From:
David Jakubowicz, MD, FACS MSSNY President
Colleagues:
The events of the past month threaten to undo a century of progress in public health.
On August 8, a gunman fired more than 500 rounds into the Centers for Disease Control and Prevention (CDC) headquarters in Atlanta. His stated motive was to “make the public aware of his distrust of vaccines.” Officer David Rose, a local police officer who responded heroically, was killed. The gunman took his own life. Thankfully, no one else was injured.
Less than three weeks later, on August 27, the White House dismissed CDC Director Susan Monarez. Five of the CDC’s top leaders immediately resigned in solidarity. Within days, states began charting their own divergent paths. Washington, Oregon, and California announced the creation of a West Coast Health Alliance to provide evidence-based recommendations on immunizations and vaccine safety. Meanwhile, Florida moved in the opposite direction, preparing to allow residents to opt out of all vaccine mandates.
Taken together, these events reveal a disturbing trajectory: violence against public health institutions, political pressure undermining scientific expertise, and a growing patchwork of state-based vaccine rules.
A Dangerous Polarization of Medicine and Public Mistrust Medicine is at risk of becoming red-state and blue-state practice, while it should be based on science and objective evidence. Physicians may find themselves not only explaining the science but also battling political perceptions that frame their advice as partisan. In such an environment, the wrong word can cause a patient to dismiss sound medical guidance as “politically biased.” Worse, physicians may face ostracism, threats, or even violence.
Medicine should rise above politics. When a child is sick, or when a vaccine prevents deadly disease and protects newborns too young to be immunized, public health should unite us. Instead, political polarization and social media platforms that amplify distrust have eroded confidence in physicians and hospitals. According to a recent JAMA Network Open survey, public trust in these institutions has fallen below 50 percent.
Restoring Trust While the unprecedented measures taken during COVID-19 pandemic meant to stop the rapid spread of the disease meant well, some of the measures taken and affirmative and absolute claims made by political and public health officials turn out not to be based on solid and validated scientific evidence. The unintended consequences of these actions and claims unfortunately caused mistrust of public health and medical professionals when it comes to immunization. Rebuilding that trust will not be quick or easy. It will require diligence, empathy, humility, political skill—and unfortunately, money. In the exam room, physicians must meet patients where they are: listening first, giving them space to process, and respecting their need to “do their own research,” then offering their professional opinion. We need to go back to the basics of physician-patient relationship and communication without injecting our personal politics.
At the state level, public health leaders must continue to advocate for evidence-based policy, even while addressing public skepticism. Federally, we must be careful not to present science as immutable dogma. Instead, we should state clearly: these recommendations are based on the best available science today. It is important to transparently lay out the risks, benefits, and alternatives, if any, of any treatment we offer our patients. However difficult, restoring trust is essential for the health of our patients.
A Call for Leadership The actions of the past month are unacceptable. Leadership matters, and accountability matters. HHS needs to objectively analyze data and publish reasonable guidelines in a way that restores credibility and stability. Fragmentation of our public health policies will only set us back and should be avoided. Public health officials must be committed to science, public health, and rebuilding trust across the political spectrum, and be held accountable.
In the meantime, Senator Bill Cassidy, who chairs the Senate Health, Education, Labor, and Pensions Committee, should exercise rigorous oversight of federal health agencies. If the federal government cannot maintain credibility, states will continue to fracture along partisan lines—leaving Americans with unequal and uncertain access to public health protections.
Standing Firm Physicians across the country are practicing medicine under extraordinary pressure. They are heroic for continuing to serve patients in this volatile environment. But they cannot do it alone. Professional organizations, policymakers, and communities must stand with them.
We cannot remain silent while public health is politicized and trust in medicine erodes. The integrity of our health system—and the safety of our patients—depend on it.
All the best,
By Hemant Kalia, MD, MPH, FIPP
This article was published in the RBJ https://rbj.net/2025/08/01/a-gilded-cage-for-primary-care-the-dangerous-promise-of-new-health-care-law/
For years, physicians pioneering the Direct Primary Care (DPC) model have fought for a simple change: to allow patients to pay for their affordable, membership-based primary care using their tax-advantaged Health Savings Accounts (HSAs). The recently passed One Big Beautiful Bill Act (OBBBA) finally delivers that victory. Effective Jan. 1, 2026, DPC arrangements will no longer be considered disqualifying health coverage for HSA purposes.
