opinion

AMA stands for much more than just one leader

A message to all physicians from AMA President Jeremy A. Lazarus, MD, on the role of the Association in American society.

By — Posted May 27, 2013.

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I've been involved in organized medicine for a long time and associated with the American Medical Association for most of that time. I've held important positions over the years: president of the Colorado Medical Society, president of the Colorado Psychiatric Society, president of the Arapahoe County Medical Society and speaker of the AMA House of Delegates.

However, none of those jobs prepared me for being the face of the AMA. When people asked to have their pictures taken with me — and they have — or when I was called to meet with very high-level officials in Washington — and I have been — it has never been about me. It is always about “the president of the American Medical Association,” the organization that is the voice of America's physicians.

Even though I knew it intellectually, I have spent the past 12 months seeing up close the breadth and depth of this amazing organization. I have come to better understand its position in the minds of the public and physicians, and in American politics.

Since I took office at the Annual Meeting last June, the AMA has been surprised often and blindsided several times by the vagaries of Washington politics and the savagery of the world at large — and each time I have seen the organization rally and rise to the occasion:

  • I'm talking about not just reacting to the brutal murders in Aurora, Colo., and in Newtown, Conn., but mustering dozens of physician organizations within days of those massacres to go to Washington and petition the president and Congress for controls on gun ownership and increases in mental health services. At the same time, being all too aware of the potential boomerang against mental health patients, we consciously went to work on initiatives to destigmatize the world of mental health.
  • I'm talking about the Supreme Court ruling on the Affordable Care Act that endorsed the individual mandate but unexpectedly struck down the mandatory Medicaid expansion — only days after I took office at the 2012 AMA Annual Meeting. Again, the AMA mobilized as states began wrestling with Medicaid and health exchanges, working in tandem with medical and specialty societies to assure access to health care for the various states' populations.
  • I'm talking about the medical community's response to the Boston Marathon bombings. This was especially poignant for me, as I have competed in that race three times. I applaud the members of the medical community who overcame their shock at the horror around them and immediately sprang into action to aid victims and their families. I have rarely been more proud to be a physician.
  • And I'm talking about the very frustrating, longtime, ongoing campaign to persuade Congress to eliminate Medicare's sustainable growth rate physician payment formula. Today, more than 100 physician groups and other medical organizations are pushing for change, which we hope to see in the not-too-distant future.

Response to strategic plan

Over the past 12 months, I also have been encouraged by the broad and positive response to the AMA's new strategic plan.

It has been gratifying to see the enthusiastic reaction to our $10 million grant-funded initiative to accelerate change in medical education for the 21st century. In all, 115 medical schools responded to our call for proposals, with 31 schools invited to submit full proposals. We are now in the process of selecting up to 10 for a five-year grant opportunity. When the AMA announces the recipients at our Annual Meeting later in June, it will mark an important step toward ensuring that the next generation of physicians is better prepared to face the realities of today's practice environment. Details are available online (link).

Equally gratifying to me has been the overwhelmingly positive response we've received to our improving health outcomes initiative. Our initial targets in this important initiative will be to prevent cardiovascular disease and type 2 diabetes and improve health outcomes for people with these conditions. Information on this initiative also is available on the Web (link).

It is ambitious but important work. Cardiovascular disease accounts for one-third of all deaths in our nation, and one in three adults could have diabetes by 2050 if current trends continue. The direct and indirect cost of cardiovascular disease and diabetes is more than $535 billion a year.

The AMA's efforts will include working closely with ongoing national programs, mobilizing America's physicians and patients to focus on preventing and controlling cardiovascular disease and diabetes and teaming with new partners to address high blood pressure and prediabetes.

For cardiovascular disease, the AMA is partnering with the Armstrong Institute for Patient Safety and Quality, a research institute within Johns Hopkins Medicine in Baltimore, to help meet and exceed the goal of the Dept. of Health and Human Services' Million Hearts Initiative to bring the high blood pressure of 10 million more Americans under control by 2017.

For diabetes, our initial efforts will be in support of the Centers for Disease Control and Prevention's National Diabetes Prevention Program. In partnership with the YMCA of the USA, the AMA will work to increase physician referrals of patients with prediabetes to the evidence-based diabetes prevention programs offered by the Y.

Meanwhile, work in our third strategic focus area aimed at enhancing professional satisfaction and practice sustainability is progressing, and I look forward to the future help it will offer practicing physicians in the current environment.

This past year has been an incredible journey for me as, in the name of the AMA, I've had the privilege and honor of interacting with my physician colleagues from across the country. Along the way, you have shared with me your thoughts and ideas on how we can work together to improve patient care and medical practice in this country. I have greatly appreciated your insights and candor in telling me the things you think the AMA is doing right and areas where we need to improve.

My exchanges with you have only confirmed something I have known for a long time: Physicians remain passionate about this great medical profession of ours and the tremendous privilege it affords us in caring for those in need.

It has confirmed something else, too. Physicians want and demand a strong and effective AMA.

As I step down as AMA president, I pledge my ongoing commitment to advancing the important work we have started, and to ensuring an AMA that delivers on your behalf and the patients we serve. We have accomplished a lot during the past year, but the AMA's work is far from over. In many ways, it is just beginning.

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