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President's Corner
M. Natalie Achong, MD



Doctor's Back to School Program (November 2017)


Blacks, Hispanics, Native Peoples are underrepresented in medicine. Underrepresented racial and ethnic groups make up nearly one-third of the American population, but represent only 9% of practicing physicians. Furthermore, only 4% of medical school faculty are from the traditionally underrepresented minorities.

Racial and ethnic health disparities are pervasive and persistent across the healthcare delivery continuum, both here in Connecticut and nationally. Although the causes of disparities are complex and multifactorial, one proposed solution for reducing disparities is increasing the diversity of inclusiveness of the medical workforce. 

I had never met a physician of color until I was well into my final year of medical school. Diversity in the physician workforce ensures that our health care system is representative of the populations served and that it is responsive to its health care needs. Physicians of color are more likely to treat minority patients, practice in underserved communities. These facts underscore the need to increase the number of minorities in the physician pipeline. One strategy to accomplish that goal is to increase awareness of medical careers among minority students. Established by the AMA in 2002, the AMA Doctors Back to School (DBTS) Program, explores different ways to engage children from diverse backgrounds in conversations about the range of healthcare careers. Traditionally, doctors visit schools and share their journey and work. This growing national program reaches more than 10,000 students  annually. This is an important way for us to connect and be a role model to future colleagues.  As HCMA president, I have presented students at various high schools and community health outreach events in area.

If you are interested in participating in this impactful outreach, please contact me at president@hcma.org or Barbara King at bking.hcma@gmail.com.

You can have a real impact on the face of 21st of our profession.  I look forward to working with you to address this important issue,

M. Natalie Achong, MD, MHL



Speech Delivered at the Annual Meeting of The Hartford County Medical Association
on the Occasion of Her Installation as the 225th President of the Association (October 17, 2017)

Physicians Leaders and the Era of Healthcare

Thank you Dr. Patel, fellow board members, HCMA members, respected colleagues from all across the state, special thanks to our keynote General Dr. Edith Mitchell and Dr. Willarda Edwards, AMA Board of Trustees, for flying in for tonight, my dear family, friends, sponsors and guests: Thank you for joining us.
I am honored to be the 225th President of the Hartford County Medical Association. My journey as the first black and the only fourth female president of the Hartford County Medical Association represents so much. As we planned this jubilee anniversary experience, we hoped that you feel excitement that is your own special birthday celebration!  So please join me, Happy 225th HCMA!

I am humbled to be with all of you on this momentous celebration and to share some thoughts with you.

We share this 225th anniversary with The New York Stock Exchange.  Certainly, the Stock Exchange and healthcare are webbed as the vast healthcare sector is a significant driver of our economy. Just like the volatility, surprise and new trends of our stock market, we are in a very unsettled and uncertain space in healthcare. No matter your chosen specialty, whether in solo practice, hospitalist or a large group, private or academic, urban or suburban, the burdens of excessive measurement, burn-out, overly complex and confusing reimbursement models and the pressure of revenue maximization and greed are all having an impact not only on the health and well-being of our patients, but actually on that of physicians themselves.

It is clear; the status quo is not sustainable. HCMA can and will take lead in Connecticut’s healthcare systems. With your help, we will continue, and build upon, the outstanding efforts of my immediate predecessors Drs. Patel, Watson, Vitale and Bollepalli in addressing each of these issues with wisdom, context and resourcefulness.

As physicians, it is our lived experience. This is not a new conversation for us. Our medical system doesn't deliver bang for its billions of bucks. Spending at least 1/6 of our GDP, we spend more money on healthcare than any other wealthy nation but it hasn't resulted in better health for major segments of across the nation and still right here in Connecticut. I consider myself a world citizen. I would love to do traveling in next chapter of my life. We can gain great perspective and insight from other places and cultures.   I am reminded tonight that as physicians, were are among the world’s most highly educated and privileged.  The WHO reports that 44% member states have less than 1 physician per 1000 population. Amidst all the current flux and controversy in healthcare delivery, no matter where we practice or how many patients we see, we are all leaders with the capacity to greatly impact the lives of others and positively impact systems. 

I have dedicated my career to working with the underserved, vulnerable and marginalized communities. As the first director for Health Equity for CSMS, I was the lead for the Care in Context program. Over the past years, we have started our state’s first authentic conversations about complex and nuanced the cultural dimensions of healthcare.  The program educated thousands of physicians across Connecticut on the striking persistent disparities in healthcare outcomes and providing culturally relevant care. The 18th century French philosopher Auguste Comte said to understand a science, it is necessary to know its history. I have come to appreciate this in my work and activism in organized medicine.

I started medical school when I graduated high school so I have been physician all of my adult life. My 25-year experience with organized medicine which began as a medical student at Bellevue Hospital, has prepared me well for this moment.  I was the founder of the Student National Medical Association society at NYU School of Medicine. As many of you know, founded in 1895, the National Medical Association is the oldest and largest organization of physician of African descent.  Less than ten years ago, in July 2008, the AMA finally apologized to black physicians specifically for a history of systematic exclusion of black physicians from the AMA and its constituent societies. For most of its history, in order to join the AMA you had to belong to a local medical society. Many of those local medical societies were closed to black physicians, particularly in the South. And this persisted right through the civil rights era. The AMA refused to interfere or penalize these societies. The AMA also apologized for other decisions it made that marginalized black patients and physicians. As 21st century physician leaders, we have much to appreciate and learn from this hurtful chapter in organized medicine.

As physician leaders, the aim is to be on the right side of history.

With your support, I hope to use this title and platform to shine a bright spotlight on the seemingly unseen or underappreciated healthcare dilemmas.   For us to be relevant and to be financially viable, we will must authentically outreach and engage women leaders and younger physicians from all backgrounds. Among my many goals for HCMA is for us to be the model for progressive work toward diversity and inclusiveness in organized medicine.

