Pardeep Kumar, MD, MBA, was sworn in as ISMA president Sept. 11 at the 173rd Annual ISMA Convention.
Dr. Kumar is an internal medicine physician practicing with Terre Haute Internal Medicine Associates, which he co-founded with his wife, Tejaswini Kumar, MD. He is affiliated with Terre Haute Regional Hospital, Union Hospital and Sullivan County Community Hospital.
“It has been a matter of great privilege and honor to be elected president of the Indiana State Medical Association,” Dr. Kumar said.
Dr. Kumar earned his medical degree from Government Medical College, Patiala, Punjab, India, and his undergraduate degree from DAV College, Jalandhar, Punjab, India. Upon graduation from medical school, Dr. Kumar completed his residency training at St. John’s Episcopal Hospital in New York. Earlier this year, he earned an MBA from the IU Kelley School of Business Physician MBA Program.
In his ISMA presidential address, Dr. Kumar described how he came to practice rural medicine.
“I had the privilege of serving in Eureka, Nevada, in a county of 1,200 folks, in what was better known as the loneliest town, on the loneliest road in America," he said. “I was the only physician serving in a 60-mile radius. I was a first-generation immigrant, and that was my first exposure to rural America after getting my medical training in the city of New York.”
“I served the local community day and night,” he said. “They provided me a great love and affection. This is where I realized how important a physician is to the local community.”
Since joining ISMA in 2005, Dr. Kumar has served as president-elect, treasurer and assistant treasurer, as well as District 5 president, trustee and alternate trustee. He has also served on the Commission on Legislation.
Dr. Kumar is also a member of the Board of Trustees for the Indiana Health Information Exchange. In addition, he is a member of the Board of Trustees at Terre Haute Regional Hospital, where he has also served as medical staff president, credentialing committee chair and Department of Medicine chair.
Presidential Address
Sept. 11, 2022
Pardeep Kumar, MD, MBA
It is matter of great privilege and honor for me to be elected president of the Indiana State Medical Association. I accept it with a great humility from the bottom of my heart.
ISMA is the largest physician organization in Indiana; it has more than 9,000 members and is slowly growing. Indiana has more than 16,000 practicing physicians. When somebody presents a resolution based on his or her thinking or ideas, once it is adopted by the majority of the House of Delegates, it becomes the guiding principle for ISMA to follow. Such is the strength of organized medicine: The voice of one person becomes the voice of more than 9,000 members, and effective legislation is sought, or changes are made, based on that feedback or idea. This is a very democratic process.
My personal journey with ISMA started nearly two decades back, when I moved to Terre Haute, Indiana, to serve the Hoosiers living in Vigo and adjoining counties. Before that, I had the privilege of serving in Eureka, Nevada, in a county of 1,200 folks, in what was better known as the loneliest town, on the loneliest road in America. I was the only physician serving in a 60-mile radius. I was a first-generation immigrant, and that was my first exposure to rural America after getting my medical training in the city of New York. I served the local community day and night. They provided me a great love and affection. This is where I realized how important a physician is to the local community.
My personal leadership style includes empowerment, persistence and perseverance, which have guided me throughout my life. There are several issues that are important for me to work on in the coming year.
Physician reimbursement has been stagnant for the last two decades. We have had a meager 11% raise from Medicare in the last 20 years. But the rate of inflation has been in the 2% range per year until recently, and the consumer price index has been in the range of 9.1%. Adjusted for inflation in practice costs, Medicare reimbursement went down 20% in the last 20 years.
Because of the federal budget neutrality requirements, organized medicine has had to lobby to avoid payment cuts rather than asking for a raise. We also spent a lot of time and effort getting Medicare’s Sustainable Growth Rate payment formula repealed, but the data shows the payment system that replaced it is also problematic. Now, things have reached a level of unsustainability for physicians and private physician practices. We know anecdotally that the number of private practices is shrinking. Physicians just dealt with a health care recession from COVID, and now, they have been hit with significant inflation. Organizations like ISMA and the AMA will be advocating for financial relief for physicians.
In addition, while ISMA was instrumental in adding exceptions to Indiana’s abortion restriction bill, SB 1, we remain concerned about the criminalization and license-revocation penalties. We stand ready to continue our efforts to roll this back, at the will of the House.
Thank you to all of you who have contributed to fighting the COVID-19 pandemic, now in its third year. However, this has taken a toll on physicians and medical communities – it has increased physician burnout. Other factors, like preauthorization requirements for medications and imaging studies, along with inefficient EMRs (electronic medical record systems), contribute to physician burnout. HR 8487, the federal legislation passed by the House Ways and Means Committee to streamline the prior authorization process for seniors under Medicare Advantage Plans, will help. In May of this year, U.S. Surgeon General Dr. Vivek Murthy issued an advisory about health worker burnout. He said we need to understand the stress and strain of burnout on the medical community – physicians, in particular – and find adequate organizational-level solutions for decreasing administrative burdens, providing mental health services, and improving EMRs so that physicians don’t spend long hours on chart notes after the day’s work.
We passed transparency legislation in Indiana this year. However, scope of practice is the real issue for the practicing physicians, even now. Many primary care physicians are being replaced by nonphysician providers. We want physician-led teams to be responsible for patient care. We understand the importance of nonphysician providers, but ensuring that they work under the supervision of physicians leads to the best patient care, considering physicians’ level of education and training. Having more nonphysician providers has not significantly improved care in rural areas, as most choose to practice in the same geographic areas as physicians. Rural areas also need more physician-led care, rather than care provided only by nonphysicians. ISMA will continue to work on scope-of-practice issues as a frontline defender of physicians.
The only good thing that came out of COVID was the expansion of telemedicine. Many state governments, including Indiana’s, have called off the COVID-19 public health emergency. However, the federal health emergency will continue at least until October 18. Whenever it does end, several COVID-related services will be affected. Therapeutics, testing, etc. will go private. Telehealth coverage will also be impacted. However, the U.S. House has passed a bill with bipartisan support to extend COVID telehealth flexibilities, including Medicare coverage of telehealth services, until December 31, 2024. ISMA will continue to advocate for coverage of telehealth services where physicians determine they are appropriate for patient care.
We have significant public health concerns in Indiana. Indiana lags in public health metrics: We are close to the bottom in most public health measures. Our governor has created a public health committee which has already published its recommendations, but much more needs to be done. One main reason for Indiana’s poor metrics is its public health funding. While we spend close to $12,000 per capita on sick care, Indiana’s expenditure on public health is less than $50 per capita. Most of the funding is from the state and county governments, with a small amount from the federal government. A significant increase is needed in public health infrastructure and funding, especially from the federal side, so that we can reduce our sick care expenditures. We have a very decentralized public health system, which is inadequate to meet the need in case of a national public health emergency. A second major challenge is Hoosiers’ acceptance of public health measures, so an information campaign based on facts, not on misinformation, will be needed. The vision for our ISMA is to make Hoosiers among the healthiest people in the country, so we will continue to work in this direction.
I am very confident about the future of ISMA due to its deep physician leadership. Some are my mentors, and others are enthusiastic young physician leaders who will carry on these big reforms. Also, we have the very talented ISMA staff, which works day and night to serve the physician community. At this time, I would like to thank my wife and my two boys, who have always stood by me in all my endeavors, for their wholehearted support.
I leave you with two pearls of wisdom:
- Take care of your health and get your colonoscopies and mammograms in a timely manner, so that a healthy work force can make Hoosiers healthier.
- Peaceful resolution of conflict is a road to prosperity. Resolve your personal, professional and business conflict peacefully, and prosperity will follow.
Thank you very much for your attention.