opinion

"Office Hours" gives doctors a chance to stay connected

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 Oct. 4, 2010.

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In my role as president of the AMA, I appear to be building up enough frequent flier points to assure free air travel for the rest of my life. It is a true privilege to represent America's largest physician organization in so many places and with so many different groups. However exciting as the job is, I do worry about being so busy that I risk losing touch with the people I represent.

That's why I am particularly proud of "Office Hours," the monthly call-in time when I listen and talk with AMA members about what's on their minds. It's also a sort of report card, as I get an earful about what people feel we in AMA leadership are doing right and where we miss the boat.

These sessions are extremely valuable to me. To hear you ask questions and discuss issues verbally is different from and, in a lot of ways, less susceptible to misinterpretation than just reading e-mails.

I am particularly gratified that, over time, the sessions have involved more and more two-way discussions and not just consisted of questions for me to answer.

For those of you who have not joined one of the sessions, here are the mechanics of how they work. "Office Hours with Dr. Wilson" is open only to AMA members, and we ask that you register beforehand (link). You may send questions ahead of time, ask them during the call, or both. If you want to talk during the session, you can signal the operators as you sign in or during the call. If the queue gets too long, I will answer your questions or comments via e-mail after the session.

After each "Office Hours," I make a report to the top leadership of the AMA on the subjects covered and the tenor of the get-together. This means that what you have to say to me will be heard by AMA officers, the Board of Trustees and senior staff.

Physicians who have participated in "Office Hours" have raised issues on a broad range of topics, but so far each session's participants have requested that I report on the status of health system reform, the Medicare sustainable growth rate formula and the AMA's labors toward implementation of electronic medical records.

When those subjects come up, I give an update on the AMA's latest efforts. Right now, in a nutshell, SGR cuts are due on Dec. 1, and we are working on strategies to keep that from happening. We continue to be involved at the national level on issues such as "meaningful use" as well as developing tools physicians can use to make the transition to health information technology. And the rollout of health system reform already is an important part of AMA daily activity.

Another question surfacing in the "Office Hours" sessions is one that affects me personally -- the outlook for small practices and solo practitioners.

As Mark Twain said, "The reports of my death have been exaggerated." Likewise, I believe the outlook for small practices is not as grim as many fear. The reality is that even now, 52% of physicians practice in groups of three or fewer. The AMA is working hard to make sure that health system reform regulations recognize this, and we do not for a minute see this legislation as a death knell for small group practices. For one thing America's sprawling geography dictates that the country must have small practices. For another, there always will be physicians like me who want to practice solo or in small groups.

In each session, I also try to bring "Office Hours" participants up to date on the AMA's ongoing push for tort reform. The flawed tort system in this country adds billions of dollars every year in costs of defensive medicine that, if not checked, have the potential to capsize health system reform. Many members of Congress do recognize this, and as a result we have seen funding at the federal level for pilot programs that offer alternatives to our present system. These small steps are only that, but they are in the right direction. In the meantime, the AMA also will continue to push at the national and state level for caps on noneconomic damages, the only proven reform.

Last year, in the heat of the health reform debate, I and the rest of AMA leadership spent a lot of time hosting phone conferences and crisscrossing the country talking with physicians about issues in the legislation.

This year, "Office Hours" offers an opportunity for me to hear -- and you to speak to -- the things you still have concerns about. Personally, I am concerned that there is still so much uncertainty and partisanship among physicians. However, I am pleased that on these calls we have been able to have civil discussions even about some of those divisive topics, and that I can carry your concerns forward to the rest of AMA leadership.

The late, great economist John Kenneth Galbraith noted, "In all life one should comfort the afflicted, but verily, also, one should afflict the comfortable." I don't believe any of us are in a position of being too comfortable, but we all benefit when there is honest give-and-take. That's what I was hoping for when we began "Office Hours with Dr. Wilson." And that is what I am finding.

The next "Office Hours" sessions will be at 7 p.m. Eastern time on Oct. 6 and Nov. 3. Plan to join me and your colleagues from across the U.S.

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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