What’s  the HCMA Plan? 21st Century Rebrand and Reboot.  For our work and advocacy, like Huskies make HCMA a household name. So how could we do this?

Invoking the strategic communication Rule of 3, where the listener will only remember about three things from your presentation and not to overwhelm with twenty-nine key points, here 3 highlights for the upcoming months.

Strategic Friend Outreach I Catalyst Initiative   Over the next year, HCMA will also be more engaged in reaching out to new membership and allies across the healthcare sector. Last year we began a Legislative Breakfast initiative to connect and build relationship with county legislators. We will look forward to continue work with our lobbyist to advance agenda and influence at the capital.   Working closely with Dr. Patel,  we have already met and  hopefully developing  lasting enriching relationships with the main stakeholders, many of whom are here with us tonight,  across the healthcare space the Connecticut Hospital Association, Connecticut bar Association, The Governor’s office, Aetna, UCONN School of Medicine.

Reactivation of the HCMA Foundation.  We have a new charge to improve the health and healthcare of the communities represented by our membership. We are differentiated from other counties by having our own foundation.  We will Increase engagement with patients and healthcare consumers (Facebook, PSAs, media outreach. Talk about cost shifting, advance care planning, how to be effective consumers of quality healthcare, dedication to education of health professional students.   Proceeds from tonight’s silent auction and donations will be directly used to advance the work of the HCMA Foundation. Based on member feedback and respond to patient needs, we will have a new programming focus on end of life patient and physician awareness and education.

AMA Doctors Back to School Campaign During this year, I intend to deploy the AMA national program Doctors back to school campaign across our active and retired physician membership as one of the HCMA signature programs. This program aims to increase the number of physician from the historically underrepresented groups and work toward eliminating racial and ethnic health disparities. The program sends physicians into the community as a way to introduce students to professional role models and show children of all ages from underrepresented racial and ethnic groups that a career in medicine is attainable. We had a most successful grand kick-off earlier this month at a community Health Fair at Waverly school in the Northend.  We engaged the community and touched hundreds of young students.

Practicing physicians across our county and state are facing all new challenges- not just economic. We are losing newly minted physicians to other states. Community physicians are struggling with unprecedented transitions in healthcare delivery.   With the unpredictable climate in the healthcare and politics, HCMA and organized medicine must innovative and strategize to be relevant and impactful in our profession and for the patients we care for and represent. The 2017 physician leader is called to demonstrate true leadership by modeling the right behavior, working together across perceived lines, developing evidence-informed solutions, drawing on the skills of each health care team member, and demonstrating integrity and respect in their interactions.

As an OBGYN, at deliveries as the first one to touch a new life, I silently wonder who will this baby will become, “Is she a teacher, scientist, technology whiz, next president of HCMA?”  It is the small precious, moments that have stuck with me over these decades of practice and as health consumer myself and for my own family.  With all the looming uncertainty and complexity, it is even more important that we physicians focus on dedicate our lives to serving others.
I see the physician/provider-patient relationship as the focus of the health care’s new age. The physician-patient relationship is and will always be the true value zone in healthcare. We as physician leaders should not abdicate our value and expertise to business interests, computer algorithms or metadata.  

We need to recommit to improvement of healthcare and continuing education.  For systems improvement methods and technology to work, you have to know about them and use them, and too many of us are not. It was my experiences in CSMS and HCMA and encouragement from many colleagues here that inspired me stretch and to go back to school and for my master’s degree from Brown University, which was a truly transformative experience. Involvement in organized medicine is a valuable platform for leadership and personal development.

We need to embrace transparency and civility within organized medicine and also within our practice. As we grapple with seeming overwhelming problems, as colleagues, we must be mindful of how we deal with each other and how we lead and express empathy and care for one another. We should bring out the unique brilliance in one another.

Our membership represents a cross section of the physician community. Particular at this time, the need for attention on physician wellness and resiliency is real. More than 50% of physicians report experiencing professional burnout nationwide. Repercussions affect personal health and relationships.  It also has a professional dimension related to job satisfaction, quality of patient care, and patient satisfaction.

A recent Mayo Clinic study identified seven drivers of physician burnout—workload, efficiency and resources, meaning in work, culture and values, control and flexibility, social support and community, and work-life integration. Individual, organizational, and national factors all influence these drivers. 

The Institute for Healthcare Improvement recently published an excellent white paper addressing this issue.   It recommends engaging the physicians to identify “What matters to you?” and then work on the impediments to achieving these goals. The paper also provides a framework for shared collaboration and suggests tools to measure progress.

Moving forward, I ask you to help identify issues, topics, concerns you would like us to consider as we plan our short and long-term strategic objectives for HCMA and CSMS.   Should you be interested in serving on one of our many committee or its subcommittees, please let me know. 

Listen. Not hear but really listen: With these terms — care coordination, patient/person-centered care, quality of care metrics, a new balance of power is taking hold: the transfer of control over patients’ lives to the people themselves. That includes, and I would be remiss if I did not say this, it has to include the voices of the underserved, people of color impoverished and the excluded in our county and across Connecticut. We are a state of striking disparities and contradictions. These patient populations need our mission, expertise and compassionate the most.
As we address critical problems, advocate for health reform in charged political environment, shape the future of health care, and mentor those who will one day follow us, I need your help and support to tackle the health care healthcare challenges before us and our profession. We are stronger together, and working in unity, there is no limit to what we can accomplish.

Thank you all for support of HCMA and our service, mission and vision.  It is everything.

M. Natalie Achong, MD, MHL, FACOG
225th President, Hartford County Medical Association