October 2008
By Christy Simo
With rising medical costs, a looming physician shortage crisis, and skyrocketing administrative overhead due to insurance requirements, anesthesiologist Dr. Steven Walsh faces many challenges as the new president of the Medical Association of Atlanta (MAA).
But just as he looks for new ways to help patients cope with post-operative pain, he hopes to not only grow membership, but also take MAA in a new direction to help meet those challenges.
“What we really want to do during my presidency is to reinvigorate our membership to promote the health and safety of our community through physician leadership,” says Dr. Walsh, who became the new president of the MAA in June. “We want to champion our community’s wellbeing and safety, and to advocate a healthy environment in which we practice and serve.”
The MAA is an advocate for physician issues as well as a valuable resource for education, socializing, community service, referrals and legislative support. Having been in existence for 154 years, the MAA is one of the oldest medical associations in Georgia. It was originally created in 1854 to promote the interests of Fulton County physicians and currently serves as the largest and strongest organization to speak for Atlanta-area physicians regardless of specialty, hospital affiliation or mode of practice. Today, it has nearly 1,000 members.
Still, that’s not enough for Dr. Walsh.
“There’s about 4,000 doctors in Fulton County. So although we have a thousand [members] and that’s great, we also want to increase that membership,” he says. “The larger our membership, the stronger our voice, and the greater are our resources to accomplish our mission.”
Making His Way in Medicine
Dr. Walsh completed his Anesthesiology Residency at the Medical University of South Carolina in 1985. That year, he moved to Roswell and joined a local anesthesiology practice. Two years later, he formed North Fulton Anesthesiology Associates.
“I started out with a group of two physicians, and since that time, we’ve grown to a group of 10 physicians and 12 nurse anesthetists,” Dr. Walsh says.
Although his mother was a nurse, Dr. Walsh originally had no intention of going to medical school. But after a stint as a nurse’s aid and later as an operating room technician at the now-defunct West Paces Ferry Hospital, he was inspired to attend medical school. While at the Medical College of Georgia, he was drawn to anesthesiology.
“I think you’re most influenced by some of the mentors that you have in your training. I was most influenced by Dr. Zack W. Gramling, M.D., past chair of the Department of Anesthesiology,” recalls Dr. Walsh, who noted the field focused on two of his favorite sciences in school: pharmacology and physiology. “I had a chance to work with him and see the type of care that he and his residents provided to patients. It persuaded me to pursue that specialty.”
At North Fulton Anesthesiology Associates, Dr. Walsh is using new techniques in acute pain management for patients coming out of surgery. Traditionally, post-operative pain was treated with an IV or oral narcotic medication. Now, more physicians are starting to use regional anesthesia to help patients cope with pain associated with surgery.
“We’re finding very much of an advantage in reducing the patient’s narcotic medication requirements as well as the potential to provide a more effective pain management with the use of regional anesthesia, which is the injection of local anesthesia around the nerves,” he says.
For example, if somebody has shoulder or arm surgery, the injection would be placed around the nerves of the arm to provide pain control.
Imaging has come quite a long way in recent years as well, and Dr. Walsh has found that a portable imaging device helps him administer the local anesthesia.
“It has allowed us to use ultrasound imaging in the operating room area so we can identify those nerves and inject a local anesthesia around those nerves.”
Taking a New Path
As president of the MAA, Dr. Walsh hopes to lead the organization down new paths as well. The group recently elected a new executive director, David Waldrep, and met to discuss a more strategic five-year plan. As a result, the organization has several immediate initiatives as well as some long-term goals.
“One of the initiatives that we will add this year is to truly identify our physician representatives from each hospital, so that each hospital’s medical staff within the metro area can have a voice in our organization.”
The group will focus on developing and strengthening various committees to help grow membership and awareness of the group.
Membership in MAA helps the organization truly be a representative voice of Atlanta physicians and provides an avenue for grassroots legislative involvement, a starting point for leadership in organized medicine and numerous practice-building opportunities.
Dr. Walsh also hopes to open up more avenues for physicians to participate in community service.
“There’s an altruistic component to many physicians, and the community service committee will provide a means for us to reach out and help the underserved,” Walsh says.
He hopes to provide physicians and care to free clinics such as the Mercy House to not only help those less fortunate who cannot afford healthcare, but also to help physicians become involved in their communities. Such outreach efforts will also provide the public a way to better understand the charitable healthcare contributions that the medical profession makes.
Still, the medical field as a whole faces many challenges in the future.
“One of the biggest challenges facing medicine, whether it’s on a local, state or national level, is having a voice in policy,” Walsh says. “I think a lot of the policy making that’s happening in medicine is at a level of insurance companies and the big corporations. And it’s often times far removed from our bedside experience and focus that we physicians have in terms of what we feel is best for the patient.
The organization has been actively involved in promoting torte reform, and helped pass a reform bill nearly three years ago. The legislation set a $350,000 cap on non-economic damages in medical liability lawsuits. At the time the law was passed, Georgia was listed as one of 20 the American Medical Association declared to be in crisis because of rising medical liability insurance premiums.
Still, constant vigilance is needed to preserve what was accomplished in 2005. It’s no secret that Georgia is facing a physician shortage, due in large part to the state’s liability exposure. Many physicians are considering retiring early, while others are forced to discontinue high-risk procedures or leave the state.
“As malpractice premiums became more expensive, even physicians who finished their training within the state may make decisions to leave the state because of the liability exposure, and that contributes to the shortage of physicians within our state.”
And the costs to medical practices are growing.
“Administrative overhead for our practices imposed upon us by managed care requirements is an ever increasing burden,” notes Dr. Walsh, who adds that it creates a lot of uncompensated time and effort for a medical practice. “We need to create greater administrative efficiencies and use those found dollars to bring better health to healthcare.”
On a national level, Medicare reimbursement is affecting physicians everywhere.
“Medicare reimbursement, from the government perspective, is a budget neutral entity, and healthcare costs in this country continue to increase,” he says. “That puts an incredible stress on the Medicare system.”
The Sustainable Growth Rate (SGR) system requires a reduction in Medicare payment fees to physicians each year.
“Thus far, through advocacy, we’ve been able to postpone those reductions,” he says. “That’s important for patient access because as Medicare rates decrease, physicians have to make difficult decisions from a business standpoint, and that can sometimes affect patients’ access to care.”
For more information on the Medical Association of Atlanta or how you can join the organization and get involved, call 404-881-1020 or contact executive director, David Waldrep at dwaldrep@maa-assn.org.
