opinion

Our living strategic plan for 2011 reflects AMA's mission

A message to all physicians from AMA President Cecil B. Wilson, MD.

By Cecil B. Wilson, MDis an internist in private practice in Winter Park, Fla. He served as chair of the AMA Board of Trustees during 2006-07 and was AMA president during 2010-11. Posted Dec. 6, 2010.

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The 2011 Strategic Plan, which was rolled out at the American Medical Association Interim Meeting in San Diego, has been a group effort. One could say that the work actually began in 1847. That was when AMA founders determined that our mission would be to promote the art and science of medicine.

From that day, we committed ourselves to play a role in the public debate, to become a source of expertise on key medical and public health issues, and to set standards for the medical community. All that is front and center in the 2011 plan.

This year's strategic plan is built around five main goals. Together, they are about assuring that Americans have 1) access to health care that is 2) high quality -- including 3) wellness and prevention measures -- provided by physicians who are 4) fairly compensated for their work, as we seek to 5) contain the cost of health care.

None of these issues is new. They are at the core of the AMA's work on health system reform, and have been part of our agenda in one way or another for years. All are important.

The plan also has two other parts. One concerns the businesses of the AMA, things like The Journal of the American Medical Association and our other journals, education and publishing that, along with dues income, provide the resources to implement the AMA's mission.

The other segment addresses AMA centers of excellence -- in-house expertise in such areas as medical education, quality, advocacy, disaster preparedness, senior care and ethics. These groups serve as a national resource, and their varied expertise also plays a key role in advancing the goals of the strategic plan.

In all, every AMA Strategic Plan is the result of an 18-month effort that involves a large number of people. It begins with research -- we conduct surveys, consult with AMA leadership, gather input from AMA councils and other stakeholders. Then, with that broad array of contributions, a plan is developed, voted on by the Board of Trustees and presented to the House of Delegates.

It's an evergreen process that takes into account both the long-range aspects of our vision and year-to-year changes -- like the November election -- that may affect how we reach those goals.

We are now in the eighth year of these "rolling" strategic plans, and I, for one, am pleased to be part of the process. When you're a sailor, it becomes almost instinctive to pull in your sails, or let them out, or shift your direction to take advantage of the prevailing winds. Wherever you begin and end, the journey is rarely straightforward. That's how I see the strategic planning cycle.

Strategic planning always has been an important part of the AMA. The perennial challenge -- in the past and now -- has been to provide focus. In the past, with an agenda that sometimes included as many as 120 items, we risked having plans that were a mile wide and an inch deep.

Our current, more cogent focus on a limited number of issues critical to AMA success means we make wiser and more effective use of AMA funds.

Not surprisingly, the 2011 Strategic Plan is not dissimilar to the one rolled out a year ago. However, a new Congress and the emerging regulatory rulemaking for the Patient Protection and Affordable Care Act mean that our approaches certainly will shift -- another "sail adjustment" -- as we address the 2011 goals.

When the 2010 plan was developed, access to care was a key issue. Today, with the health system reform law a reality, that access is assured -- so long as we can educate enough physicians to meet the needs of our growing population. So our focus this year includes work force issues, particularly in the area of funding to expand graduate medical education.

Quality of care continues to be high on the AMA agenda -- especially finding ways to integrate quality measures into physician practices and help physicians as they adopt health information technology.

Physician payment issues are only increasing in importance. In 2011 we will focus on eliminating Medicare's Independent Payment Advisory Board authorized by the health reform law. We will support physician leadership in innovations such as accountable care organizations and patient-centered medical homes while seeking changes in antitrust policies that hinder physician participation.

Prevention and wellness remain urgent national issues in terms of America's overall health and because, left unchecked, lifestyle issues like smoking and obesity threaten our already out-of-control health care spending. One aspect of our 2011 plan will encourage physicians to partner with patients and their families to prevent and manage chronic diseases.

If obesity threatens an individual's well-being, the cost of health care similarly threatens the nation's well-being. We have renewed our commitment to identify ways to reduce waste in the health care sector. For example, standardized processes for filing insurance claims would reap savings in both money and time.

And it goes without saying that medical liability reform, through legislation or alternative approaches, promises significant cost savings.

Our 2011 Strategic Plan, of course, is about how to implement AMA policy directed toward helping physicians help patients. Working together, we can make that happen.

Cecil B. Wilson, MD is an internist in private practice in Winter Park, Fla. He served as chair of the AMA Board of Trustees during 2006-07 and was AMA president during 2010-11.

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