A special message from the Pelican State.....

Welcome to another edition of The Pelican, the campaign newsletter of the Louisiana State Medical Society (LSMS). Initiated in 1987, it has been used in numerous campaigns to inform AMA delegates and alternates about LSMS candidates running for AMA office. This issues's focus will be on Dr. Donald Palmisano in his bid for election to AMA President-Elect. We hope you will find it informative, as well as enjoyable, with a number of favorite features continuing-just as we urge you to elect Dr. Palmisano President-elect to continue his outstanding service since his election to the Board of Trustees in 1996!

Elect

Donald J. Palmisano, MD, JD
AMA President-elect 2002

A Strong Voice.
A Proven Choice.

Dr. Palmisano welcomes your comments and suggestions and looks forward to talking with you about issues regarding our AMA and the Federation.
Keep this handy cut-out for your use throughout the coming year.

Office: 4417 Lorino Street, Suite 200
Metairie, Louisiana 70006
504-455-5895
FAX: 504-455-5740
E-mail: DJP@intrepidresources.com
or Donald_Palmisano@ama-assn.org
Web Page: www.intrepidresources.com

LOUISIANA STATE MEDICAL SOCIETY
6767 PERKINS ROAD       BATON ROUGE, LA 70808
225.763.8500      800.375.9508      FAX: 225.763.6122
www.lsms.org

January 1, 2002

TO:

• AMA Delegates and Alternate Delegates
• Presidents and Chief Executives of State Medical Associations
• Presidents and Chief Executives of National Medical Specialty Societies

Dear Colleagues:

The Louisiana State Medical Society, the Orleans Parish Medical Society, and the Louisiana Delegation to our American Medical Association are pleased to announce their endorsement and support for the candidacy of Donald J. Palmisano, MD, JD for AMA President-elect

Donald brings to this office an outstanding record of service and experience at all levels of organized medicine. As a past president of the Louisiana State Medical Society and a private practicing physician, he is keenly aware of the concerns that face our colleagues daily. He is an attorney with special expertise in tort reform, risk management, and claims negotiation, and has channeled his education and expertise to assist his fellow physicians and many healthcare organizations in dealing with professional liability and other healthcare issues.

Serving as your representative on our AMA Board of Trustees and now as Secretary-Treasurer, he has been a strong voice for medicine on the national level. Donald has testified on Capitol Hill on numerous occasions on a broad array of issues important to medicine, such as privacy, antitrust reform, and health plan accountability. In addition, he has been a frequent spokesperson for the AMA to all types of media and the public, including tours of duty on AMA National House Call, as well as visits to federation organizations throughout our great nation.

Donald has an exceptional ability to frame the issue and clearly articulate a solution. His wisdom and experience, coupled with dedication, integrity, courage, and commitment, are all qualities Donald has brought to the Board. Join us, along with the American Gastroenterological Association and the American College of Surgeons, in supporting Donald J. Palmisano for President-elect in June 2002.

Sincerely,

K. Barton Farris, MD President

Jay M. Shames, MD Chair, AMA Delegation

When representing AMA, I present AMA " policy and do not give my individual opinions on a topic. However, in this initial 2002 President-elect campaign column I will share with you the analytical approach I use in discussing and debating issues brought before me as a Board member before consensus is reached or the vote is taken. This may be of special interest to any new delegates who have not had much direct exposure to me as an individual.

• Words mean something. It is critical to use the correct word and to carry out the intent of the resolution by its clear and unambiguous meaning. “Brain damaged at birth” gives a conclusion as to etiology. Plaintiff trial lawyers use this approach to influence the jury. “Neurologically-impaired newborn” documents impairment, but doesn’t conclude birth caused it.
• Clarify the framework of analysis. Framing the question frequently predetermines the answer. What are the criteria to judge the merits and risks of a proposed project? Are they consistent with the past, or are the criteria chosen to justify a predetermined result? Understanding the framework of analysis also is critical in assessing the ethics of a proposed action. For example, what is the model of ethical analysis? Is it Deontological? (Rightness is not defined in terms of its goals and consequences; violate no rights is paramount.) Is it Teleological? (Goal or consequence oriented.) Is it Social Utility? (Greatest good for the greatest number.) Has the analysis included a discussion of fundamental ethical principles of beneficence, nonmaleficence, autonomy, and justice? Each of these analyses has additional choices to consider for the analysis.
        In short, disputes frequently arise in ethical debates because opponents are using different models of analysis or the thinking is subjective and not objective. Finally, never forget the patient! Is it in the patient's best interest? Will the patient give informed consent?
• Don't go along just to get along. Do your homework, have courage, and don't give up! Do the right thing, for the right reason, at the right time. Decisions should be based on facts and for the good of our AMA, not for individual political considerations. Rumor and innuendo have no role. Due process is critical. Fair play is the American way. Speak to the issue and not against the person; no arguments from intimidation or personal attacks.
• Listen more and talk less. I try to understand the other person's viewpoint. I have learned much by listening more. The benefit is that a win-win solution usually can be found faster. Trust is enhanced.
• Communicate! Communicate! Communicate! This is the heart of a successful mission. If you want to be on my biweekly update, send me an e-mail. Replies have taught me much. We learn from each other.
• Love and respect America. I think the Declaration of Independence and The U.S. Constitution are wonderful. I believe Liberty is the absence of coercion. I do not think our future lies in government-controlled medicine, a single-payor system, elimination of competition, and bureaucracy. I believe that fallacies have led us to the emerging "Perfect Storm" in healthcare. Consider price-controls by government and insurance companies, escalating overhead (professional liability insurance, unfunded mandates, etc.), draconian actions by third parties that interfere with the patient-physician relationship and the belief that the only options are managed care (with many examples of monopsony power and abusive insurance company practices) versus single-payor. The universe of options is larger. AMA policy gives a splendid additional option: defined contribution, individual ownership, individual selection (of a policy whether it is a medical savings account, managed care, indemnity, etc.), and tax credits.

