William Pond, MD, Fort Wayne, was sworn in as ISMA president for 2024-2025 during the 175th Annual ISMA Convention in Plainfield.
Dr. Pond is an anesthesiologist with William W Pond MD, LLC in Fort Wayne. He earned his bachelor’s degree in chemistry and zoology from Butler University, and his medical degree from the Indiana University School of Medicine. An ISMA member since 1991, Dr. Pond has served as the association’s treasurer and assistant treasurer, and as a member of the ISMA Commission on Legislation, among other roles. He is a colonel in the Indiana Air National Guard.
In his ISMA presidential address, Dr. Pond thanked outgoing president David R. Diaz, MD, before emphasizing the higher calling of physicians and the importance of working together as a team to help improve health care for all Hoosiers. Dr. Pond also touched on the topics of prior authorization, noncompetes, scope of practice overreach, and other critical issues that need to be addressed in the upcoming year at the Statehouse.
Dr. Pond’s full presidential address is below.
Presidential Address
Sept. 8, 2024
William Pond, MD
Physician-led care:
Restoring and preserving the health of our fellow Hoosiers is a high and noble calling; I thank you for the privilege of leading this organization of physicians who provide that care. Medical care is a team effort; the best person to lead that team is the most highly trained, responsible, and rigorously selected person: the physician. It is you in this room and our physician colleagues. Imagine a football team without a quarterback or ship without a captain. Everyone plays an indispensable role when we provide care for our patients: not just physicians, but also physician assistants, nurses with various levels of training, dietitians, housekeeping, medical records, security, technicians, pharmacists, and administrative support. Each should be appreciated for the unique and special skills that advance the care of our patients. The responsibility delegated to specially trained assistants should be determined by the physician based not only on level of training, but clinical competence, roles, and level of trust. ISMA firmly believes in the team practice model with the physician leading it.
Transparency of Medical Provider Care:
Yesterday, Dr. Huber and Dr. Azad eloquently noted that patients also have a right to know the degree of training and level of responsibility of those involved in providing their care. All medical workers, including nonphysicians, are to be commended for endeavoring to provide a professional appearance, but a white coat with a clipboard and a stethoscope around the neck do not qualify that person to be a director of the patient’s medical care. No wonder patients are confused. When patients see a pharmacist, dietitian, therapist, nurse, it is easy for them improperly to assume qualifications and responsibility that these important team members do not possess. ISMA advocates for transparent badging and titles, so that patients know the qualifications and level of authority of the team members providing their care.
The ISMA led the way in winning passage of one of the first state laws to make clear that the title of doctor communicates to our patients a specific promise of qualifications and training. Be assured that we will continue our work on transparency in patient care.
Competition and Patient/Physician Freedom:
The ISMA has also made progress toward tearing down the barriers created by non-compete clauses. As physicians, we have seen the tragic impact of these provisions more often than you may think. At Friday’s wellness symposium, physician autonomy or rather lack thereof was identified as a major factor in “physician burnout.” When employment conditions change or become overly burdensome, physicians must have the right to change their employment arrangement. Indiana is an “at will” employment state, which means that you may quit, or your employer may fire you for any reason – or no reason. But with noncompete clauses, when the relationship ends, the employer may stay in town, but you must leave your home, your friends, your community, and your patients. Imagine that you’ve had a long day, it’s time to go home, and your employer now demands that stay late to work on medical records or work on them at home in your “pajama time,” or that you must decrease your time spent with each patient to generate more revenue, or that you can no longer see your patients in the hospital, or that you cannot cut back to take care time of your children or your debilitated spouse. We as physicians and our patients must have freedom to maintain our relationships and remain in our communities. Physicians, especially younger ones who are saddled with debt, have no leverage to negotiate a contract without a noncompete clause when all the employers have colluded to make noncompete clauses a condition of employment. Going to court may ultimately be successful, but can take years, and tens of thousands of dollars. So, most physicians stay trapped in the undesirable situation or simply leave town. This deprives patients of their choice of a physician and the doctor of the freedom to work.
Happily, the times they are “a-changing.” The fight for common-sense employment rights has been a long one; the actions by state and federal government and by some individual employers show that physicians’ voices are being heard. Because of the work of all of you in this room and the ISMA, 14 months ago, the Indiana General Assembly extended protections against noncompete contracts to all primary care physicians in Indiana. In November, Eskenazi Medical Group, the 6th largest in the state, removed non-compete clauses from all physician contracts, regardless of specialty. During its consideration of a rule to ban noncompete contracts, the Federal Trade Commission received 26,000 public comments of which more than 25,000 supported an end to this unfair and anti-competitive practice. So, in April, the FTC banned noncompete contracts for all physicians under its authority. Since the FTC protections may face years of litigation, it is essential that the Indiana General Assembly act now to afford the protections to all Indiana physicians; such equality can be accomplished, with a simple strike out of two words, With your help, the ISMA will continue to work to level the playing field.
Prior Authorization:
Twenty-three states have now enacted laws addressing the senseless burdens of prior authorization. All of us have experienced this, probably too many times. For example, your patient has tried an orderly, stepwise, medically sound progression to arrive at the least expensive and most effective medication, which was well documented and approved. Then the insurance company, pharmacy benefit manager or formulary changes and the patient must start the process all over again. This is causing real harm to real patients. Then, the physician or staff must spend hours of uncompensated time hacking through mazes of red tape; this takes away from time that should be spent on our patients. We understand that patients have a right to select their insurance carrier and determine the benefits that will be covered -- but it is the interminable delays and hassle factor to which patients and physicians object. When flying an airplane, there is a checklist before takeoff. Medicine should have the same type of checklist, developed by physicians in conjunction with the insurance companies to expedite approval. And Indiana should join those states which have adopted a” gold card” rule: a physician whose prior authorization requests are approved 95% of the time should earn the right to receive blanket approval for specified medications or procedures. When we speak with our legislators and governmental experts, they are guided by data and by personal stories. The ISMA has been collecting this data and these stories; please continue to send them in because they do have an impact.
Protection of Physicians:
This year, we received a reminder of how the ISMA’s work years ago continues to have an important and positive impact years later. None of us will soon forget the first months of the COVID pandemic: diagnosis and treatment by video, schools and businesses closed, patients isolated and terrified to leave home, single patient masks used for the entire day, shedding clothes at the home door for an immediate shower. Physicians valiantly did the best they could, treating patients every day when others were afraid to go to work. With the work of you here, the ISMA, and the Indiana General Assembly, legislation was enacted to protect physicians working in these difficult, dangerous times, and to be held accountable to the standards of that time, not later when the pandemic subsided and resources were again available. As memories of the emergency faded, those protections were challenged. The Indiana Court of Appeals turned to the ISMA, and a brilliant amicus curiae (friend of the court) brief shepherded by our remarkable Executive Vice President Julie Reed guided the decision that preserved these protections for all of us.
Summary:
Colleagues: legislation and policy will be made, and fiscal allocations made, with or without us. It is critical that we physicians be intimately involved. We have continuing work to do to promote the medical care team, transparency, access of patients to their physicians, physician freedom, prior authorization, and protections for physicians.
Thank you.
We are here because of the support of so many to whom we owe great gratitude: our parents, family, physician colleagues, ISMA staff, our patients, and communities, and for me, my wife Camille, past National President of the AMA Alliance.
Concluding:
The future remains bright for us in medicine: more than any profession, we are blessed to be able to render vital services to patients in their most vulnerable time, to share their most intimate confidences, to enjoy great community respect and to use our minds and skills to their utmost potential. With all of you here we will continue to lead good, fulfilling lives with a sense of purpose.