Resolved: To actively shape the future of medicine

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 Jan. 24, 2005.

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Among the growing list of reasons I'm proud to be a member of the AMA is the Association's heritage of setting tough goals and accomplishing them.

Throughout its history, the AMA's achievements have contributed to the public's awareness of our organization as the most influential advocate for health care in America. You have helped earn that reputation. Our allies throughout the House of Medicine have helped earn that reputation as we continue to be stronger by working together.

It's appropriate, then, to celebrate the New Year by once again repeating the tradition of making resolutions. Historians say this tradition dates back to the early Babylonians about 4,000 years ago, whose most popular resolution was to return borrowed farm equipment to neighbors along the Tigris and Euphrates rivers.

I have a different suggestion, however. This year, I propose that we in the AMA:

  • Participate in the campaign to save 100,000 lives, launched last month by the Institute for Healthcare Improvement. Our institution is actively involved; I hope yours will be, too.
  • Improve our clinical skills, because I am convinced that quality improvement is the surest way out of the medical liability morass and could save money at the same time.
  • Focus even more on patients and their long-term needs. Patients aren't customers or consumers of health care, as some would paint them. They are dynamic, living individuals and so their care, too, must be individual.
  • Expand our base of successful political activism both in Washington and in the several states. Organization and petitioning our government are not only our rights as citizens, they are our duties as the only true voice of our patients.
  • Personally spend at least one day in my home state legislature. Many a fine lawmaker on both sides of the aisle needs to hear from us, become our friend and know we are backing their efforts on behalf of our patients.
  • Enhance my contacts with and efforts on behalf of the AMA Alliance. The more I learn of the Alliance, the more grateful I become. And gratitude demands that I help the Alliance achieve its goals, too.
  • Give more time helping out my local medical school. If you want to see the future, get to know a medical student. Take at least one medical student to lunch this year. I will.
  • Do something in my community outside of my career area, such as working at a local homeless shelter or food bank. Active citizenship yields enormous personal satisfaction and, in the process, helps others.
  • Focus on the positive aspects of our profession instead of carping about how bad things are. Do we really want to go back to the days before antibiotics, MRI scans and chemotherapy? Our future is as bright as we choose to make it.
  • Read some nonmedical books. A broader horizon makes better navigators of us all.
  • Get closer to my family. True wealth is all around us at home.
  • Most difficult of all, lower my golf handicap. No comment needed.

"Well, Dr. Nelson," you might say, "you've bitten off more than you can chew."

Perhaps, but there's precious little nutrition and growth without some chewing.

And, if you look at those 12 pledges, there is a common thread linking them all -- and that is a laser-like focus on patients. Well, maybe the last one falls outside that generalization; it has to do with patience.

The first three are my resolutions regarding the profession; the next four, organizational; then, five purely personal.

These are a dozen ideas to guide my thoughts and actions in the coming weeks. Nothing brilliant but, taken together, the 12 crystallize a number of forces at work in each of us these days.

The profession: Ours is more than a job, it is a passion. Each of us was drawn to medicine not for gain, not for prestige, not for an easy life. We were called to serve. We were called to help infants and children, men and women, seniors and that great bulk of humanity that cannot serve itself. That's why we work so diligently for medical liability reform, for Medicare reform, for extending health care to the uninsured and for all our other issues. Not for us; for others.

The AMA: Our Association is a time-honored institution best-designed to attack and resolve those issues and a host of others. I have written repeatedly about how proud I am to be a member of this Association. And I mean it. I believe that, if you give it just a moment's serious reflection, you, too, will see the pride in membership that AMA conveys. The AMA and the AMA Alliance are two of the finest examples of human cooperation and accomplishment on the planet. The facts prove it.

Ourselves: All of the plans for reforming the U.S. health care system -- and there are literally thousands -- rely on one unstated assumption that is the fulcrum for any change. They all assume physicians will be there to deliver the care -- regardless of system or regulation or compensation plan.

This naïve belief has spawned a tidal wave of half-baked proposals, many of which have become law and have produced the unintended negative effects that plague our profession. For any new change to succeed means that we become the whole person, the complete professional. Strong. Intelligent. Diligent. Informed. Most of all, humane.

I'm partial to my own set of resolutions. But I urge you to set your own -- for yourself, for the organization and, most of all, for our wonderful -- even miraculous -- profession.

Accomplishment, purpose and progress are three more reasons I am proud to be a member of the AMA.

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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