“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.” Theodore Roosevelt delivered this quote in a speech titled “Citizenship in a Republic,” also known as “The Man in the Arena.” on April 23, 1910, at the Sorbonne in Paris, France.
Good evening esteemed colleagues, friends and family. Thank you for attending this wonderful event tonight and for showing your support for the Mississippi State Medical Association. It is my honor and privilege to address you tonight as MSMA’s 157th President. President Roosevelt’s words give meaning to what it is to be an advocate. It’s when we believe in our causes, display devotion and enthusiasm for them and when we recognize that all may not understand or may even criticize our work, but we persevere because of a shared vision of what medicine should be that we are our most successful. We anticipate pitfalls along the way but with those pitfalls also come great triumphs. MSMA has been bringing physicians together now for over a century and a half to discuss the issues that are important to physicians and patients. It is the wind at our backs, the calm in the storm, the body that not only understands the problems Mississippi physicians face but then works to tackle these problems to allow physicians to continue to do what they do best – to take care of patients.
For those who don’t know me, I grew up just down the road in Brandon. If my parents taught me nothing else, they taught me to meet challenges head on and that just because someone has never done it before, doesn’t mean it isn’t a meaningful and valuable path forward. My father who had grown up working in his father’s service station thought there had to be an easier way to change oil in cars than in the driveway laying flat on his back under an automobile, and as a result, and despite my father’s successful career as a special agent with the Internal Revenue Service, my parents and my uncle worked with Pennzoil out of Nashville to develop and open the first oil change this side of the Mississippi River with only one other similar idea being developed simultaneously by a gentleman in California. We took great pride in my mom serving as President of that company, and I learned from watching everyone in town frequenting Quick Change Oil Company at the corner of County Line and Ridgewood, that someone’s small idea could bring big change. Now we see them on every corner around the country.
My family has been a strong foundation for me throughout my life. Many of you know I lost my mom, Marsha Joiner to pancreatic cancer suddenly about 2 and a half years ago. She was so supportive of my advocacy and involvement with organized medicine, a voice of reason, and taught me that no matter how hard you fight for something or believe in something, that other people are tremendously valuable and can and do bring different insights to the table. She instilled in me a deep respect for others and that the reality they may be experiencing is many times different from ours and yet no less important. She was our family’s rock, seeing my dad and brother through law school, my youngest brother through seminary and me through medical school. I miss her more than anyone can describe and would give anything for her to be with us all tonight. To Colbie, Kylie, Conner, Molly, Stella, Rhett and Julia and the rest of my family, she was so proud of all of you.
Following my parents’ successful oil change and law school ventures, my parents opened a law practice. We had long been involved on the political scene and participated in multiple campaigns for elected office and I just naturally developed an interest in the legislative process and how our laws are made. My dad was appointed Mississippi’s first federal public defender by the 5th circuit court out of New Orleans where he spent the next 17 years until his retirement, and I spent my time working summers for a decade in his brother’s family medicine office. You know him as Dr. Tom Joiner, past-MSMA President, current member of the Mississippi Board of Medical Licensure and Chief Medical Officer of Molina Healthcare of Mississippi. I spent time with Tom at MSMA more times than I can count, have had a relationship with Becky Wells since I was 14 years old and I guess you could say that all of this just runs in my blood and I get it honest! Spending time in the 1980s and 1990s in a private practice family medicine practice allowed me to see “the way it used to be”. I saw the changes in real time and when I graduated medical school in 2003, the landscape had significantly changed and it hasn’t stopped.
So, with a little of my background before you, it’s not hard to see how I got interested in advocacy. I had seen happier times in medicine, had seen others problem-solving life’s issues and I knew I wanted to be a part of it. In addition, I had learned the hows and whys along the way of how to navigate some of these issues. MSMA was a natural fit.
When my husband Tim and I married in 2000, we knew we wanted to have children. Our three lovely children brightened our days and our household and are with us tonight. Thank you for being here, Colbie, Kylie and Conner. As they grew, my love of organized medicine grew as well. I found myself concerned with not only the care of the population as a whole and who would be there to take care of them one day, but would they even see medicine as a desirable career anymore? With physician burnout raging and others stepping up to seemingly practice medicine without going to medical school at all, it only made me want to get involved more.
I could go on and on about WHY I love MSMA and what it stands for, but I think our time here is better spent talking about how we spread that enthusiasm and garner increased involvement from our physicians to stand up for medicine and the things that we all hold as core values.
First, there is no cavalry coming. We are our own cavalry. I have said that before and think it’s a basic principle that underlines what our organization stands for. It is a difficult task to try to explain to someone what it means to go to medical school or to residency and fellowship and to then outline what that expertise looks like. If someone has not experienced it, there is just no way to quantify it. It’s complicated to discuss our scope of practice battles and they easily can be misunderstood as “turf wars”. We face an image problem that’s just not easy, and it seems that many look for a quick fix to the medical problems that plague our state’s population, and well, there’s not one. As the years have gone by, the data is beginning to stack up, and thanks to leaders in this space like Hattiesburg Clinic (for whom I am so proud to work for) we can confidently and enthusiastically say that we KNOW physician led team based care is a must and that anything else leads to poorer outcomes and increased cost. Increasingly these scope of practice battles get harder every year, and hear me when I say, that I predict THIS coming year is going to be this generation’s “tort reform”. We need every single one of you, your colleagues, your families and your friends to help us as we work to protect patient safety. At our very core, FIRST, we do no harm and to allow the unfettered practice of non-physicians on some of the sickest patients in the country would be an epic tragedy. I call on all of you to please help us and step up when asked to. We need you and your patients need you. We are our own cavalry.