This is, on its face, a landmark achievement. It treats DPC membership fees — capped at a reasonable $150 a month for an individual — as a qualified medical expense, not an insurance plan.1,2 This single change unlocks a vast market of millions of Americans with high-deductible health plans, giving them a powerful new way to access comprehensive, relationship-based primary care. For physicians, it offers a path away from the burnout of fee-for-service bureaucracy and toward a more sustainable and patient-focused practice model.
But this victory is dangerously deceptive. It is a beautiful, gilded cage built in the middle of a collapsing ecosystem. While the OBBBA hands DPC a powerful new tool with one hand, it dismantles the rest of the health care safety net with the other.
The same law is projected to strip health insurance from an estimated 12 million Americans through massive cuts to Medicaid and the Affordable Care Act. This will not happen in a vacuum. The newly uninsured will still get sick, but they will delay care, arriving in emergency rooms with more advanced and costly conditions. This will trigger a tidal wave of uncompensated care — projected to cost physicians $24 billion and hospitals $63 billion over the next decade.2,3
A pyrrhic victory for physicians?
This is where the gilded cage slams shut. DPC practices do not exist on an island. They depend on a stable network of specialists and hospitals for referrals and escalations. What happens when a DPC patient needs a colonoscopy, a cardiac stress test, or an urgent surgical consult? They are sent to the very specialists and hospitals that will be buckling under the financial strain of uncompensated care.
When local hospitals are forced to close service lines, lay off staff, or shut their doors entirely — as many health care organizations predict will happen — a DPC membership becomes a ticket to a broken system. The promise of better primary care is undermined if there is no reliable specialty or hospital care to back it up.
The OBBBA’s gift to DPC is a classic Faustian bargain. It offers a clear and immediate business opportunity in exchange for systemic instability that threatens the viability of the entire health care community. True innovation cannot flourish in a system facing financial collapse. Unless we address the profound, indirect harms of this legislation, the long-awaited victory for Direct Primary Care may prove to be a hollow one indeed.
Hemant Kalia MD MPH FIPP is Consultant, Interventional Pain & Cancer Rehabilitation Medicine; CEO & Chief Medical Officer, Savya Neuroscience Institute; and President & CEO, C.R.I.S.P Center for Research & Innovation in Spine & Pain.
1https://www.ralaw.com/media/insights/alert/blog_post_or_one_big_beautiful_bill_a_boon_for_concierge_medicine
2https://www.congress.gov/bill/119th-congress/house-bill/1/text
The Monroe County Medical Society (MCMS) is proud to partner with St. Ann’s Management Company, Inc. (SAMCI). Through this partnership, MCMS members have access to SAMCI’s full spectrum of billing and revenue services, including revenue cycle management (RCM) support including:
Whether you’re a solo provider or part of a large group practice, MCMS is please to collaborate with SAMCI to support medical practices by working to streamline your RCM processes allowing you to focus more on delivering quality patient care.
To learn more or schedule a consultation, please send an email to info@samci.org or mcms@mcms.org.
Rochester, NY, June 23, 2025 - The Monroe County Medical Society has recognized Stanley Schaffer, MD and Mary Zelazny with its 2025 Edward Mott Moore Physician and Layperson Awards. This award recognizes individuals whose dedication to the community goes above and beyond the usual call of duty.
2025 Edward Mott Moore Physician Award Stanley Schaffer, MD
Dr. Schaffer is a Professor Emeritus of Pediatrics at the University of Rochester School of Medicine and Dentistry. He did his pediatric residency at Albert Einstein Medical Center in Philadelphia, his fellowship in Academic General Pediatrics at the University of Rochester and joined the faculty in the Division of General Pediatrics at the University of Rochester Medical Center in 1991. Dr. Schaffer worked as a primary care pediatrician mainly serving children and adolescents in impoverished families while also leading and participating in health services research and activities supporting a healthier community. His research activities mostly focused on ways to improve blood lead testing rates for young children and to enhance childhood immunization rates. In 1994, Dr. Schaffer became the inaugural Co-Director of the Western New York Lead Poisoning Resource Center’s Rochester Office, funded by the New York State Department of Health. He continued to direct the center, working closely with community groups and local health departments in the 9-county Finger Lakes Region throughout his career. In 2000, recognizing the need to address childhood lead poisoning in a community-wide collaborative manner, Dr. Schaffer participated in the founding of Rochester’s Coalition to Prevent Lead Poisoning (CPLP), which subsequently was recognized nationwide for its community-based approach to addressing the problem of childhood exposure to lead. He has been a member of CPLP’s Executive Committee for many years and, in 2004, he established CPLP’s Screening and Professional Education Committee to focus on improving blood lead testing rates and educating health care professionals about lead poisoning. Throughout Dr. Schaffer’s professional career, he has been focused on improving the health of children through prevention and collaboration to build a healthier community.
