opinion

A prescription for health care system stakeholders

A message to all physicians from AMA President Cecil B. Wilson, MD.

By Cecil B. Wilson, MD is an internist in private practice in Winter Park, Fla. He served as chair of the AMA Board of Trustees during 2006-07 and was AMA president during 2010-11. Posted Aug. 2, 2010.

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When I accepted the presidency of the AMA in June, I knew my term of office would revolve around two major challenges (there are many more, of course, but these two stand out). The first is to see that we physicians continue to be actively involved as the new health system reforms are finalized and rolled out.

Second, and no less important, is to lead the healing process that is so needed within organized medicine and among our medical system's many stakeholders.

We all recognize that last year's battle over health reform was bitter and divisive, but we also must understand that the future depends on cooperation among all of us -- from physicians to businesses to patients.

In my last column, I offered my prescription for four of the biggest challenges we face to make health system reform a success: medical liability, skyrocketing costs, inefficiencies in health care delivery and Medicare underpayment. This month, I have more prescriptions for the groups who were so involved in last year's historic and turbulent battle.

As reform moves from Washington to the cities and small communities across America, our focus must be about what's best for our profession and patients. So here are recommendations of what we must do -- beginning right now -- to make sure our health system reforms really work.

Private sector

My first prescription is for the private sector. Health plans, insurance companies, pharmaceutical and device manufacturers have a special responsibility in health system reform. Their products and services, like ours, directly affect patients' lives and health. This isn't as simple as selling a new phone.

My prescription for our brethren in the private sector is to remind them that they are more than just businesses. I would encourage them to keep their business practices transparent and keep the needs of their customers -- our patients -- foremost when developing products and policy.

Government

To government leaders, especially elected officials in Washington, I offer a reminder that we are ill served by partisan bickering in a toxic atmosphere that poisons efforts to work together. Turning every policy decision -- even suggestions -- into a 30-second attack ad damages our democracy.

The prescription: Develop legislation and regulations that serve us well. Move beyond the partisan fight. Seek accommodation -- or at least understanding -- across political divides. Tolerate differences of opinion.

Above all, I would ask government officials to remember that they represent the interests of the nation and to act accordingly.

Business

To other businesses, I would offer a reminder that investing in the health of employees today can lead to significant savings in the long run. And it's not just a matter of offering insurance. It's also a matter of fostering healthier lifestyles.

My prescription to America's businesses, large and small: Take an interest in the health of your employees. If they smoke, help them quit. Provide a gym membership -- or better yet, a gym. Replace some of the candy bars and snacks in the vending machine with healthier options.

The rewards aren't just physical. They're also financial. Healthier employees mean fewer incidences of obesity, diabetes and cancer and the costly chronic care that goes with it.

Patients

Because they are the people that health system reform is ultimately about, I also have a prescription for our patients.

My prescription for patients is to urge each of them to empower and educate themselves and take responsibility for the kind of care they receive.

I urge all of our patients -- and us as patients -- to make important health decisions now, such as insuring your family, choosing a personal physician and documenting wishes about end-of-life care.

Remember, most common diseases are preventable. I challenge everyone to adopt healthier behaviors and remind them that their health and well-being are their biggest assets. Don't waste them.

Medical students and residents

To our medical students and residents who are just now learning what this calling entails: Remember that although the system itself may need fixing, the tradition of excellence in this country is as strong as ever. American physicians are world leaders in medical knowledge, technical skills and cutting-edge care.

And most important, remember that this profession you have chosen is incredibly rewarding. To heal, to comfort, to relieve pain -- to be trusted with this most sensitive part of your patients' lives -- is a great privilege.

After more than 30 years of practice, I can honestly say that the sense of gratification I get from helping patients now is just as strong as it was when I first started out.

My prescription for our medical students and residents: Listen to your patients; they will tell you their problems. And sometimes their diagnoses as well.

And join the AMA. Get involved in organized medicine so you can influence the policies that affect your education and your future profession.

Physicians

Finally, to my fellow physicians: Keep in mind that this new era of health system reform is not just a challenge, but also a tremendous opportunity for all of us.

My prescription: Support the AMA, support all your medical associations -- they are the only way to focus light on the challenges we face, and our efforts to better serve our patients. Do not let others divide us.

Let's work together to bridge the legitimate differences that exist between us. And let's keep in mind that we're in this boat together.

For my part, as president of the American Medical Association, I promise to do what I can to mend the divisions within our ranks.

There is an old German saying that God helps the sailor, but he must row. I would like to see all the stakeholders -- from patients to lawmakers to businesses to my fellow physicians -- taking the oars together as we navigate the waters of health system reform.

Cecil B. Wilson, MD is an internist in private practice in Winter Park, Fla. He served as chair of the AMA Board of Trustees during 2006-07 and was AMA president during 2010-11.

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