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| Dr. Palmisano debates an issue on the floor of the LSMS House of Delegates. |
The latter characterizes Donald J. Palmisano, MD, JD, who over the years has been a valuable resource for his fellow physicians in Louisiana and other parts of the nation.
Unlike some who seek an office for a personal goal only to fade into the background afterwards, Dr. Palmisano's service with the LSMS was a launch pad for continuous involvement in the activities of organized medicine.
A board-certified vascular and general surgeon and a Louisiana-licensed attorney, Dr. Palmisano is seeking a position on the AMA Board of Trustees in June. In addition to his recently reduced private surgical practice, he is the president of Intrepid Resources/ The Medical Risk Manager Company, a firm specializing in professional liability claims handling, risk management, medical staff bylaws, and managed care contracting consultation to physicians, clinics, and hospitals.
Dr. Palmisano first became active in organized medicine in the early 1970s when he joined with several other physicians in the state to press for passage of the Louisiana Medical Malpractice Act, modeled on the Indiana state law.
"I called on Don to help me put together a team to get the Indiana plan enacted in Louisiana," says John C. Cooksey, MD, a Monroe, LA, ophthalmologist who spear-headed the goal to enact a limitation of liability cap in the state. "He was on-call for his surgical group when I called and told him that I wanted him on a plane the next morning so that we could meet with a senator who was a key player in the passage of the Indiana law. There was no hesitation on his part ... he made the appropriate arrangements for coverage and was on the 6 a.m. flight the next morning."
Dr. Palmisano was elected President of the LSMS in 1984-85 and was elected a Louisiana delegate to the AMA in 1986. He has chaired the delegation since 1992.
He continues to be involved in the activities of organized medicine, at local, state, and national levels. He has served continuously as a delegate to the LSMS House of Delegates from the Orleans Parish Medical Society since 1974.
Dr. Palmisano was a moving force in the formation of the Louisiana Medical Mutual Insurance Co (LAMMICO), a physician-owned liability insurance company developed by the LSMS when Louisiana faced a significant crisis. Many national companies were refusing to write professional liability insurance in the state. He was a founding member of the board of LAMMICO and was the company's vice president of claims.
"Don is a physician who has used his legal training to help the profession of medicine," observes LSMS President Lawrence L. Braud, MD. He was the Society's point man on the Governor's Commission on Medical Malpractice, served as a valued medical/legal consultant when the state's malpractice law was successfully defended before the Louisiana Supreme Court, and now heads the legislatively-mandated Louisiana Medical Disclosure Panel, a body that is determining therapy risks that must be disclosed to patients.
"Don's energy and enthusiasm for his varied interests - medical, legal, political, and cultural - earned him the headline A man of many seasons, when Physician's Management Magazine profiled him in a special feature in 1987," says fellow AMA delegate W. Juan Watkins, MD of Shreveport. "He hasn't changed; he remains wedded to ideals and goals that make him an excellent candidate for the AMA Board of Trustees."
The NEJM editorial of December 21, 1995, "Extreme Risk - The Corporate Proposition For Physicians," decries the abuses of managed care and offers as the cure-all the single payer system. In my opinion, single-payer is the wrong solution. Alas, does not a model of competition, freedom of choice, and rewards appeal to those who write the stories for the history books of tomorrow?
In 1985, in my final speech as president of the LSMS, I addressed the
coming changes in the practice of medicine by contract medicine, or managed
care, and stated that the sine qua non of quality medical care was doing
what was in the patient's best interest. Now 10 years later, physicians
have a history of managed care to review. Most are not satisfied with the
results and have concluded, just as physicians did when faced with
unreasonable acts by commerical professional liability carriers, that the
solution is to form and operate their own managed care entities. Of course
there is an additional hurdle in this endeavor, namely, the antitrust laws.
This can be overcome by changes in federal law - not an easy task as we
know - or by forming entities with true risk-sharing by physicians. Some
intrepid physicians were visionaries and plunged into the tumultuous
managed care seas years ago, steering their own ships. One success story
is Lifeguard, an HMO formed 11 years ago with Dr. Bob Burnett of California
as a founder and initial CEO. This is a non-profit organization that pays
fee-for-service (no capitation), negotiates directly with individual
physicians and groups, and has a point of service option. It was selected
by the Bay Area Business Group On Health as #1 in patient satisfaction and
preventive care. The system of pluralism (including medical savings
acccounts), the right of physicians to privately contract with patients,
choice, and quality advocated by our AMA should be supported. We should use
the experience of those in our House of Delegates who buttress their
visions with success stories just as we do in the professional liability
arena. President Eisenhower said, "Neither a wise man or a brave man lies
down on the tracks of history to wait for the train of history to run over
him," and President Kennedy said there is one path Americans "shall never
choose, and that is the path of surrender or submission." In that spirit,
let us seize the day and control our own destiny.
DJP
New Orleans Red Beans*
1 lb red beans 1/2 cup chopped bell pepper 1 1/2 tsp sage
1 cup chopped onion 1/4 cup salt-free chicken base 1/2 tsp black pepper
1/4 cup chopped parsley 2 1/2 quarts of water 1 tbls minced garlic
1 cup chopped celery 1 1/2 tsp ground thyme 1/4 tsp liquid smoke
Wash and sort beans. Soak in fresh, cold water in a covered container.
Refrigerate overnight. Before cooking, rinse beans with clear water and
drain. In a large pot, saute onions, celery, bell pepper, and chicken base
for 5 minutes or until vegetables are soft. Add soaked and drained beans
and 2 1/2 cups water. Cover pot loosely and simmer for 1 1/2 hours,
stirring occasionally. Add thyme, sage, black pepper, garlic, parsley and
liquid smoke, stirring occasionally. If beans cook too quickly, more water
may be added to get the desired consistency. Serve over rice. Yield: 12
servings
* The Heart Healthy Recipes of Touro Infirmary, New Orleans