AMA president-elect candidates share views: Peter W. Carmel, MD

During my 24 years of service in the House of Delegates, including eight years on the Board of Trustees, I have been a builder of our organization. As chair of the Specialty and Service Society, I helped author the AMA bylaws recognizing the SSS and defining its role. During my tenure as chair of the Council on Long Range Planning and Development, we created the International Medical Graduates Section. On the board, I was founding chair of the Task Force on Medical Liability Reform.

My ability to bring diverse groups together, and to achieve consensus, is exactly what the AMA needs now. Creating a more effective, more unified organization is my goal.

Dr. Carmel

My candidacy comes at a time when many physicians are angry over the AMA's performance on health care reform. It is important to recognize the depth and intensity of physician disappointment. The AMA failed to accomplish four of the major advocacy goals for physicians: 1) Elimination of SGR; 2) Modification of the Independent Payment Advisory Board for Medicare; 3) Stopping "payment for quality" until reliable methods exist; 4) Medical liability reform.

The problem was not policy; our policies are clear. The problem was tactics. Critics say the AMA should have withheld support until the goals for physicians were achieved. Would this have worked? Possibly, but not certainly.

Now is the time to be vocal and demanding on physician issues. The threat of adverse effects on patient gains is gone, and physician issues must be our focus.

Many physicians have lost trust in the AMA. Regaining their trust will take a major effort.

I have two suggestions.

After major decisions, the board has held conference calls with the Federation. This process of talking to physicians after the fact portrays the board as patronizing ("The board knows best"). This sends the wrong message!

Conference calls with the Federation might be held before board decisions. Technology exists to set up such calls within hours of e-mail notification to Federation members. Physicians must feel that the board has factored their input into board deliberations. My goal is to achieve both exchange of ideas and transparency of process.

Another step toward transparency and accountability in board decisions is to record and publish board votes on advocacy issues. While the business process must be confidential, it should be feasible to separate business and advocacy issues.

For the board to regain trust, physicians must know that their opinions are being heard and count. Physicians must have a vocal and effective AMA working for them!

The responses were not shared among candidates. Voting for the next president-elect will be held at the House of Delegates Annual Meeting, June 12-16 in Chicago. Results for the president-elect and trustee elections will be included in our Annual Meeting coverage.