Count your many blessings and resolve to join the AMA

A message to all physicians from William G. Plested III, MD, chair of the AMA Board of Trustees.

By William G. Plested III, MDis a thoracic and cardiovascular surgeon from Brentwood, Calif. He served as AMA board chair during 2003-04, and as AMA president during 2006-07. Posted Jan. 5, 2004.

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This is the time of year to give thanks for our blessings and to reflect upon past accomplishments. For physicians, these are important exercises, particularly since we find ourselves constantly harried and hassled, as we toil under a seemingly endless array of people telling us how to do our jobs.

We in organized medicine will continue to redress every intrusion and injustice in the coming year.

However, that said, let us take a moment to give our most sincere thanks for the real blessings that do occur in our daily lives.

First and foremost, let us give thanks for our families and loved ones, with whom we are able to live in a degree of freedom and safety unmatched anywhere in the world.

Next, let us give thanks for our ability to be pivotal parts of the most productive medical care system ever devised.

We teach, innovate and provide the results of our research to all nations and peoples. We lead in the generous provision of voluntary, compassionate care, treatment and medications.

We are also blessed by the quality of the colleagues and allied health professionals who help us in our offices, clinics and hospitals. As we have more and more to offer our patients, we rely even more on an ever-enlarging team of specialized assistants. The array and competence of these dedicated people is unmatched.

I am certain that every physician can make improvements to this brief list. My principal concern is that you take time to make a list. A little quiet introspection about what's good in our lives is therapeutic.

In fact, if one is unable to come up with a list of blessings, that is also an important fact that should probably lead to some serious consideration about a career change!

While we are counting our blessings and giving thanks, I want to acknowledge some people to whom I owe a tremendous debt of gratitude. These are the hundreds and thousands of medical students and physicians who have made the personal decision to become members of the American Medical Association.

As noted above, the woes faced by physicians are many. Yet we also have a very potent mechanism to counter these problems. That is our medical associations -- whether geographic, specialty or ethnic. Each of these associations provides not only an avenue for professional interchange, but also a venue for concerted political activity.

Unfortunately, the need for such political activity has never been greater. Associations need to advocate for the whole profession, as well as for specific groups of physicians. Also, our legislators have many and varied needs for our professional advice and consultation -- some specialty specific, and some that apply to the entire profession.

Our advocacy must involve a wide variety of societies, including the one that can legitimately speak for all physicians: the AMA. Only the AMA allows all physician groups to have a voice and a vote in their policy-making process. Thus the AMA's leadership is widely accepted by our profession and the public.

It should be noted that, although the AMA is primarily involved in advocacy issues that affect all physicians, we are constantly asked to join with other societies and support their issues. The executive vice president of one of our largest specialty societies has frequently noted that his organization's strength and influence are significantly enhanced when he appears with the AMA. The value of the AMA to our profession may be questioned, but in the end, the positives far outweigh the negatives.

Speaking of value, we have recently celebrated an unequalled legislative event. We have seen increases in Medicare payments -- for 2003, 2004 and 2005, years when Medicare payment was projected to plummet.

The most recent increase was included in the Medicare prescription drug bill and substituted a 1.5% payment increase for a previously announced 4.5% decrease. This is a positive 6% swing for 2004. In 2003, we prevented a Medicare payment cut of 4.4% -- and won a 1.6% increase instead. These changes mean real dollars in the pockets of all physicians. On average, replacing the steep cuts scheduled for 2003, 2004 and 2005 with positive updates will mean nearly $36,000 to every physician over that three-year period.

Yet this is only part of the story. Today, almost all physician reimbursements by HMOs, PPOs, private insurers, etc., are tied directly or indirectly to Medicare reimbursement rates. This means that we will see some increase in physician reimbursement from all sources as a result of this legislative victory.

Make no mistake about it; the AMA deserves great credit for this very significant legislative victory for all physicians. As the American College of Gastroenterology stated, in a special communication to its members, "Doctors should thank the AMA, for this is primarily the AMA's good work. ACG and virtually every other organization in medicine supported this interim step (although a permanent fix of the unfair sustainable growth rate formula would be vastly preferable). Any organization other than the AMA that claims credit or otherwise claims to have achieved the SGR correction both detracts from the AMA and underestimates the intelligence of the audience. The AMA deserves the credit."

I would like to add my own thoughts. The AMA is an organization of dues-paying members. Those members, by paying their dues, demonstrate their belief that the AMA can be of significant value to our profession. This time, the value they have enabled is tangible, has a dollar amount, and will benefit all physicians.

In my opinion, every doctor who is not an AMA member owes a sincere thank you for this wonderful holiday gift from those doctors who are AMA members. I would suggest that in the spirit of the holiday season, which is to combine giving with receiving, an appropriate New Year's resolution for all nonmembers would be to become lifelong members of the AMA. This single act of giving would be repaid many times over by the increased value the AMA could then bring to our profession and our patients.

In closing, I hope that 2004 will be a wonderful and productive year for every patient and physician in America. Furthermore, my heartfelt desire is that all physicians join in the holiday spirit of giving, for the betterment of our profession of medicine.

William G. Plested III, MD is a thoracic and cardiovascular surgeon from Brentwood, Calif. He served as AMA board chair during 2003-04, and as AMA president during 2006-07.

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