opinion

The power of organized medicine makes a difference

A message to all physicians from AMA President Ardis Dee Hoven, MD, on the benefits of physicians working together to achieve common goals.

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 July 15, 2013.

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During my travels over the past year as AMA president-elect, I was struck by just how many physicians feel disempowered.

It's not hard to imagine why. After all, we are living through some of the most dramatic changes to America's health care system in a century: Accountable care organizations, electronic health records, physician quality reporting, health insurance exchanges.

When it comes down to it, physicians fear that someone else will tell them how to practice medicine — someone who has never sat next to a patient and delivered a lifesaving treatment. Or a life-changing diagnosis.

And all of that could happen — but it doesn't have to.

Early in my career as a physician, I learned the value and the power of organized medicine.

I was an infectious disease specialist in the darkest days of the AIDS epidemic. I was part of the advance guard — treating very sick patients without a good understanding of what was wrong with them or what to do about it. As AIDS began to spread, fear gripped the nation, including my home state of Kentucky, where the state Legislature set out to make the situation even worse. They were intent on passing a bill that would have made life significantly harder for my AIDS patients.

For me, that was one indignation too many. I may not have been able to save my HIV patients at the time, but I knew I could do something about the Legislature. I also recognized that it would take the clout of an organization like the Kentucky Medical Assn. So I stepped up my involvement in my local society and was soon elected to the KMA House of Delegates. We fought the legislation, and we won.

In that moment, I recognized the power of organized medicine. For the first time, I saw how an issue I faced in my exam room could be taken to a higher level. And if resolved at that higher level, the benefits would reach not only my own patients but also every patient in the state of Kentucky.

I realized that the collective voice of America's physicians had the power to make a difference.

Then in 1993, the year I was elected KMA president, the governor of Kentucky attempted to pass legislation that would have made it virtually impossible for physicians to continue caring for the uninsured.

So all of us at KMA banded together. We fought the legislation, and we prevented it from passing.

At the same time, the AMA was fighting for reform at the national level. In the late '90s, as chair of the AMA Council on Medical Service, I had the opportunity to help develop policy for covering the nation's tens of millions of uninsured.

In 2007, we launched the “Voice for the Uninsured” campaign. We gave America's underserved a voice in the halls of Congress, on TV and in the newspapers. And the nation listened. Health system reform became a central topic of the 2008 presidential election. As a result, just six months from now, some 30 million Americans will gain access to insurance.

Organized medicine has an astounding record of achievements in this country. In the past 166 years, we have delivered the first Code of Medical Ethics, the first standards for medical education and the most widely circulated medical journal in the world.

Organized medicine helped physicians fight quackery at the turn of the 20th century, promoted the adoption of modern surgical techniques and, as I noted above, battled the disease that has defined my career: HIV/AIDS.

During this controversial time, we must not lose sight of the progress we have made — or the tremendous influence that physicians carry.

We are considered the indisputable authorities on health care. Whether it's in the church, the local civic organization or the federal government, we bring something to the table no one else can — the physician perspective. This means we can listen to our colleagues not as Republicans, Democrats or Independents, but as physicians.

And while each of us has a role to play with our individual patients, together we increase efficiency and improve outcomes. Together, we accomplish what none of us could have alone. And that is true in the political arena as well as in the medical world.

Sometimes I think “change” has become almost a dirty word. Something to be resisted at all costs. But the reality is that change breeds opportunity and, more often than not, progress.

So I believe that we are actually lucky to be living through this time of historic change — because we can shape what happens.

In the months to come, I envision that by working together, we will accomplish what many people believe is impossible. By working together, we can combat the epidemic of chronic conditions plaguing the nation, foster innovation in medical education, improve health care technology so we don't have to spend two hours at the end of the day typing data into an electronic health record, achieve meaningful medical liability reform, eliminate the Independent Payment Advisory Board and put the so-called sustainable growth rate formula to bed once and for all!

The power of organized medicine — the AMA — is such that I really believe we can accomplish all these things. By standing together, united in vision and commitment, we physicians can shape the health care system this country needs.

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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