Final and Firm

 

Recently, the Supreme Court of Puerto Rico issued its ruling on the second motion for reconsideration related to mandatory licensing. To the best of my limited legal knowledge, mandatory licensing is definitively dismissed, leaving members of the Puerto Rico Medical College (PRMC) "legally unlicensed." The organization's survival now depends on our voluntary union as a guild, through the payment of the annual fee by vote.

 

The PRMC has waged a constant battle to improve the island's healthcare system, currently dominated by insurance companies. However, facing influential lobbyists backed by large sums of money makes it challenging to advocate for the patient. When you add the considerable financial lobbying power of insurance companies in the legislature, the college fee seems inadequate and powerless. It is a historic battle, akin to David and Goliath, where the latter has outplayed the former in a yo-yo Duncan fight.

 

One aspect I have never quite understood about our leaders in the medical association is the lack of technology for strategic warfare. An electronic system could be implemented to assess the capabilities of all its members, chart action plans, gather guild opinions, document victories and defeats, and build a workforce capable of making substantial changes in the rules of the game. Even voting could be electronic, but they insist on witnessing a handful of people.

 

Historically, doctors have been limited by the state, insurance companies, and hospital institutions. We are like pawns in a chess game, often not fully understanding what is happening. Although we leave medical school or residency believing we have control over patient care, the reality is different. We face third parties with profit motives that complicate our medical practice. Although they did not study medicine, they are the pawns that manage the cost of caring for the sick. They control diseases with their red or green traffic light system.

 

The PRMC has not recognized that a universal healthcare system, like those in developed countries in Asia and Europe, eliminates excessive profit and provides uniform care. They have never conducted a feasibility study for a single-payer system or asked their constituents about related ideas. Capitalist minds that fear the old socialist bogeyman will devour us. Instead of advocating for radical changes, they prefer to fight small battles.

 

For now, I will continue to pay the fee, as the absence of our guild reduces the chances to almost zero that we become the rook moving vertically and horizontally in the care of our patients.

 

*The author is a pediatric surgeon and professor at the RCM. Appointments (787) 340-1868.

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