Lynchburg Academy of Medicine

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Letter from the President

What is Happening in Happy Valley???

As I begin my tenure as President of LAM, I honestly do so with a heavy heart. As I survey the landscape in our corner of the world that Tom Eppes has so frequently referred to as “Happy Valley”, I see gathering storm clouds and I am worried. Consider this column to be an extension of Jay’s last column…

I grew up in medicine in Richmond where three hospital systems compete in a malignant environment for survival. I heard stories of the dark side that lived outside of academia, and I didn’t stray too far from home for fear of confronting an angry community physician lurking in the shadows of the ivory tower. I spent 13 years all told at MCV in training and on faculty, culminating with an attempt at building an adult congenital practice through a joint appointment to the Department of Internal Medicine and Pediatrics. I finally got my big break when I cared for a kid whose father happened to be the head of marketing, but by then I had committed to coming to Lynchburg.

My arrival in Lynchburg in 2009 was a breath of fresh air. My introduction to the medical community was the new provider reception at Boonsboro where I first heard about “happy valley”, and I was welcomed by integrated and community physicians alike. I visited many of the local primary care offices impromptu and was welcomed with open arms. Some of those early visits have translated into close friendships, and I don’t hesitate to call the cell phones of those colleagues who so warmly welcomed me to the practice of medicine in Lynchburg. I built the practice of congenital cardiology in a forward thinking, nationally recognized cardiology group that served as an excellent calling card in a highly sophisticated medical community, the combination of which is not duplicated in many communities of our size throughout the country. Dan Carey asked me one morning how I was fitting in, and I raved about everything from swerving to miss deer during my trips to the ER at night to the warmth of the medical community and the generosity of those I had met; Dan looked at me like I was a little bit odd (he is a good judge of character), but the short of it was that I was thrilled to be in Lynchburg.

These days, I still swerve around deer as I drive through town, but I get more odd looks than I used to: I have a Centra name badge. I hear our administrators suspiciously talking about “the other guys”, and I hear the other guys talk about Centra as though we aren’t to be trusted. There are storm clouds mounting in happy valley. The first time I heard about the practical application of a clinically integrated network, I was sitting at a table at the Centra retreat with someone who now is a member of “the other” network. Maybe I am imagining things, but some of our colleagues seem bristle as they pass each other in the halls because they are on opposing sides of the fault line that runs down the middle of happy valley.

Let’s face it – medicine is changing. The way we practice is changing, the way we are measured as physicians is changing, and the way we are going to be paid is changing. Change scares people – it always has. I am not opposed to competition as a catalyst of change, as long as it is friendly competition. When we don’t call up our neighbor and have an honest conversation about a change in a business relationship and we rather chose to hide behind the coat tails of an administrator who delivers our bad news for us, the first rain drops from the gathering clouds in happy valley are falling. As we sit back and survey the landscape, I see the growing duress of our friends and colleagues running for cover. Let’s face it: medicine is running out of money, so why don’t we pair our clinical data with claims data, dispatch an army of navigators to contain cost, tighten our belts, work harder and later than we ever have before, and… STILL BE FRIENDS! Let’s weather this storm together as friends and colleagues who share the common belief that we can better the lives of those we serve.

Mark Townsend, M.D.

 
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