Reply to the Montgomery County Medical Society Call for More Physician Particiaption in Policy Making

 Subject: Barriers to Physician Engagement and Patient Safety Advocacy

Thank you for the invitation to become more involved in the Pennsylvania Medical Society. I believe it is important to explain candidly why many physicians remain disengaged.

The Society is widely perceived as politically unbalanced. Many Pennsylvania physicians hold conservative or nonpartisan views, yet Society positions and public advocacy consistently align with one ideological framework. This discourages participation and contributes to low membership penetration.

Equally problematic is the Society’s limited defense of clinical care against external pressures from the legal profession and insurance industry. Defensive medicine, insurer interference, and post-hoc liability distort patient care daily, yet the Society rarely confronts these forces directly or forcefully.

The internal resolution process compounds the problem. Requiring sponsorship by senior leadership before consideration ensures that dissenting or minority viewpoints—particularly from frontline clinicians—rarely reach debate. This structure suppresses meaningful discussion and policy innovation.

Most concerning is the absence of serious leadership on patient safety reform. Pennsylvania experiences an estimated ~2,000 deaths annually associated with medical error. Yet the current system prioritizes liability avoidance over learning. Immunizing internal root-cause investigations from civil discovery would encourage honest analysis, reduce repeat errors, and improve outcomes.

Finally, the Society has not adequately challenged licensing practices that disproportionately penalize physicians—often ethnic or immigrant doctors—for being labeled “disruptive” when advocating strongly for patient care, while systemic failures remain unaddressed.

Physicians need a Society that defends clinical judgment, welcomes ideological diversity, and places patient safety above institutional risk management.

Respectfully,

David Behar, MD

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Here is a resolution you will never allow to come up for discussion, and that will find no sponsor from your hierarchy. Please, explain why your hierarchy is qualified to select resolutions anyway.

Formal Resolution Proposal — 

Resolution: Protection of Patient-Safety Root Cause Analyses

WHEREAS, Pennsylvania experiences an estimated ~2,000 deaths annually associated with medical error; and

WHEREAS, effective patient-safety improvement requires candid, multidisciplinary root-cause analysis of adverse events; and

WHEREAS, the discoverability of internal safety investigations in civil litigation discourages honest analysis and perpetuates repeat errors;

THEREFORE, BE IT RESOLVED, that the Pennsylvania Medical Society advocate for legislation granting privilege and immunity from civil discovery to bona fide patient-safety root-cause investigations, while preserving accountability for willful misconduct and gross negligence; and

BE IT FURTHER RESOLVED, that the Society opposes the use of professional discipline based solely on speech or tone when a physician is advocating in good faith for patient safety or care quality. Harassment of physicians by the Licensing Board is intended to drive them out of the profession. Drive a doctor out, save $6 million a year in medical costs.