opinion

For doctors in all practice settings: a new AMA voice

A message to all physicians from AMA President Jeremy A. Lazarus, MD.

By Jeremy A. Lazarus, MD , a Denver psychiatrist and immediate past president of the AMA. Posted Oct. 1, 2012.

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Change has become the byword for almost everything about medical practice these days, even down to how medical practices themselves are organized.

Of course, group practices or even integrated practices like those found at Mayo Clinic and Kaiser Permanente are nothing new to American medicine. On the other hand, we all know colleagues who are heading up and working in innovative kinds of practice settings that were unheard of a generation ago. And we know more who are thinking about it.

And although team-based care in all its forms is just one aspect of our 21st-century medical world, a great part of the future hinges on how well these physician-led integrated practices work to keep patients healthy, and how well they work for their physician members.

For that reason, I am excited to report that a new Integrated Physician Practice Section — the IPPS ­— will join the House of Delegates at the American Medical Association’s Annual Meeting in June 2013.

In the development stages right now, the IPPS will address the issues and needs facing physicians in group and integrated practices, and provide a forum for those who have moved into the many untraditional types of practice that we are beginning to see.

The IPPS will enable physicians from multispecialty, physician-led, integrated health care delivery, along with groups actively working toward such systems, to have an official vote in the AMA policymaking process.

The addition of this section to the House of Delegates is significant. It represents change, of course, and gives recognition to the emergence of new ways of practicing. At its core is the belief that physicians must take the lead now and not wait for organizations that are not physician-led to organize them around an integrated model.

The IPPS also will give us an opportunity to gauge physician satisfaction in those new settings. This is key, as we know only too well that the more satisfied a physician is with his/her practice environment, the better it is for patients.

It is also a big part of the AMA strategy: Enhancing professional satisfaction is one of the three focus areas — along with improving health outcomes and accelerating change in medical education — that drive the Association at this time.

This new section is also significant in two other ways. It reaffirms the AMA’s role as the place where all physicians, regardless of practice size or specialty, come together to address the issues confronting medicine. And the IPPS can help the AMA influence emerging medical policy and regulations regarding these integrated practice models. We can use the knowledge and experiences of IPPS members to optimize the future of health care delivery for physicians and patients.

Of course, the AMA already is helping to set parameters for our emerging health system in many different ways.

Lobbying efforts have strengthened physician roles in accountable care organizations and have extended deadlines for adoption of electronic health records and the ICD-10 codes, among others.

The AMA’s Payment and Delivery Reform Leadership Group has supported data collection and analyses needed to ensure that physicians have the information and resources they need when they become involved in new systems of care and payment.

I am particularly proud of the AMA-convened Innovators Committee. These 12 physicians from across the federation are leaders in shaping the future of our health care system. In June, they took part in a White House discussion about opportunities and barriers for delivery system innovations. They talked about their work on specific payment and delivery models and raised issues that might prevent physicians from participating in certain models, including tight deadlines and burdensome administrative requirements. It was an important meeting, and it was important that the AMA Innovators Committee could be there to represent the interests of physicians.

Similarly, when the IPPS holds its inaugural meeting next June at the AMA Annual Meeting, it will serve within the AMA and inside the House of Delegates as an advocate to advance integrated care systems.

Many physicians have practiced in groups for decades, and many health systems have long had integrated care coordination embedded in their practice cultures. However, most physicians are still gathering information to understand how integration applies to their practice and patients. The IPPS should help provide that understanding.

Right now, nine physician leaders are overseeing the organization of the IPPS. This governing council represents a broad spectrum of large, medium, small, single- and multispecialty systems/groups and IPAs, all of which are physician-led. These are organizations like Mayo Clinic, Cleveland Clinic, Aurora Health System, Henry Ford Health System, Mount Auburn Cambridge IPA and others. They bring their expertise on leadership and governance of their organizations and systems of care that focus on comprehensive, integrated primary and specialty care services, a commitment to measuring and improving health outcomes, value and performance.

As stated in its mission, the IPPS is committed to providing a learning environment where physicians from existing physician-led, integrated organizations can network and learn from each other, and share their experience with physician leaders moving toward integration.

The addition of this new House of Delegates section is good news. It will provide insights and opportunities for the physicians involved and will give us a chance to gauge how satisfied they are in their groups.

The AMA always has represented physicians in all practice settings; this new section is an important one and a sign of the future in which we will all play a role.

If you are interested in learning more about the IPPS, go to the IPPS website (link). Or contact Carrie Waller at the AMA (carrie.waller@ama-assn.org).

Jeremy A. Lazarus, MD , a Denver psychiatrist and immediate past president of the AMA.

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