Preparing for 2009: Lessons from a successful 2008

As 2008 comes to a close, it affords an opportunity to review our accomplishments, take stock of this year's work and reflect on what we must do in the year to come.

The year was framed by a national election, the passing of a public health champion and the growth of a movement for change that the American Medical Association has embraced.

At the start of the year, the AMA Voice for the Uninsured Campaign was in its early stages (link). We had just made our entry into the national debate with our barnstorming of the Iowa caucuses and New Hampshire primary. We launched national ads calling attention to the nation's 46 million uninsured, met with editorial boards across the country to detail the AMA proposal to cover the uninsured and made it an internal priority to devote ourselves to curing this national disgrace.

In 2008, we were a leading national voice for the uninsured. Our efforts complemented the national urgency that was reflected in the campaigns of the nation's candidates for president and Congress.

Covering the nation's uninsured is more than a priority; it is a public commitment by President-elect Obama and leaders in Congress. We already are engaged with key committee staff and have strong relationships with announced members of the new administration. We are optimistic that the momentum begun in 2008 will lead us toward positive reforms in 2009.

This past year also demonstrated that when the nation's physicians put their minds to something and stand together, we can overcome incredible odds. Facing a 10.6% payment cut in Medicare, the Association and the nation's medical societies joined together to ensure that Congress knew the implications of that cut. We reached out to grassroots physicians and patients to make sure that they knew who in Congress needed a little extra persuasion.

It worked. We turned the scheduled cut into a 1.1%positive update. But that will last only until January 2010. Then we'll be facing a 21% cut. Suffice it to say that we have a lot of work to do in 2009, and we're going to need the help of the nation's medical societies, America's physicians and our patients to make sure that Congress gets the work done to replace the flawed sustainable growth rate payment formula.

One privilege I had this year was working with New York Attorney General Andrew Cuomo to help ensure accountability from some of the nation's largest health insurers. In 2008, subpoenas uncovered practices that the health insurers now have agreed to curtail. Agreements were reached with health insurers to curb unfair physician profiling arrangements.

That work is being used in other states to ensure transparency that benefits physicians and patients. In 2009, we'll continue to demand fair treatment from health insurers.

We'll also continue to stand up for physicians against state laws and hospital board policies that run roughshod over medical staffs and physicians in conflicts over privileging, contracting and quality issues.

The Florida Supreme Court's ruling in Lawnwood Medical Center v. Lawnwood Medical Staff struck down a Florida statute that would have eviscerated the rights, duties and responsibilities of physicians at Lawnwood Regional Medical Center. The Litigation Center of the American Medical Association and State Medical Societies provided key assistance in this victory.

These are just a few of the important efforts we have undertaken on behalf of America's patients and physicians. I firmly believe that these efforts are possible because they all are based ultimately on our core foundations of professionalism and ethics. It is difficult to quantify a "victory" in these fields because this is the work that sustains us in a continuum of practice.

The Physician Consortium for Performance Improvement expanded its reach in 2008 in developing quality measures that will help physicians today and in the future (link).

And the AMA's commitment to ethical practice was exemplified in resources such as the Ethical Force Program and Virtual Mentor -- efforts that are central to our profession (link).

Many ongoing efforts in medical education, science and public health are quiet underpinnings of our profession, and I will be highlighting some of them in future columns. And of course, the continued excellence of the Journal of the American Medical Association and our family of Archives journals brings the best of scientific research to the world, and brings pride to our organization.

With full confidence, I pledge to you that our efforts in 2009 will continue to focus on what is most important for physicians to care for their patients.

Medicine lost a champion

As many of you know, our friend and colleague, AMA Immediate Past President Ron Davis, MD, last month lost his heroic battle with cancer. His life as a physician and champion for medicine was always clear, yet the outpouring of love and affection for Ron from across the country and across the globe revealed just what a public health champion he was to the world.

I mention this because the AMA Foundation has created an endowment fund that will honor his legacy for many years to come.

As this year comes to a close, I encourage you all to learn more about the AMA Foundation and its efforts to help America's patients and physicians as we move into 2009 (link).

We accomplished a tremendous amount this past year. And we learned many lessons.

I look forward to working with you in 2009 as we all serve America's patients.