Your Life, Your Health: Promise of the New Year

James Holly, M.D.

For those who were born before the mid-20th Century (1950), the approaching of 2018 brings us closer and closer to the mid-21st Century and only seven years until the quarter-of-a-century mark. It seems like yesterday that the Y2K scare was at the top of our “worry list.” How, those of us “historically” minded, often think in terms of anticipated events expected within the next 20 years and wonder how many of those events we will personally experience.

All of my life I have found it easy to say, “I love you,” I am surprised at how eager I am to say those words today.   As my wife walked out of the room yesterday, having told her “how cute she looked,” I said to her, outside of her hearing, “I really do love you.” As I talked to my daughter yesterday, having a political discussion in which we radically and vigorously differ, I stopped her and said, genuinely and sincerely, “I just want you to know how much I love you.”  Even though my son and I work together, we hardly ever hang up the phone without saying, “I love you.”  

I wondered to my wife later last night why I feel such urgency and need to say these words, which I have said so often? One good thing, I added is that no matter what the future holds, or when it holds it, nothing important will have gone unsaid. I conducted the funeral for my father and began by saying, “Nothing that needed to be said, or that I wanted to say has not been said.” Grieving is so much easier when there are no regrets for what should have been said and wasn’t.

We never know when an often recurring and deeply treasured experience is the last time, so we make sure that every time is a good time so that if it is the last time, it’s OK. I remember exactly where my mother stood, when as our visit drew to a close, I put my arm around her and said, “Mother, we have had a good time, haven’t we?” She responded, “Yes.” I added, “So, if this is the last time, it’s OK!” It was the last time I saw her conscious. She died four weeks later.  

At this time of year, we often sing again the melancholy song, “Auld Lang Syne.”  A lump often forms in our throats as the melody brings to mind those whom we have lost to death or to distance.  Either way, we lament that the past years have separated us from those we have known and loved. It is on this day, in the joyful anticipation of the New Year, we remember the old, and, we are both sad and glad.  

Translated literally “Auld Lang Syne” means “old long since,” but the meaning is more like “old times” or “the olden days.” The lyrics are haunting:

“Should old acquaintance be forgot, and never brought to mind? “Should old acquaintance be forgot, and old lang syne?


“For auld lang syne, my dear, for auld lang syne, we’ll take a cup of kindness yet, for auld lang syne.”

SETMA Approaches 25th Anniversary in 2020

The coming of the New Year holds particular promise for Southeast Texas Medical Associates, LLP.   For the past two years plus we have been “digesting” the impact of the Affordable Care Act which imposed a heavy tax upon the IPA in which we participate.  Added to the 28 percent reduction in reimbursement from our largest insurance carrier, SETMA has experienced tremendous financial pressure. Our response was to continue to pay our employees and to take care of those who have entrusted their healthcare to us without reduction in services.   

We end 2017, with all accounts current and with all employees’ salaries current.  As of December 31, 2017, all of SETMA’s partners will have received 96 of their 2016 and 2017 salaries. For those who have lived through this time that seems and is miraculous.

We have come through a very hard time but NO partner, even when he or she was not being paid, left or abandoned ship. That is remarkable. No patient received less care and the partners continued to fund the care of our neediest patients out of the SETMA Foundation. In 2016, the Christmas bonus for employees was meager but in 2017, we were able to give a generous Christmas bonus to our employees and we  finished the year with ALL invoices and obligations met. 

This may seem strange to many because “don’t all doctors make a lot of money?”  In reality physicians who are the most socially responsible in caring for the neediest patients often struggle to meet the obligations incurred by assuming the care of patients with great needs and to meet the needs of all employees, such as affordable and excellent health insurance.   Increasing demands are being place upon healthcare providers without the provision of funding for those demands.  In the face of this, we all wonder how the proposed one trillion dollar reduction in the funding of Medicaid and the one half trillion dollar reduction in the funding of Medicare are going to affect us and others.   Our confidence is that as we have met the challenges of the past, we will meet those of the future.

2018 will be SETMA’s twenty-forth calendar year in practice, counting the years and partial years we have existed.  For some of us, 2018 represents 44 years of providing healthcare services for the residents of Southeast Texas.  Either way, 2018 marks a time when we remember those we have lost both providers and patients.  HIPPA prevents us from naming those we remember but we remember hem with a smile on our face and warmth in our hearts. We remember the children and he elderly.  We remember the laughter and the tears.  The most important thing is that we remember.

With the challenges of the past met, and with the expectations of the future bright,  providers, management and staff of SETMA celebrate the new year with joy.  We look forward to the challenges and the opportunities of the coming year.  The accomplishments of the past which are documented at  provide us with the foundation for this bright future.  Those accomplishments challenge us to renew our commitment to excellence and to transformation.  

As in the past, the difference between our “reality” – where and what we are -- and our “vision” -  what and where  we want to be – provides the “creative tension” – the pressure and energy for creating the future..   

Dr. James L. Holly is CEO of Southeast Texas Medical Associates, LLP (SETMA) in Beaumont.