Academic medicine linked to core of the AMA's mission

A message to all physicians from AMA President Peter W. Carmel, MD.

By Peter W. Carmel, MDis a pediatric neurosurgeon in Newark, N.J., and is immediate past president of the AMA. Posted Oct. 3, 2011.

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A few months ago, when I was speaking to an alumni group from my alma mater, Columbia University Medical School, the audience and I surprised each other.

They were astounded to hear that the AMA not only had supported passage of the Patient Protection and Affordable Care Act but also is a key player in refocusing medical school education and the adoption of electronic medical records, and is waging a war in the courts and Congress to reform the medical liability situation.

I was surprised so many of them were surprised.

The AMA is a large, diverse organization. We have sections for female physicians, minority physicians, international medical graduates, medical students, residents and fellows, and medical schools, among others. That means we generate a lot of opinions, but it also means that we can muster our common convictions to work on behalf of common concerns.

Since the AMA's founding in 1847, medical education has been one of its highest priorities. The AMA's Council on Medical Education advocated for medical school standards that laid the foundation in the early 1900s for the Flexner Report that transformed medical education.

Today the AMA is heavily invested in the future of academic medicine. We are one of two sponsors for the Liaison Committee for Medical Education, the accrediting body for medical schools in the U.S. and Canada.

With the Assn. of American Medical Colleges, the AMA has embarked on a mission to transform medical education for the 21st century. For example, the two organizations worked together to sponsor the New Horizons in Medical Education conference in fall 2010, to celebrate the 100th anniversary of the Flexner Report and to take stock of where we are and where we need to go in the next 100 years. To that end, the AMA is sponsoring an online community to encourage discussion and debate on the key issues facing medical education (link).

Like education, ethics is an issue as old as the AMA. We wrote the first Code of Medical Ethics in 1847. The AMA Ethics Group helps establish ethical policies for physicians, pursues scholarly research and offers resources to physicians seeking ethical guidance. The AMA stood up for the uninsured back in 2006 and supported enactment of the health system reform law. We are still involved as different aspects of the law are being defined, to be sure that when they are finally issued, they serve the needs of patients and physicians.

Today, my AMA colleagues and I are out on the stump many weeks of the year, listening to other physicians, working with other parts of organized medicine, negotiating with government officials and helping to plan for the future of the medical profession. It's a time-consuming, busy and exhilarating experience ? only possible for me because I believe I am making a difference for my profession, my colleagues, other physicians in my family and our patients.

On the other hand, this is not an effort that can be accomplished by a few people. It takes many of us from a variety of backgrounds and specialties, all pooling our expertise and energy.

That's why I had been talking to my academic brothers and sisters from Columbia in the first place: The AMA needs your input and your energy as we move forward.

As another part of AMA leadership in defining future medical education, the AMA Center for Transforming Medical Education is working collaboratively with 29 American and Canadian medical schools and 4,000 medical students on a multiyear study to examine the medical education learning environment. This initiative, Innovative Strategies for Transforming the Education of Physicians, has an ultimate goal of improving professionalism and patient care.

Elsewhere, we are going to bat every day to improve the lives and learning for medical students, residents and fellows. Right now, AMA staff and members are engaged in Washington and with key accreditation and regulatory bodies to improve resident and fellow duty hours, expand the availability of clinical sites for medical students, find ways to lessen medical student debt, and initiate more interdisciplinary education and more collaborative care.

Other issues of concern to medical educators but also to the larger physician community and our patients are the AMA's involvement in addressing overall work force issues -- from the looming physician shortage to expanding care in medically underserved areas, to discrepancies in access and disparities in care. This includes finding ways to support physician re-entry into the work force and promoting physician health.

There are plenty of places inside the AMA for academic leaders:

  • The AMA Council on Medical Education formulates AMA policy, and authors reports on important topics, including GME and work force, and physician maintenance of licensure and certification. The Council on Medical Education also recommends individuals to the AMA Board of Trustees for nomination to key medical education organizations such as the LCME, the Accreditation Council for Graduate Medical Education, the Accreditation Council for Continuing Medical Education, the American Board of Medical Specialties, the National Board of Medical Examiners and the Federation of State Medical Boards. Information on leadership opportunities in the AMA is available online (link).
  • The AMA Section on Medical Schools gives academia a voice in the AMA House of Delegates. It is also a forum for academic physicians to participate in formulating AMA policies on medical education, public health and health care reform. The section also holds educational programs on medical education and mentors students in organized medicine.
  • The Council on Ethical and Judicial Affairs maintains the AMA code of medical ethics and analyzes and reports on timely ethical issues confronting physicians.
  • The Council on Science and Public Health evaluates and reports on medical, public health and scientific issues.

Participation of academic physicians in AMA policymaking is so important that we recently have issued a special group offer to medical school leadership, offering discounted AMA membership when a medical school's dean and five administrative leaders join together. This lowers their dues, and also the dues of physicians on the medical school staff. See details of the membership plan at the AMA MedEd Update page (link).

The AMA mission is "to promote the art and science of medicine and the betterment of public health." Our link to academic medicine is at the core of what the AMA is all about. That's why it is so important for more academic physicians to add their voices to what we have to say.

Peter W. Carmel, MD is a pediatric neurosurgeon in Newark, N.J., and is immediate past president of the AMA.

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