AMA ends the year on an upbeat, productive note

A message to all physicians from the chair of the AMA Board of Trustees, Duane M. Cady, MD.

By Duane M. Cady, MDis a general surgeon who was in private practice for 35 years in Syracuse, N.Y. He served as chair of the AMA Board of Trustees during 2005-06. Posted Jan. 2, 2006.

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In this holiday season, I was reminded of what an unusual and unusually strong year 2005 has been for both the American Medical Association and the nation. The year is summarized in single words and phrases:

Physicians of America became heroes after hurricanes ravaged the Gulf Coast. Physicians responded to the multiple disasters by the thousands. More volunteered with the U.S. Health and Human Services Dept. Web site than could be placed.

The AMA Foundation launched a Health Care Recovery Fund to help physicians rebuild their practices in the wake of Katrina and Rita. In addition to $100,000 the AMA contributed, funds have flowed in from concerned individuals and groups, all motivated by one thought: How can I help?

I cannot recall a single event in my professional life that warmed my heart more than watching the outpouring of talent, time and money to help our fellow Americans in need.

Medicare's fatally flawed sustainable growth rate calculation has been a continuing focus of attention for years. In its most concerted effort yet, the AMA called on physicians and patients to warn America of the negative effects of payment cuts at the very time more and more Americans become seniors. The effort is not ended, but there is no doubt that the year 2005 saw dramatic evidence of AMA's concern on behalf of patients.

The AMA continues to believe that SGR is unsustainable. It has to be repealed before we can link payment with pay-for-performance plans. Any such plan, moreover, has to be aligned with the AMA's principles, which are: Ensuring quality of care; fostering the patient-physician relationship; offering voluntary physician participation; using accurate data and fair reporting; and providing fair and equitable program incentives.

Moreover, we believe that there should be modest updates in the SGR while Congress takes time to repeal it.

I recently had a very productive meeting with the director of the Centers for Medicare & Medicaid Services, Mark McClellan, MD, PhD, explaining in detail the AMA positions. More information will be coming to you soon on future AMA actions.

President Bush signed the patient safety legislation into law in July. This capped years of AMA efforts on behalf of patients and those of us who serve them. Establishing a system of voluntary, confidential reporting and analysis of errors, the law has triggered long-needed reforms and quality improvements.

Just last month, the AMA extended its long tradition of eradicating disparities based on race and ethnicity by introducing a new kit to help physicians eliminate inequalities in care. Called "Working Together to End Racial and Ethnic Disparities: One Physician at a Time," the kit includes tools to reverse trends in lower quality of health care services linked to racial or ethnic identities. In addition, two major studies have been launched to isolate further any causes related to inequality of care.

The ongoing effort to bring reason and sanity to bear in medical liability cases reached a crescendo in 2005 as well. A nationwide, coordinated effort resulted in constitutional change in several states and increased awareness coast-to-coast of the pernicious effects of runaway jury awards.

2005 also saw continued work to change state constitutional limits on jury awards in medical liability cases. Alaska, Georgia, Illinois, Missouri and South Carolina enacted legislation that establishes a cap on noneconomic damages or strengthens their existing cap.

In addition, a number of states enacted legislation addressing other medical liability reforms supported by the AMA at the state level, such as creating pre-trial screening panels and establishing standards for expert witnesses who testify in medical liability cases.

Twenty states remain on the critical list, and America's patients are losing access to care due to an out-of-control legal system. In many areas, conditions are forcing physicians to retire early, relocate or give up performing high-risk medical procedures. Nationally and locally, the AMA is working to correct things.

Through all of 2005, the AMA maintained its commitment to the highest level of professional ethics the world has known.

It expanded ways in which members participate and make their voices heard. It focused on a tight agenda of issues and goals. In all of our successes, and even when we didn't succeed, the AMA has been the voice of reason, the voice of ethics, the voice of America's patients.

When the most influential management thinker of the 20th century passed away in November 2005, the world lost a man whose insights and motivation paralleled those of the AMA. Peter Drucker saw the limits of large organizations and their hierarchies and told managers to think about workers and customers. He saw the implications of information technology and told the Silicon Valley to think about knowledge workers.

In simple prose, Drucker focused on individuals -- workers, customers, taxpayers, patients. In advising corporations and nonprofits alike, his was the voice of the little-heard to serve them better. The results for corporations that heeded his advice can be measured in profitability and investor confidence. The results of a medical association that heeds his advice can be seen in the AMA's 2005 successes.

Quite a year of accomplishment and challenge. And 2006 looks to be no less demanding.

For now, however, I urge you to take a moment to reflect on your professional and personal lives, on the challenges and accomplishments closest to your own heart.

And accept both my thanks and congratulations, and the best wishes from the Cady family for a happy holiday season.

Duane M. Cady, MD is a general surgeon who was in private practice for 35 years in Syracuse, N.Y. He served as chair of the AMA Board of Trustees during 2005-06.

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