July 27 - 29, 2023 Save the DATE!
Andrew Sherman, M.D., President, FSPMR
A Call to Florida Physiatrists
One of the most debated and stated philosophical questions cited is, “If a tree falls in a forest, and no one is around to hear it, does it make a sound?”
It was John Locke who stated that no one would hear the sound since it is a mere sensation of falling that is not perceptible if not present.
However, English philosopher, George Berkeley, in his work “A Treatise Concerning the Principles of Human Knowledge,” felt differently and was confident that a tree will make a sound if it is an object existing in one’s mind. If we know that there are trees, that trees fall, then even if not physically present, each fall registers in our awareness.
Without getting too deep into the debate, it is clear John Locke never heard of social media posts so that previously “unheard, unseen” events become “viral” events broadcast to the world to be “heard” and known forever.
In the context that is in our organization, the Florida Society of Physical Medicine and Rehabilitation (FSPMR), why would this question above apply? It is my belief that although membership is currently small, maybe many current physiatrists have never even considered FSPMR in their “metaverse.” We continue to benefit from trees the FSPMR has “fallen” over the years.
The old reality was when I moved to Florida 22 years ago, PM&R was a relatively small specialty, most whom knew each other, and quite comfortable with their “niche” practices, or kingdoms. A good percentage were members of the FSPMR and used the membership to foster fellowship and when needed, protect our ability to maintain PM&R clinical practices, to stop other fields from blocking our ability to practice PM&R.
For example, I remember in 2002, suddenly CMS stopped paying for electrodiagnostic services from PM&R! It was the FSPMR that sent a representative to CMS and educated them on the training and validity of PM&R physicians performing these services and payment, plus valuable recognition of the field, was resumed. For years, the FSPMR has worked with the FMA and other state specialist societies on similar problems that threatened our livelihood and that of our patients as well as they came up.
Now however, the landscape of PM&R has changed. We see changes to the number of practicing PM&R physicians dramatically increased and still increasing. Some of that due to relocation (no state income tax) and the rest due to the creation of new (now 7!!) PM&R residency education programs and several fellowship programs. Finally, we have witnessed an unprecedented expansion in scope of practice in PM&R to include interventional physiatry, cancer, trauma early care, sports medicine, regenerative medicine, neurotoxin, ultrasound, construction of large State of the Art Inpatient Rehabilitation Hospitals, and more. Yes, things in the PM&R world of Florida are getting larger and more complex!
Yet somehow, as I check the membership rolls, until just this year when the entire PM&R Department of Brooks Rehabilitation joined the organization, which has helped, FSPMR found itself with a similar number of paying members (non-resident members) that it had in 2000! Why the lack of engagement? Why the lack of conversion of resident members to paying FSPMR members as young and then “not so young” PM& practicing physicians? What are the implications for our specialty in the state of Florida and the FSPMR?
As are many of the conditions we treat in PM&R, the causes for relatively low membership are “multi-factorial.” We can assume that costs, organization fatigue as many of us in PM&R identify with a subspeciality that often takes our attention, and perceived lack of “hard” benefits all play a role. Although in the past, “hard” benefits: discounts on insurance, equipment, supplies, financial advice, and other items were draws to smaller state medical organizations. (Yes, this issue is not unique to FSPMR.) Now with “internet promos,” this no longer holds as discounts are available everywhere. Finally, I often identify a lack of perceived interest getting involved with organized medicine by younger physicians since they are often more concerned with starting new lives that were so often delayed by years of medical training.
This, it is upon us who are (or even once were and dropped out) enthusiastic and grateful FSPMR members to sound the alarm, to generate interest once again in our peers and younger newly minted PM&R colleagues fresh out of residencies and fellowships, the importance of joining FSPMR. For example, we must impart our knowledge that it is the state specialty society that, often through the FMA, protects each specialty’s ability to provide the clinical care each of us was trained to do, and not allow those with less training (extenders and others) to provide the same care at lesser quality while eroding our ability to earn a suitable and deserved living. It is the FSPMR that promotes the benefits of our beloved specialty to other fields and patients directly. The FSPMR that points out that while valuable, when necessary, more “traditional” specialties such as orthopedics, neurosurgery, and neurology cannot provide the holistic care designed to maximize function that we as PM&R specialists were trained to provide. And for many of the conditions we evaluate and treat, we often get better patient satisfaction and outcomes at less cost to the health care system.
It is the FSPMR that recognizes that the expanding high quality residency training programs in Florida create not just more PM&R specialists, but more well-trained PM&R specialists, versed in the cutting-edge new diagnostics and treatments available. FSPMR recognizes, the true competition is not from within the specialty but from without, that by working together to promote brand awareness and quality care, FSPMR can be that agent of teamwork that lifts all boats in the PM&R community. That this is a true calling of FSPMR, the most important reason to reach out and ask for support through membership in the FSPMR from our state physicians. We ask so FSPMR can advance the daunting task of creating the environment in Florida where every PM&R physician feels valued and allow us all to accommodate larger numbers of PM&R physicians by creating ever increasing demand for our excellent services in all PM&R subspecialties.
In the end, in my humble opinion, despite the recognition that the small core of FSPM&R members has done great work over the years, it is time to get the message out to a wider audience of our peers and encourage them to join with us – officially. To be heard and respected by FMA and other state societies in the fullest, the FSPMR requires the standing of a state society that, at a minimum, the majority of practicing Florida PM&R physicians endorse by becoming full members. Ideally, this credibility can be achieved by realizing membership growth in such overwhelming numbers, that everyone else looks to the FSPMR as the model for true representation of its specialty members.
So, in final, I would just like to say that I am honored to be chosen as your FSPMR president for the next two years. I hope to represent each physiatrist in this state with integrity and inclusion. I welcome direct contact to discuss any ideas for advancing the FSPMR you have, ASherman@med.miami.edu. Instead of having goals for the presidency, I hope to achieve your goals for improving FSPMR for the physiatrists in Florida as its president.
Andrew L. Sherman, MD
to these groups
100% FSPMR membership participation
their PM&R physicians:
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The Florida Society of Physical Medicine and Rehabilitation's mission is to promote and advance health and function through education and research in the field of Physical Medicine and Rehabilitation, in order to provide quality patient care and promote a person’s quality of life and improve functional outcomes.
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