The AMA: Making a difference in the halls of power

A message to all physicians from AMA President John C. Nelson, MD, MPH.

By John C. Nelson, MD, MPHis an obstetrician-gynecologist from Salt Lake City, Utah, and was AMA president during 2004-05. Posted Nov. 15, 2004.

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The November elections may be over, but the work of the AMA Washington, D.C., office never stops.

The AMA set up shop in the nation's capital in 1943. Now, 61 years later, our approximately 65 staff members continue to shape and influence policy and advance the interests of physicians and our patients.

In the halls of Congress, in such agencies as the Depts. of Health and Human Services and Veterans Affairs, and at the White House itself, the AMA makes sure medicine's voice is heard loud and clear.

In my contacts with the Washington office over the years, I am always struck by the professionalism of staff members, their command of the facts, their access to the powers that be, and their dedication to the cause of medicine and the concerns of patients.

Whether it's meeting with members of the House of Representatives or Senate, advising officials at HHS or the Centers for Medicare & Medicaid Services, or preparing an AMA trustee for testimony before Congress, the AMA's advocacy staff stays atop the issues and is prepared for any twist or turn in Washington's administrative and legislative labyrinth.

It's no surprise. AMA staff in Washington includes people with prior experience at the White House, the Senate and the House, as well as leading health care organizations and medical specialty societies. They know their stuff and they know how the system works. And that's recognized and respected by the officials they contact.

In the past year, the AMA Washington office made notable progress on several fronts on behalf of physicians and our patients:

On the nagging sustainable growth rate issue, the AMA convened a specialty work group to send a unified message to Congress and the White House on the need to fix the SGR.

The AMA worked with the Federation to secure support from more than 70 senators and 270 representatives for an AMA recommendation to remove physician-administered drugs from the SGR. This is a crucial first step toward a long-term fix of this flawed formula.

On medical liability reform, the AMA worked closely with the leaders of the House to inform members and muster support for two successful votes on national MICRA-style reforms -- in May this year and March last year.

The AMA helped coordinate the communications effort among members and with the media. And the AMA's liability crisis map made many appearances on the House floor during the debates -- just one of the more visible ways the AMA made an impact.

The AMA's Fund for America's Liability Reform has raised more than $1.7 million from state medical societies, national medical specialty societies, physician insurers, group practices and more than 7,000 individual physicians.

In its first year, the AMA's Patients' Action Network recruited 80,000 patient activists who delivered more than a quarter-million communications to Congress. This network has grown to more than 330,000 patients. When joined with the AMA's 90,000 grassroots physicians, this force could generate more than 1 million communications to members of Congress on medical liability reform this year alone.

On patient safety, the AMA led a coalition of 100 professional and 24 consumer groups in securing Senate passage of the patient safety bill, which previously passed the House by a wide margin. During this month's "lame duck" session, we'll press for final action by the House-Senate conference committee to finish its work and send the bill to President Bush.

On insuring the uninsured, AMA policy was embraced by a Senate Republican task force studying the issue. The AMA also worked with hospitals and other groups successfully to block an $11 billion cut in Medicaid funding. And the AMA twice blocked attempts to halt funding for health care services for undocumented immigrants.

On public health issues, the AMA Washington office helped drive the passage last month of the Anabolic Steroid Control Act (S 2195). And we testified to advance a national clinical trials registry.

Sometimes the benefit is not in making something happen, but in stopping something from happening. For instance, the AMA Washington office has stopped efforts to impose user fees on Medicare claims on multiple occasions during the last 10 years.

The AMA's presence in Washington isn't restricted to Capitol Hill. The federal affairs office is in constant contact with the White House and the executive branch.

They work to cut red tape, influence changes to regulations such as the Emergency Medical Treatment and Labor Act and promote the appointment of practicing physicians to federal advisory commissions. Be it electronic record keeping, HIPAA or pain management policy, the AMA is there to influence the discussion.

When the VA wanted to allow optometrists to perform laser surgery, the AMA stood with the American Academy of Ophthalmologists to ensure that surgery is performed only by trained surgeons.

Also, influencing the debate on issues important to medicine and our patients is AMPAC, the AMA's political and campaign arm. It is the oldest nonunion political action committee in the nation and one of the largest.

AMPAC raises more than $4 million each election cycle and plays an important role in helping elect physician-friendly candidates to the House and Senate.

Because when the AMA weighs in on an issue, Congress, the White House and voters listen.

The work of the AMA Washington office to advance the interests of our patients and profession is another reason I'm proud to be a member of the American Medical Association.

John C. Nelson, MD, MPH is an obstetrician-gynecologist from Salt Lake City, Utah, and was AMA president during 2004-05.

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