the art of medicine to one based upon a blend of art and science. 

As the science becomes more and more compelling, as market forces impinge upon us more and more, we risk forgetting the art of medicine.    

Sir William Osler, the father of modern medicine, reminds us "medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be equally exercised with your head."

As we move forward:  It is not clear what the evolution we are seeing will bring. It is not clear what our payment mechanism will be. It is not clear what legislation looms ahead.

One thing, however, is very, very clear - to make man whole - is our charge and if we adhere to those principles that have guided us over the years - honesty, integrity and scientific excellence, our family of medicine will once again be cemented together in unity - assuring us the success and satisfaction we seek and deserve.

As we go forward, we simply do not have the luxury to become so self consumed that we become divided. Dr Ed Hill, our current AMA president warns us of this when he tells of attending a meeting of trial lawyers.  One speaker stood up and said, "I sue doctors - I sue them in an atmosphere of fear.  But I also have one fear - and that fear is that someday they will get together and become unified."  

I Call Upon all physicians of Texas, members and nonmembers, to be a part of our Vision 2010-to become one of our "Trusted Leaders."

I Call Upon each specialty society and each specialist to speak out in unity for medicine.

I Call Upon each alliance member to speak out in unison for medicine.

I Call Upon each academician to become a voice for the family of medicine.

We need many trusted leaders - many voices speaking out for medicine - but one message.  

And so, around this great state we will come together. Whether it be when speaking for your county society, your state association or the AMA

Whether it be when speaking as a physician or an alliance member,  weather your specialty is OB or Psychiatry, many voices will ring out but there will one message - and this will be a resounding cry of victory for our patients.

Yes, I am just as proud today to be a member of this great profession, of this worldwide family of medicine, as I was my first year in medical school. Have we undergone changes? Yes. Will we undergo more changes? Of course. Can we remain a unified honored profession? Absolutely. I Pledge to you that I will stand by the principles upon which this profession was built to avoid its destruction and relegation to the ash heap of history!

As this curtain of responsibility descends upon me today I pledge to this house and all the TMA and TMAA members you represent back home that I will work for you with all the strength I can muster and with all the talent I possess to make this happen.

Thank you for allowing me to serve as your president.