2025 Edward Mott Moore Layperson Award
Mary Zelazny
Mary Zelazny has been the CEO of Finger Lakes Community Health, a Community Health Center program, since 2006. As CEO, Ms. Zelazny has led a major expansion effort to provide access to healthcare services throughout the Finger Lakes region of New York, including the development of enhanced programs and services designed to reach out to the many culturally diverse communities it serves. Under Ms. Zelazny’s tenure, Finger Lakes Community Health has grown from a single health center site to 9 comprehensive health center sites across 6 counties of rural New York State, serving about 30,000 patients annually. In addition, Ms. Zelazny has focused much of FLCH’s work on the integration of health information technology within the organization. FLCH is now a nationally recognized leader in the implementation and use of telehealth, connecting a wide variety of healthcare providers through technology, to provide more access to care for patients. Ms. Zelazny has promoted the incorporation of a high level of cultural competency of staff, as well as integrating care coordination and technology into primary care that has created important collaborative relationships across the region and state. This effort has resulted in expanded access and better health outcomes for patients by addressing the many barriers to care that are inherent in many rural communities of New York State. Ms. Zelazny serves on the NYS Rural Health Council, is Board Chair for Forward Leading IPA, and is the NYS representative to the National Association of Community Health Centers Board of Directors. She also serves on the FLPPS Board, and the Common Ground Health/RRHIO Board.
About Monroe County Medical Society
Over 1,200 physicians are members of the Monroe County Medical Society/7th District Branch. The Monroe County Medical Society is a non-profit organization formed to extend medical knowledge and to advance medical science, to elevate the standards of medicine, to promote reforms and to enlighten and direct public opinion on the problems of health and medicine for the best interests of the people of Monroe County. For more information visit www.mcms.org or email mcms@mcms.org.
For more information on Senator Brouk, go here!
Transition to Remote Operations – Effective June 1, 2025
MCMS has exciting news that we would like to share you. After careful consideration, and with approval and support of the full MCMS Board of Directors, we would like to inform you that effective June 1, 2025, the Monroe County Medical Society will transition from a physical office to a fully remote work environment.
All contact information—phone numbers and email addresses—will remain the same, and there will be no disruption to services or communications.
MCMS Physician Line: 585-473-4072
MCMS Public Line: 585-473-7573
Email: mcms@mcms.org
Mailing Address: PO Box 22894, Rochester, New York 14692
Please contact Jen Casasanta at jcasasanta@mcms.org with any questions pertaining to the move. Thank you.
On Tuesday, April 29, 2025, MCMS celebrated the annual Transition of Officers at Max of Eastman Place in the city of Rochester. The event was sponsored by our friends, Sebastian Diaz & Robert Powalski at the Alliance Advisory Group and Ben Levy at M & T Bank.
For photos of the event, click here!
Our new slate of officers are:
President
Scott Hartman, MD
1 year term: 5/2025 - 4/2026
President-Elect
Sahar Elezabi, MD
Secretary
**NEW** Jane Bennett, MD
Treasurer
**NEW** Kristen Walker, MD
Censor
Madonna Tomani, MD
3-year term: 5/2024 - 4/2027
Ralph Pennino, MD
**NEW** Sarah Minney, MD
3-year term: 5/2025 - 4/2028
Cathy Goodfellow, MD
3-year term: 5/2023 - 4/2026
**NEW** Ashanthi Gajaweera, MD
Kathy Hughes, MD
(completing Michael Privitera’s Term)
3-year term: 5/2023 – 4/2026
Delegate
Matthew Witmer, MD
2-year term: 5/2022 - 4/2026
Rachael Wojtovich, MD
2-year term: 5/2024 – 4/2026
Jack McIntyre, MD
2-year term: 5/2025 - 4/2027
Steve Schultz, MD
NOTE: Derek tenHoopen, MD is RE-ELECTED to be appointed to the MCMS Board of Directors as a guest with voice so that he may be called upon as an Alternate Delegate should the need arise.
Welcome our new 2025 new slate of officers!
