I RECENTLY READ Atul Gawande's book The Checklist Manifesto: How To Get Things Right which he describes how medicine can benefit from following checklists, as do pilots. We are overloaded with knowledge, training, specialization, and instrumenta­tion and yet we still have unnecessary errors. He shows how outcomes for pro­cedures benefit from following some basic protocols... By making sure the basics are covered, in a checklist, the really bad out­comes can be decreased. He also mentions, at one point in the book, the definition of professionalism or code of conduct. He states, “All learned occupations have a definition of profession­alism, a code of conduct. It is where they spell out their ideals and duties… (these) have at least three common elements:

First is an expectation of selflessness: that we who accept responsibility for oth­ers will place the needs and concerns of those who depend on us above our own. Second is an expectation of skill: that we will aim for excellence in our knowledge and expertise. Third is an expectation of trustworthiness: that we will be respon­sible in our personal behavior toward our charges. Aviators, however, add a fourth expectation, discipline: discipline in fol­lowing prudent procedure and in func­tioning with others.”

Selflessness, skill, trustworthiness, and discipline—four traits that can serve one well in taking care of patients. How about in representing the members of a medical society? Especially one as diverse as we have in Los Angeles County? The types of doctors we represent run the gamut from modes of practice such as academic, solo/small group, large group, HMO, private pay, and concierge, to dif­ferent specialties, to different ages, gen­ders, and ethnicities.

How do the parts fit into the whole? How does a medical society meet the needs of such a varied base? Well, we need for our different voices to be heard but we need to find common themes. Usually we come together on SGR reform, patient access to care, protecting MICRA, or maintaining the patient-doctor relationship.

I would also like to encourage your involvement. Support your local district events, call the leaders of your district with any concerns, and consider join­ing your district board. If you find it meaningful, you may eventually want to join the LACMA board. This past year, through bylaws reform, we decreased the size of our board to allow a more efficient streamlined approach to business. We also recently created a spot on our board for a “young physician”—anyone under the age of 40 or in the first five years of practice after completion of formal training. This is to specifically encourage input from those new to medicine.

We are also aware that Los Angeles County has 40 ethnic medical organiza­tions. We would like a louder voice for these ethnic physicians and are in the process of creating an advisory commit­tee of these leaders.

We want LACMA to represent all of the doctors in Los Angeles County and to provide avenues for inclusiveness. If you have thoughts in this regard, please let me know. As LACMA President, I want to hear your concerns and repre­sent your needs.

Selflessness, Skill, Trustworthiness, and Discipline. You have these traits as a doctor. Bring them with you to medical leadership in LACMA.

Troy Elander, MD, is an ophthalmologist at Elander Eye Medical Group in Santa Monica. He is the 140th President of LACMA.