PHILADELPHIA REFLECTIONS
Musings of a Philadelphia Physician who has served the community for six decades

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Philadelphia Medicine
The first hospital, the first medical school, the first medical society, and abundant Civil War casualties, all combined to establish the most important medical center in the country. It's still the second largest industry in the city.

Membership and Fellowship in the College

{College of Physicians}
College of Physicians

The College, I fear, has allowed itself to resemble the Board certification process, where a great deal of effort is put into attaining the honor, but once attained, there is not a great deal to do. I believe this is the main reason we see so many Fellows stop paying dues after a few years. Last year, I believe it was said there were 90 drop-outs from all causes.

My suggestion is that we contemplate a more formal subdivision by specialty, linked to local specialty societies, and ultimately to the national specialty societies -- especially when they hold their annual conventions in Philadelphia. We already have a small number of specialty societies who use our facilities, and it would be important to learn their feelings about what I propose before doing anything that might upset them.

I am proposing more than just renting the hall. My proposal is that we explore offering College membership (not fellowship) to every physician active in a specialty society which joins with us, for the duration of his activity in the specialty section. I think we should require their officers to be fellows of the College, and suggest that their national President be offered the honor of yet another new class of affiliation, that of Master. For this to be seemly, our own officers might be made Masters as well. When national meetings are held in town, I would hope that officer dinners here at the College might be welcomed.

There are things to be explored. Many of the local specialty societies have the expenses of their monthly meeting dinners paid for by drug firms, and I am familiar with the discomfort the College has felt with pharmaceutical relationships. Perhaps if the pharmaceutical companies themselves had a membership class, there might be sufficiently generous dues to substitute for the present system.

I am not proposing this idea as a revenue center, but rather as a way to get the physician community within the building, hoping that a substantial number would go on to full fellowship, but recognizing that many residents and junior staff may have only transient interest in Philadelphia. The relationship I would seek is not between their staff and our staff, but between their leaders and ours. I would hope they could be given space to display their trophies, and possibly specialty libraries, and accorded space among College meeting notices, and website space.

As a footnote, I considered the idea of linkages to local hospital staffs, but discarded it. It might be fine if every hospital linked up, but for a long time there would be affilitates and non-affiliates, which has led to a caste system in the past, and would do so again. Curiously, having some specialties affiliate and others not, seems to avoid this issue. Perhaps you remember that Philip Synge Physick was called the Father of American Surgery, but he was never a fellow of the College because he was only a surgeon. Those days are behind us, but it is always good to be sensitive.

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