Second, I love the camaraderie that MSMA brings for physicians. We had an elegant evening at the Women in Medicine gala last night. Thanks to all of you who came out. As I mentioned above, physician burnout has been at extreme levels in recent years at least in part due to the COVID pandemic and also due to many doctors’ employment situations and loss of autonomy. MSMA is a home for physicians. It’s the place that understands us and fights for us, who provides wonderful events like last night, tonight, our Destin conference and numerous other events to just connect as friends and colleagues. In unsure times, it’s great for physicians to share these experiences and to support each other, and then we take that collegiality to the floor of our annual house of delegates where we make meaningful and impactful policy to direct our beloved organization to advocate for our issues and our needs.
Third, and I mentioned this briefly earlier, is the employment situation physicians find themselves in. As the environment has gotten more difficult in which to practice medicine, MSMA works hard for physicians to maintain autonomy and to navigate what it means to work FOR someone. By nature, we are some of the most hardworking and independent people out there, but with the increasingly complex landscape, we see a loss of autonomy and many times respect for the individual physician. MSMA has created sections where physicians can share their issues whether employed or in private practice as well as other sections that fit our members. It allows us visibility to what our docs are facing and then the ability to help them face those problems. Our own physician leadership academy, helps to grow physician leadership skills so that they can adapt to the environments in which they practice and to develop solutions. I think it is vitally important that we train physicians to continue to lead medicine through corporate changes and shuffling. MSMA is the single organization that represents all physicians in every arena. It truly is the voice of Mississippi medicine, and as we see corporations looking to cut a dollar here or there, it’s important to all of us that we continue to see support for the medical association. It is the life blood of our doctors. Please be the cavalry. Talk to your partners, to physicians you refer to. Invite them to join you at component society meetings and at our events. The army of medicine is strong… and also ever recruiting.
There are many issues affecting our physicians and patients that are crucial and demand our involvement. I mentioned scope of practice because I believe protecting the profession is of utmost importance. Just this past year, we worked on Medicaid expansion which is also a timely issue important to our members. It’s not a sound byte issue and is nuanced and complex, but we are in need in change in our state to make sure our citizens have access to healthcare and as Dr. Edney says “Change can’t wait.” No matter our views, there is no mistaking there is a great divide and many working moms and dads cannot afford healthcare for their families. How we bridge that divide will be how history looks back on us. We either met the challenge or we did not.
Other important issues the medical association is involved in is funding for our rural scholars program, fixing the broken prior authorization process and on a federal level, MSMA and our AMA delegation are fiercely working to fix the Medicare payment system. We need reform and we need it now. Many doctors cannot afford to continue seeing Medicare patients and we are in an unsustainable spiral downwards. With doctors literally the only ones in the proverbial room not tied to an inflationary index over the past two decades, while others in the healthcare space see payment increases year after year, things must change. Our Medicare patients do not deserve to lose access to care, and that’s where we are. We are to the point where physicians can’t keep the lights on and that’s just not acceptable.
I want to thank you all for your faith in me and for your support over the years. There are a few people here tonight I want to mention, but please know that if I listed everyone who has positively impacted me, I would spend most of the night calling names, and I want you guys to get to dancing and enjoying the band and to participate in our draw down tonight so I can’t name all of you, but please know how much I appreciate so very many of you. Thank you to my husband of 24 years, Tim Bryan, and our three children. I could do none of this without your support and I love you. Thank you to my dad, Dennis Joiner, and my brothers here tonight, Sam and John and their families, with thanks also to my Uncle Tom, Aunt Debbie and Uncle Charlie who are here to support me with special gratitude to Tom as my loved one and mentor who always is a sounding board and helps steer me right! Thanks to Chris and Meredith Boston, who are more like family than friends, who are here to celebrate with me tonight having shared all of the years together since medical school and still counting. Thanks, Chris, for covering me during all of the numerous times I duck out for a meeting or a call and making sure the patient care is handled seamlessly. Thank you to Katherine Pannel and Avni Patel for your friendships and support. I enjoy our work at AMA together tremendously. Finally, let me thank Ms. Becky Wells who has kept me between the lines since I was a teenager and Dr. Claude Brunson who has provided years of mentorship and taught me what it means to be a physician leader with his only payback requested that I do the same for others. I have tried to bring others along the way just as you asked and to mentor them into the family of MSMA. We have years of excellent leaders ahead. I could go on and on with the “bench” and how exciting it is to see others grow and develop, and I am humbled to be a part of some of their journeys.
As I close tonight, I want to call on you all to continue giving of yourselves to the worthy battles we face. We went into this field to help people. We still want to help people. It may look different on an organized medicine level, but the policies we make and the advocacy wars we wage, do make changes in the lives of our patients. I’ve always considered myself not to be a single-issue member meaning that I don’t have to agree with every single thing an organization does as long as I agree with the majority of the work being done, and I can tell the hearts of the people leading it are in the right place trying to do good work. That’s what we’ve got at MSMA. We’ve got THE organization for Mississippi physicians fighting for the betterment of Mississippi physicians and patients, and those leading it truly love the work we do and what we stand for. Thank you for believing in me and for allowing me to serve you as your President. I promise to continue to work hard and to represent you well. Please stick around tonight and enjoy dinner, dancing and music with your friends and colleagues. We are fortunate to have this time together and our shared experiences lead to a healthier and stronger MSMA as we prepare for the upcoming year. I hope you all have a wonderful evening. Thank you.