opinion

AMA entering an era of transition and transformation

A message to all physicians from Ardis Dee Hoven, MD, chair of the AMA Board of Trustees.

By Ardis Dee Hoven, MD , an internal medicine and infectious disease specialist in Lexington, Ky., is president of the AMA. She served as chair of the AMA Board of Trustees during 2010-11 Posted Dec. 20, 2010.

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While in medical school, it never occurred to me that the biggest challenges I would face as a physician would be in Washington, D.C., and not in my practice.

That is the case today, of course, and we are all scrambling to make sense of the health system reform legislation and make it work both for our patients and our practices.

Yet as we work aggressively to create fair regulations and systems of care that make sense, whether in solo practice or in large integrated systems, we must recognize that change is necessary.

Over the past few weeks, I have been using the phrase "transition and transformation" a lot. This fits the AMA's present state; it also fits where we are as a profession, and it describes what we need to do.

This has been a year of transition -- from the world as we knew it of practicing medicine to a different environment surrounding health care delivery. As the primary representative of America's physicians, your AMA has focused on salvaging the best of what we have and working hard to see that needed change will come to pass without sacrificing either physicians or patients in the process. We want our practices to thrive, not just survive.

Things are looking up in some areas. We see an effort, albeit in the form of several small pilot programs, to find a way around the crippling problem of medical liability. We see steps toward innovative care models, things like physician-led teams for medical homes and accountable care organizations. And there is more.

Even with congressional passage of a 12-month Medicare payment fix, we are still struggling to find a way through the sustainable growth rate mess. While members of Congress -- in both houses and on both sides of the aisle -- individually agree that the nation is facing a crisis that must be dealt with, they can't seem to take the next step. It is heartbreaking for physicians who can see no other way out but to cut back on Medicare patients. And it will be devastating for our seniors. But there is "light at the end of the tunnel." Our SGR strategy task force has thoughtfully outlined what must be done and will continue to pursue the ultimate resolution. This is a priority for the AMA.

As we look toward 2011, it is evident that health system reform was not the only transforming event of the past few months. September's groundbreaking New Horizons Conference on Medical Education, sponsored by the AMA and AAMC, was convened to begin the transformation of medical education to meet the future. As a participant in this conference, I was very gratified to see the forward thinking and potentially game-changing concepts addressed and debated.

And if you've been paying attention, you have seen the beginnings of transformation at the AMA as well.

Most obviously, the AMA will say farewell to Michael D. Maves, MD, MBA, when his contract ends in June. The nine years that Dr. Maves has been our executive vice president have been good for the AMA. Under his guidance, we have weathered the recession, stabilized our finances, created the successful "Everyday Heroes" and "Voice for the Uninsured" campaigns, built the Scope of Practice Partnership, implemented a number of critical initiatives to improve quality of care, increase access to care created tools to help you transition into electronic health records and more. The Physician Consortium for Performance Improvement is a particularly stellar example of these innovations.

However, as Dr. Maves himself has said, it is the right decision at the right time, for everyone.

The AMA must become more forceful in our dealings with the political world, more creative in our ability to communicate with you and the federation, and more agile in recognizing and addressing small and large changes that affect physicians and patients. We anticipate continued dialogue with you -- in a deliberative way.

You can already see new kinds of communication launched to meet the demands of the times:

  • The monthly "Office Hours" with AMA President Cecil B. Wilson, MD, offers a unique opportunity to talk with him and send messages directly to AMA leadership (link).
  • We recently reinitiated our AMA Member Connect Surveys to obtain your feedback on critical issues, and the response has been excellent. We launched a separate Member Connect Survey on health system reform. Responses to that will inform the AMA's actions on this hot topic going forward.
  • AMA Wire, our new electronic weekly newsletter, gives you more information plus increased opportunities to tailor your subscription to your personal interests and needs (link). We also published the first volume of AMA Advantage, a concise guide to the latest AMA products and services (link).
  • Finally, the AMA has created opportunities for members to interact with one another. We've launched a series of private, online communities devoted to discussing specific topics -- from medical education to physician health to medical student issues -- accessed by invitation only.

Our two newest groups are a Health IT Group and a Young Physicians Group.

These have been added to our stable of communications that already includes American Medical News, Twitter, our Facebook pages and a host of other New Age tools. But we need to do more, especially in finding new avenues of relevant, real time, two-way communication.

Transforming the AMA, of course, means more than better communication and new leadership. It also means sharing concerns.

Membership remains a problem that needs to be solved. I have no doubt that it will. In a world where all organizations are battling with issues of numbers and participation, the AMA has a unique advantage in our role as the primary representative of both America's physicians and her patients.

Back in July, we convened a task force to investigate alternative membership structures that will make for a stronger, more effective AMA. After initial months of investigation, the task force is now developing a plan, establishing a timeline and determining resource requirements.

During this next phase, we will engage representatives from each of the key stakeholder groups, including AMA council members, state and specialty leaders, special groups, delegates and others.

This is a priority for the AMA and your board.

The future of the AMA also depends on more active members. If you have not checked lately, I encourage you to go to the AMA website's membership tab and investigate opportunities. I recommend getting involved. My AMA participation has been an education and an amazing experience since the beginning. If you do not like the opportunities that are presented, create your own opportunity. Play a role in the AMA's transformation.

Health system reform, a new EVP, better communication, membership -- as the AMA looks forward, I'm afraid I don't see a yellow brick road. The challenges are daunting. Yet I am confident we will meet the future as we have the past by finding the best, most appropriate, most effective ways to promote the art and science of medicine and be an essential part of the professional life of every physician in the 21st century.

Ardis Dee Hoven, MD , an internal medicine and infectious disease specialist in Lexington, Ky., is president of the AMA. She served as chair of the AMA Board of Trustees during 2010-11

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