Looking back on accomplishments but moving forward

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 June 5, 2006.

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It's safe to say that my past year as AMA Board of Trustees chair has been an eventful one. Every year is. That's because at the AMA, every day, every minute, every second -- we're helping doctors help patients.

We helped when we worked with the administration and specialty societies to help to stop a 4.4% physician payment cut for 2006 that took effect Jan. 1.

In all, more than 600,000 of our colleagues and patients contacted their federal representatives to stop this cut, which had grave implications for Medicare patients' access to care.

On this issue and others, I was impressed throughout my year as AMA board chair by the amount of cooperation on issues important to physicians, both within the House of Medicine, and in talks with Congress, agencies such as the Center for Medicare and Medicaid Services, and the White House.

Cultivating trust among all these players doesn't happen overnight -- and isn't always perfect -- but the results can be impressive and give cause for optimism as these issues move forward.

Of course, we haven't solved the Medicare payment issue, not by a long shot. We face cuts through 2015, further adding to the woes of physicians and patients. Over the next nine years, already-lagging payments will drop 34%, while practice costs will increase 22%.

We need to adopt the Medicare Economic Index (MEI), which accurately reflects the cost of providing medical care. The current sustainable growth rate formula isn't sustainable, isn't growing and isn't working for patients or physicians.

This fight on Medicare was just one of the issues that consumed the attention of the AMA over the past year.

The AMA has tried time and again to help doctors help patients by fixing the nation's broken medical liability system. But last month, federal reform was again filibustered in the U.S. Senate.

America's patients want and need medical liability reform. A full three-quarters of Americans surveyed say they want their federal lawmakers to support medical liability reforms, and 76% support caps on noneconomic damages.

And every American pays for the broken system, which adds $70 billion to $126 billion to the costs of health care each year.

The AMA supports national legislation based on proven reforms, including a $250,000 cap on noneconomic damages for physicians, which would help stabilize medical liability insurance premiums and preserve patient access to health care.

We encourage lawmakers to act before more patients are restricted from seeing a doctor in their hour of need. This is something we'll remember come November.

There was a crisis of another sort at the end of August, created not by man but by nature. Hurricane Katrina left behind a flooded New Orleans, leveled towns in southern Alabama, Louisiana and Mississippi, and thousands of physicians were displaced along with their patients.

We're helping doctors help patients by developing plans for disaster response and preparedness. We were doing this before 9/11, and now we've redoubled those efforts.

We helped set up a Web site (link) that helps displaced patients and their physicians access prescription drug records. We helped coordinate the overwhelming physician response to the crisis and helped states verify physician licenses, among other crucial tasks. Ultimately, more than 33,000 professionals and relief personnel registered.

The AMA contributed $100,000 to five medical associations in Louisiana and Mississippi and another $100,000 to the AMA Foundation's newly established Health Care Recovery Fund. We also worked with Congress to ensure that physicians who volunteered in the affected areas or in areas overwhelmed with evacuees have liability protection from frivolous lawsuits.

There is still much to do. As the stories fade from the news, some may forget the plight of physicians and patients in New Orleans and elsewhere on the Gulf Coast, but it's important that we don't. The rebuilding process will take years, and the AMA needs to continue to be a part of it.

But the AMA isn't just reaching out to physicians in afflicted areas.

We've continued to reach out to our members, and to those physicians who are not yet members.

One way is through our Member Connect Roundtable meetings. Last month, we hosted two such meetings in Connecticut. And at our upcoming Annual Meeting, we'll be connecting with medical students, young physicians, residents and fellows, and international medical graduates.

If you haven't already, members also can weigh in on issues important to medicine through Member Connect surveys -- on the AMA Web site (link).

And the AMA also has pursued its efforts to raise its profile and enhance the organization's "brand identity" as the leading voice of American medicine. You might have seen our ads on network and cable television, heard them on radio, read them in a magazine or newspaper, or point-and-clicked on one at certain high-traffic Internet sites.

It's all part of an effort to let every physician in America -- and every patient -- know that the AMA's mission is to help doctors help patients.

And that mission will be carried on, starting in a few weeks, by Cecil B. Wilson, MD, an internist from Winter Park, Fla., who will become the new AMA board chair, and William G. Plested III, MD, a thoracic and cardiovascular surgeon from Santa Monica, Calif., who will be inaugurated as AMA president.

For my part, I've been impressed by the respect and trust shown the AMA on issues ranging from public health, to the uninsured, to healthy lifestyles. That authority carries over into the public policy arena, and with that authority comes the power to do good -- for our profession and our patients. That's one reason I'll be staying active in organized medicine -- and I encourage you to do so as well.

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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