A resolution introduced by ISMA Past President Kevin Burke, M.D., asked the ISMA to study ISMA’s district and membership structure. The resolution noted that:
- ISMA’s 13 geographic districts were modeled around congressional districts that no longer exist in the same form.
- The size of our districts varies widely.
- Some county medical societies are inactive.
The resolution proposed formation of an ad hoc committee “to study the current districting plan with the thought that districts should be adjusted to give more proportional representation, that the number of districts probably needs to be reduced, and that the ISMA membership could be obtained through county society, district or by direct membership in the association outside of the county society and district.”
Task force formed
The ISMA 2013 House of Delegates referred the resolution to the ISMA Board of Trustees for study. A cross-representative task force was formed, consisting of Cindy Basinski, M.D., District 1 (chair); Dave Welsh, M.D., District 4; John Kincaid, M.D., District 7; Daniel Wegg, M.D., District 8; and Heather Gillespie, M.D., District 13. Each member of the task force is not only familiar with the ISMA, but also several have been very involved in their county medical societies, including as past presidents.
The task force carefully studied a great deal of information about the ISMA’s structure and history, including self-assessments completed by county societies. While some county medical societies are quite active, others are admittedly inactive. This is important because the ISMA Bylaws specify that in order to join one component society, the physician has to join the state, district and county component societies -- sometimes referred to as “unified membership.”
County medical societies, districts and the ISMA are legally distinct and independent entities. Therefore, the ISMA does not have the authority to dictate – and does not dictate – how the 79 county or 13 district societies function or whether they follow various financial and legal formalities the ISMA follows.
The task force also considered the national context. Although most state medical associations over the last century and a half have followed a similar unified membership model, several have been revisiting that structure in recent years and making changes if it was not conducive to the way medical associations and the medical profession operate today. These conversations are not unique to Indiana.
Task force reaches agreement
The task force ultimately agreed with the premise of Dr. Burke’s original resolution, that the current district structure does not allow consistent representation or messaging across the state, and that mandatory membership in the county medical society can be a barrier to membership in some instances.
“To be the most effective service and advocacy organization, we need every doctor in the state of Indiana to be an ISMA member,” emphasized Task Force Chair Cindy Basinski, M.D. “Improving awareness of ISMA’s role and eliminating barriers to membership are critical. That’s why the task force respectfully recommended allowing doctors to have the choice of which medical societies they join, making districts be part of the ISMA, and further studying the district structure.”
The ISMA Board of Trustees discussed the task force’s report, which remains under consideration. The board did express concerns about whether any possible legal noncompliance by the county and district societies could pose a potential legal liability to the ISMA, since the ISMA collects and remits dues for those societies and memberships are linked.
“These are very difficult issues and require difficult discussions, but they have to occur,” noted ISMA President-Elect Heidi Dunniway, M.D. “We are the latest generation of caretakers of a 165-year old establishment, and it’s our job to make sure it’s positioned to serve Indiana physicians well into the future. Although we may not like it, the industry is changing and our association has to adapt.”
The task force’s report is being provided to all physicians participating in ISMA’s annual meeting, which is Sept. 5-7. Dr. Dunniway has also created a special one-hour forum during convention to discuss these issues. That session is scheduled for Saturday, Sept. 6, from 3:30-4:40 p.m. (County society presidents/secretaries meeting).