Opportunity for AMA success is at hand if we have the courage to seize it and move confidently in the direction of our Mission. American medicine, like America, is under attack. Let us all show leadership. Let us all work together as Americans and AMA members, not just as specialty-focused surgeons, internists, obstetricians, family practitioners, and so on. Each of us can make a difference; together we are unstoppable! E Pluribus Unum!

I value your opinion and your vote, and I hope I have earned your trust.      DJP

From the Pelican Recipe files:
Emeril's Homemade Barbecued Shrimp
A signature dish at Emeril's Restaurant in New Orleans

2 pounds medium-large shrimp in their shells
2 tablespoons Emeril's Creole Seasoning, in all
16 turns freshly ground black pepper, in all
2 tablespoons olive oil, in all
1/4 cup chopped onions
2 tablespoons minced garlic
3 bay leaves
3 lemons, peeled and sectioned
2 cups water
1/2 cup Worcestershire sauce
1/4 cup dry white wine
1/4 teaspoon salt
2 cups heavy cream
2 tablespoons unsalted butter

Peel shrimp, leaving only tails attached. Reserve shells, sprinkle shrimp with 1 tablespoon Creole seasoning and 8 turns of black pepper. Use your hands to coat the shrimp with the seasonings. Refrigerate shrimp while you make the sauce base.

Heat 1 tablespoon of the oil in a large pot over high heat. When the oil is hot, add the onions and garlic and sauce for 1 minute. Add reserved shrimp shells, the remaining 1 tablespoon Creole seasoning, the bay leaves, lemons, water, Worcestershire, wine, salt, and the remaining 8 turns black pepper. Stir well and bring to a boil. Reduce the heat, and simmer for 30 minutes. Remove from the heat, allow to cool for about 15 minutes, and strain into a small saucepan (about 1-1 1/2 cups). Place over high heat, bring to a boil, and cook for about 15 minutes, until thick, syrupy, and dark brown. Make about 4-5 tablespoons of barbecue sauce base.

Heat remaining 1 tablespoon of oil in a large skillet over high heat. When oil is hot, add seasoned shrimp and saute for 2 minutes, occasionally shaking skillet.

Add cream and all sauce base. Stir and simmer for 3-5 minutes. Remove shrimp to a warm platter with tongs, and whisk butter into sauce. Remove from heat (makes about 2 cups).

Makes 4 main-course servings or 6 first-course servings.

Adapted with permission from Emeril's New New Orleans Cooking, by Chef Emeril Lagasse.

This dish is served by Emeril along with his Petite Buttermilk Biscuits. For a copy of that recipe, send Donald an e-mail!

*Past issues of The Pelican Brief by Donald can be found at www.intrepidresources.com and include columns devoted to Leadership, Communication/AMA Membership, Antitrust Reform, Managed Care, Study of the Federation: E Pluribus Unum, Tort Reform, Rescuing Our Destiny, and his Vision of Hope.

Tabasco returns as Palmisano Campaign mascot. Here she listens to campaign advice from her older adopted sister Sacha. Red-haired Tabasco was rescued by the Palmisanos as she laid severely injured on the highway near Avery Island six years ago.

AMA Meetings & Conferences
2002 Leadership Conference March 9-12 Los Angeles
2002 Annual Meeting June 15-20 Chicago
2002 Interim Meeting December 7-11 New Orleans
2003 Annual Meeting June 14-19 Chicago