B. Future Direction - Results of the Regional Breakout Sessions

Key Issues:

The participants identified the issues and concerns that their Organizations were addressing. Their responses can be grouped into:

• Medical conditions and risk factors, e.g., hypertension, diabetes, mental illness (especially depression), smoking, cancer, obesity, Hepatitis C, and teen pregnancy.
  
  
• Community-level barriers to access, e.g., limited access to care, lack of transportation, immigrant status, language barriers, and high rates of illiteracy and other problems that impact the health of the communities they serve.
  
  
• System-level barriers to access, e.g., the growing numbers of uninsured, Medi-Cal exclusions and payments that are "low and slow," IPA and HMO mergers that reduce access to specialty care, lack of workforce diversity in health and mental health specialties, insufficient numbers of people of color in medical school and residency programs, and the exclusion of and limitations placed on mental health services by health plans. One participant also noted the exploitation of immigrant Medi-Cal and Medicare beneficiaries by criminals committing reimbursement fraud.
  
  
• Provider practice issues, e.g., barriers to ethnic physicians participating in Independent Practice Associations (IPAs) and concerns about Medical Board of California bias in its discipline decisions.
  
  
• Organized medicine issues, e.g., the poor relationship with and the lack of services from the CMA, the need for better relationships with local medical societies, and the need to strengthen membership and other organizational resources of the individual EPOs.

The relationship between the CMA and the EPOs received considerable discussion. Several participants commented on the lack of opportunity to participate, the poor outreach of the CMA, and the high dues level and lack of value received for dues payment. Other participants noted that the receptivity of the CMA to the involvement of ethnic physicians had increased dramatically in recent years, and that the continued involvement of ethnic physicians is needed to keep the CMA moving in a positive direction.

Overall, the EPOs tended to focus on the health problems facing their communities. However, they also expressed considerable concerns about the system of health care and how health care is financed and how medicine is organized and that impact on their practice of medicine.

How the Network Could Assist the EPOs' Work:

The participants described a number of ways in which the Network of Ethnic Physician Organizations could assist them to address the community health, practice and other concerns that they had identified. These included:

• Enhancing services to their communities through provision of health education materials and techniques, translated materials, and access to media.
• Increasing the effectiveness of advocacy in the state legislature and with state administrative agencies through training and information support.
• Establishing more productive relationships with organized medicine at the state and local levels.
• Increasing access to information through Internet access, policy and legislative information and networking opportunities with colleagues.
• Building stronger Ethnic Physician Organizations by increasing membership, developing new funding sources, enhancing communications and information dissemination to members (e.g., about HIPAA), and outreach and communications to non-members.

Characteristics of an Effective Network:

During the Regional Breakout Sessions, Summit participants made a commitment to participate in and strengthen the Network of Ethnic Physician Organizations. They identified the following Network services and tasks as highly useful in supporting policy advocacy and other collective efforts of EPOs:

• Strengthening communications among the EPOs.
  
• Building local and regional EPO networks.
  
• Providing mini-grants to EPOs.
  
• Coordinating EPO advocacy on policy issues.
  
• Providing continuing education and information on health issues.
  
• Keeping the website and EPO directories up-to-date.
  
• Increasing outreach to EPOs that do not yet participate.
  
• Increasing advocacy with the CMA and local medical societies to build strong relationships with EPOs.

Breakout session participants also supported:

• Maintaining the role of the CMA Foundation as an incubator and fiscal agent of the network.
• Building an organizational structure that includes a Board of Directors for the Network drawn from the leadership of the EPOs with an Executive Committee and series of work groups.