by Jessica Kitchin

Practicing medicine these days is enough to make a doctor sick. Four years ago, an estimated 70 percent of the state’s 34,000 licensed doctors staged a one-week protest, postponing routine checkups and rescheduling elective surgeries, to voice outrage over soaring malpractice premiums. A Monmouth University/New Jersey Monthly poll this year found that 32 percent of physicians in the Garden State have seriously considered moving to another state, and half have genuinely contemplated retiring early.

Dr. Michael Horn says he won’t walk away from his Willingboro obstetrics and gynecology practice. “But I’m not ready to walk away from the issues, either,” he says. “I hope we can resolve some of these frustrations.”

When Horn started in private practice more than two decades ago, he says, he spent 99 percent of his time taking care of patients. Today, he and his medical-group colleagues devote much of their day to maneuvering through red tape and wrangling with managed-care companies. “It makes it difficult to focus solely on the medical aspects of care,” he says. “There have become too many business aspects.”

Hoping to strike a blow for change, Horn joined NJ Physicians, a new advocacy group formed to tackle the problems facing the state’s physicians. Dr. John Tedeschi, a pediatrician in Cherry Hill, was one of a half-dozen doctors who in frustration last year decided to start a unified organization. “I don’t like what I’m seeing happen to the medical community in general,” Tedeschi says. “We’re losing our enthusiasm.”

For centuries, the Medical Society of New Jersey has represented the needs of doctors. But Tedeschi and his co-founders decided doctors needed a fresh voice in Trenton. Twelve months of planning and a flashy website (njphysicians.com) later, NJ Physicians held a September press conference declaring its mission to speak with a stronger, more unified voice and ensure that medical decisions are made by physicians, not by managed-care companies.

As frustrating as insurance issues are for doctors, there’s a growing impression that patients are getting hit the hardest. To gather evidence, NJ Physicians has launched a Web registry where doctors can report instances when delays or denials from an insurance company ultimately caused patient harm.

“There’s a feeling among all physicians that somehow patient care has been jeopardized,” says Dr. Ronald A. White, president of NJ Physicians and chief of surgery at Bergen Regional Medical Center in Paramus. “Once and for all, we need to answer that question.”

The group has a long list of other goals, such as offering legal counsel to physicians and reducing overhead through alliances with companies such as American Express. In late September, the organization was gearing up for a membership drive to bolster its relatively meager roster. By year’s end, NJ Physicians aims to have a few thousand members—or about 10 percent of the state’s practicing physicians— with a goal of hitting 5,000 by the end of 2008.

Executive Director Jay Hedden is hopeful, based on the public response so far. “I think I can honestly say everywhere we go we’re very warmly received,” he says. “Everybody’s receptive to the idea of physician advocacy.”

But an organization already exists that’s dedicated to a similar purpose. The Medical Society of New Jersey has about 8,000 members and calls itself, “your partner in practice… your voice in Trenton.” Founded in 1766, it’s the oldest professional society in the United States.

Inevitably, NJ Physicians is moving in on the Medical Society’s turf. White says there’s no ill will toward the longstanding organization. “Historically, the Medical Society has

done a very good job,” says White, a surgeon who recently earned his law degree and joined in the planning of NJ Physicians last winter. “I think this model is a little more inclusive and might work a little bit better.”

NJ Physicians aims to enroll a few thousand doctors (about 10 percent of the state’s practicing physicians) by the end of the year.

White says the objective is to bring together New Jerseyans who have an interest in healthcare—doctors, business leaders, nurses, legislators, members of the pharmaceutical and insurance industries. “Instead of being confrontational with each other, we want to say ‘Look, we have a problem. How can we come up with answers that are acceptable to everyone?’”

NJ Physicians will include two councils—one “leadership council” of physicians and one “advisory council” of other stakeholders (nurses, legislators, and the like). These will report policy and business concerns, as well as potential solutions, to a board of trustees. The board will compile ideas and direct its staff to work with state officials and business leaders to implement changes.

Medical Society CEO Michael Kornett says he isn’t concerned about NJ Physicians. “Starbucks doesn’t worry about every new brand out there, they just keep building on what they do best,” Kornett says. “That’s what we plan to do.”

Kornett cites a list of accomplishments by the Medical Society, including successful class-action lawsuits against Aetna, Blue Cross Blue Shield, HealthNet, and other health insurance companies last year; advocacy for patient safety; and a continued alliance with the American Medical Association.

“We are, I should imagine, the leading authority in the state when people need a medical opinion on anything,” Kornett says, adding that he doesn’t see the need to divide the medical community into separate groups. “We have this down to a science, and now here’s this new organization. While this is America and a free market, we don’t see why there’s a need for any diversion. We try to speak in one voice.”

That voice, as NJ Physicians hears it, is out of step with today’s medical community. “It’s a new generation, a new voice, a new set of problems,” says cofounder Tedeschi. “I think the Medical Society has tried very hard to do a good job, but we’re just trying to create a new enthusiasm and take a fresh look at the issues.”

To White, a fresh look could impel sweeping changes that would help doctors work more as they did in the past. In his own practice, he’s taken pains to achieve that goal: A few years back, he stopped dealing with managed-care companies altogether and offered to see a handful of financially stressed long-term patients for free if they couldn’t pay.

“I got to the point where I felt it was such a burden on myself and on the patient to deal with the bureaucracy,” he says. “I’m much happier taking care of them for nothing.”

The income loss hasn’t been that great, White says, and it’s much easier on his office staff. “I can talk to my patients,” he says, “and I feel more like the doctor I grew up with in the 1950s and 60s, rather than feeling like I was on this treadmill.”