A look at AMA advocacy that doesn't make the news

A message to all physicians from Ardis Dee Hoven, MD, chair of the AMA Board of Trustees.

By Ardis Dee Hoven, MD, an internal medicine and infectious disease specialist in Lexington, Ky., is president of the AMA. She served as chair of the AMA Board of Trustees during 2010-11 Posted Nov. 22, 2010.

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Advocacy. That has been a busy word this election year as we heard nearly every candidate who ran for office referring to him- or herself as a "staunch advocate for the people of my district" and "an advocate for change in Washington."

Some of them actually were. Over the past couple of years, you've heard almost as much about AMA advocacy in Washington -- first to secure meaningful and patient-centered health system reform legislation, our work toward Medicare reform and, more recently on the regulatory front, to make sure that the "next steps" are what we need for patients and their doctors in health reform legislation.

In my column today, I want to alert you to other areas of AMA advocacy, the things the AMA does for patients and physicians that are not so much in the news.

Even when no one is looking, the AMA is out in front, working in the realm of medical education, science, public health, care of the elderly and disaster management -- to name just a few places where the AMA is speaking out -- and making a difference.

In terms of medical education at all levels, the AMA has been a longtime leader. The September New Horizons in Medical Education meeting that was a first step to setting standards for 21st century physician training was co-hosted by the AMA. We must understand that one of our primary roles in this endeavor is to advocate for what those standards should be.

The AMA is also an advocate for improved resident working conditions, and to assure an adequate and stable system of financial support for graduate medical education. And for physicians' continuing professional education -- advances and changes in care delivery -- AMA resources help physicians maintain, develop and increase the knowledge and skills they will need to care for patients.

As an advocate for quality, the AMA is nationally recognized. Specifically, PCPI -- the Physician Consortium for Performance Improvement -- has shown the way to identify areas to be improved, develop measures to secure the needed change, and then test those measures in practice.

PCPI has come to hold a strategic position within the national quality effort. AMA advocacy in the public health arena, on the other hand, doesn't always garner a lot of attention, even though, for years, the AMA has worked toward promoting healthy lifestyles, including the prevention and treatment of obesity, alcohol and drug abuse, and violence prevention. We continue in a strong, collaborative working relationship with the CDC in many areas of health care.

AMA Medical Student Section advocacy has been influential in changing national policy in public health areas. What began as resolutions in MSS meetings turned into initiatives that resulted in the elimination of smoking on airplanes, workplace nonsmoking legislation, Plan B legislation and CHIP, the Children's Health Insurance Program.

AMA advocacy also extends to improving the health of our seniors so that ultimately all have access to safe, appropriate, high-quality medical management and oversight -- and that physicians who care for them are proficient in geriatric care.

Since issuing a seminal report on health literacy in 1998, the AMA became a leading advocate to increase the health care community's awareness of this issue -- and its implications for American medicine and public health. We are a key player in making sure that our nation is prepared for disasters of all types. The AMA pushed for, and helped host, the Third National Congress on Health System Readiness in December 2009 to establish a framework to enable all health professionals to respond quickly and appropriately in public health emergencies or disasters.

Another type of AMA advocacy is "Private Sector Advocacy." Under the direction of Catherine Hanson, PhD, this group works on behalf of the nuts and bolts of day-to-day physician practices. The Practice Management Center offers tools to physicians for handling business aspects of their work such as claims management, data security, negotiations of contracts and other legal issues, payment collection and adoption of health information technology. One such tool is PATH -- Practice Analysis Tools for Healthcare -- which enables physicians to look at their practice data with the eyes of an auditor and develop fee schedules and billing safeguards without a consultant.

Finally, the AMA Advocacy Resource Center encompasses the AMA's state and local government activities. Through ARC, the AMA and AMA members work with state and local medical groups to promote our agenda through everything from conversations with key players to providing legislative language and support materials. In 2010, among hundreds of bills tracked, the AMA helped defeat optometrists' attempts to perform eye surgery in West Virginia, lay midwives' attempts to treat complicated pregnancies in Wyoming, and psychologists' attempts to prescribe powerful medications to patients of all ages in Oregon. We also supported truth-in-advertising legislation in California, Illinois and Pennsylvania to assure that patients know the level of education and licensure of their health care providers.

And for physicians and patients who want to get involved in advocacy, ARC has created an advocacy tool kit and supports annual conferences for those interested in running for office or becoming campaign volunteers.

When the American Medical Association was founded in 1847, we had a stated goal to play an active role in shaping the future of medicine and a mission to promote the art and science of medicine and the betterment of public health.

During my time with the AMA, I have been particularly impressed by the unsung advocacy that goes on every day on behalf of physicians, patients and American public health, and the results that advocacy has produced. I thought you would be, too.

Ardis Dee Hoven, MD , an internal medicine and infectious disease specialist in Lexington, Ky., is president of the AMA. She served as chair of the AMA Board of Trustees during 2010-11

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