opinion

In turbulent times, AMA projects physicians' united voice

A message to all physicians from Robert M. Wah, MD, chair of the AMA Board of Trustees.

By Robert M. Wah, MD is a reproductive endocrinologist and ob-gyn in McLean, Va. He was chair of the AMA Board of Trustees during 2011-12 and is currently AMA president-elect. Posted Feb. 20, 2012.

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I had the recent privilege of being part of a cross section of America's physicians. We represented a variety of specialties and geographies as well as practice types -- from solo practitioners to partners in group practice, academics and those who work in hospitals or other largersettings.

We had come to Washington for the annual AMA Presidents' Forum and National Advocacy Conference.

Just one look at the two conferences' agendas illustrates the many critical issues facing physicians and our profession. Issues such as:

  • Advancing innovations in health care delivery and payment systems.
  • Reducing health care costs.
  • Developing reasonable rules for accountable care organizations.
  • Optimizing data collection to improve quality and enhance patient care.

We also came to Washington with a "to do" list of common issues we wanted to advance with members of Congress. Our common positions on these issues were hammered out in the AMA House of Delegates, a group whose members represent 175 medical societies and virtually all American physicians.

On two consecutive afternoons, we walked the halls of Congress, carrying the message of America's physicians to our elected representatives.

Here is what we asked from members of Congress:

  • Eliminate the sustainable growth rate formula.
  • Halt implementation of ICD-10.
  • Eliminate the Independent Payment Advisory Board created by the Patient Protection and Affordable Care Act.

We also asked them to:

  • Support liability reform bill HR5.
  • Support HR 1409, an antitrust bill that exempts health care professionals from federal and state antitrust laws when negotiating contract terms for covered items or service.
  • Support HR 1700, the Medicare Patient Empowerment Act that allows patients to use the Medicare benefits they have paid for all these years to see the physicians of their choice.

For me, the annual Advocacy Conference is particularly edifying, because it reflects the unity and power of physicians working together for issues of universal importance.

Congress, like the public, rarely stops to separate physicians into our many unique and different roles. They see us all as doctors.

That is why it is so important that we, in turn, speak with one voice. When we fail to do so, our audience becomes confused. And they may stop hearing us at all.

Granted, every physician specialty, geography, practice mode and career stage has unique and distinct needs and desires. Yet we all share even more. And it is because of what we share -- and what we represent as physicians -- that makes the AMA the powerful voice to be listened to.

Advocacy may be one of the AMA's most well-known roles, but our impact is far greater than that. We also serve other universal needs of the physician community. We provide expertise in managing physician practices ? valuable resources like CPT, our Practice Management Center, and health information technology assistance and resources.

Thanks to the AMA and a battle spearheaded by the Litigation Center of the AMA and the State Medical Societies, nearly $200 million in settlement payments are being distributed to physicians in February following our historic victory over UnitedHealth Group, which underpaid physicians for out-of-network health services.

We serve as an ongoing source of research and education, career support and practice enhancement. For example, the AMA-convened Physician Consortium for Performance Improvement has contributed more than 70% of the quality measures now embedded in the federal government. With a weekly circulation of 315,000, The Journal of the American Medical Association is the most widely circulated medical journal in the world.

In addition, the AMA serves as a crucible for change in the medical community. This is extremely significant. Today, as we see the health care system evolving around us, it is key that physicians be the ones who drive change and improvement in the way medicine is practiced.

The AMA is the one umbrella organization that includes all physicians across geography, specialty, mode of practice and career stage. The AMA provides a forum to air differences on many issues. I believe we should be like Chinese families that have vigorous discussions (or arguments) in the "kitchen," but outside we are a strong unified family. We all should be working to improve and change the AMA and medicine from within, not throw rocks from the outside.

To lead improvement in health care, the AMA has convened a new Physician Payment Reform and Delivery Leadership Group and a 12-member Committee of Innovators who have hands-on experience with pilots and demonstrations of new payment and delivery models. The goal of the group is to improve our common understanding of how the models will work and how they can provide financial stability for physician practices while simultaneously improving patient care. Ultimately, we hope to take these innovations and scale them across all of the country.

Put simply, there is no other physician group with the resources, expertise and opportunity to influence the future of health care in this country more than the AMA.

Think of it: We set policy in the House of Delegates, composed of 175 societies that together represent nearly the entire body of American physicians, in a very open and democratic way. In addition, there are thousands of physician users of our practice management tools, plus physicians who read our journals, plus the physicians we help through advocacy, dues-paying members or not.

As physicians, we cannot help but recognize that we are part of a transformation in the way medicine will be practiced in the future.

There are those who see this as a dark and turbulent time. It is, indeed, turbulent. Yet it is also a time of great opportunity and unparalleled promise -- a chance to refocus and shape a better health care system for this country.

In difficult times, it is all too easy for our unity to splinter. Should that happen, medicine as a whole will be prevented from moving forward. The AMA can be an amplifier for groups and organizations of physicians -- getting done what they cannot do as a single state or specialty organization. Some may attack the AMA as a way of promoting their own narrow interest or organization. This is shortsighted and hurts our overall efforts as physicians. And if the voice of medicine fails and we become divisive in a way that is apparent to the public, our strength also will fail. Then who will represent the needs of physicians, patients and, particularly, the physician-patient relationship?

With all the forces allied against us, this is a time that calls for America's physicians to work together to tackle medicine's tough issues. As the nation's largest physician organization, the AMA is uniquely positioned to do just that.

To all of you who are members of the AMA, I thank you for your membership and support. To other physicians, I encourage you to join your physician colleagues, because together we are stronger -- and more effective. Together we can protect our profession and continue to take the best possible care of our patients.

Robert M. Wah, MD is a reproductive endocrinologist and ob-gyn in McLean, Va. He was chair of the AMA Board of Trustees during 2011-12 and is currently AMA president-elect.

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