Chair's midterm review: Change brings opportunities

As I approach the midpoint in my year as chair of the AMA Board of Trustees and reflect on what we have accomplished, I am pleased.

Back in June, I wrote how I see change as an opportunity and always seek to maximize opportunities, even in difficult times like these. I believe we have found opportunities ? to enhance awareness of the AMA itself, publicize the expertise that exists within our organization, transition to new leadership in several areas and make the voice of America's physicians heard in Washington.

Here are some of the details:

As chair, I set out to increase dialogue/conversation between the Board of Trustees and the House of Delegates and also with the rest of medicine. To that end:

• We have initiated more conversations on the phone and in person. I have instituted calls with the chairs of the geographic caucuses (i.e. Southeast Delegation, Pacific Rim, Western Mountain, Great Lakes, etc.). Our excellent initial call this fall was cited in regional newsletters and other venues.
• We have started sessions for AMA delegates and alternates to call or write in with questions. About 150 doctors joined in a conversation with AMA House of Delegates Speaker Andrew W. Gurman, MD, and me.
• At the Interim Meeting, I was pleased to meet with the SSS -- the Specialty and Service Society -- Assembly and with section council chairs. To follow up, we are planning a call with the section council chairs like the geographic chairs call.
• Also at the Interim Meeting, we held a forum to discuss Medicare's sustainable growth rate, the Congressional Joint Select Committee on Deficit Reduction known as the "super committee," the Medicare Patient Empowerment Act, and our new media campaign on SGR and the doctor- patient relationship. On the last day of the Interim Meeting, I reiterated my goal to have more dialogue, and invited delegates ? as I am now asking you ? to write or call me.
• We have sought more visibility from speaking opportunities, i.e. when members of the Board of Trustees make representation visits, we now look for multiple forums. As an example, I recently spoke to a full assembly of several hundred at the California Medical Assn., but I was also able to speak with their board of trustees, meet with past presidents, and with the San Diego County Medical Society. Another effort has been the work toward SGR repeal. This is one of the biggest issues facing physicians and one in which the AMA has been deeply involved.

This summer, we re-convened an SGR strategy committee with specialty and state society participation. I was able to meet with members of the super committee to press for our plan: full SGR repeal followed by a five-year period of stability in Medicare rates (with updates to cover inflation) while we craft ideal delivery reform, followed by the introduction of a payment system that incentivizes the new delivery reforms.

A third area of focus has been to increase awareness of the medical and scientific contributions made through the AMA. Look at these successful groups the AMA has nurtured to enhance health care for our physicians and our patients:

• PCPI -- the Physician Consortium for Performance Improvement -- an organization convened by the AMA, is a leader in developing quality measures in clinical situations. Sixty-eight percent of measures adopted by the Centers for Medicare & Medicaid Services for use in its demonstration projects and programs are PCPI measures.
• RUC, the AMA-convened Relative Value Scale Update Committee, plays a critical role in providing data, insights and expertise to CMS. RUC Chair Barbara Levy, MD, recently met with the AMA Board of Trustees regarding RUC's work with CMS to develop the resource-based payment systems. Along with Dr. Levy, we met with senior Health and Human Services Dept. officials to explain how the great work of all the specialty societies is harnessed through the AMA for CMS at no cost to taxpayers.
• Just getting under way is our delivery reform group, made up of state and specialty societies as well as the AMA-convened Innovators Group, which includes doctors from around the country who are delivering health care in innovative ways. The Innovators Group will be bringing their experiences to an in-person meeting in December to share what works and what does not. I look forward to attending this meeting. This year we also have been concerned with transitions within the AMA.
• Starting at the Interim Meeting in 2010, we began the process of transitioning to a new CEO. My goal was to make it a no-drama, no-trauma event. I believe we have been successful in that goal. Great credit and thanks go to the outstanding leadership and dedication of AMA senior management and the Board of Trustees.They kept the AMA humming along in a challenging environment with many unknowns. Outgoing CEO Michael D. Maves, MD, MBA, was a true professional in transitioning leadership to James L. Madara, MD, who, in turn, has been a thoughtful, observant learner. He is now leading and focusing the organization.
• Our new editor-in-chief at The Journal of the American Medical Association, Howard C. Bauchner, MD, is doing a fabulous job at the journal and moving us rapidly into the new era in medical publishing and communication, while continuing to attract top authors and papers.
• We also welcomed seven new members of the Board of Trustees. These men and women have brought new perspectives, experiences and energy to the table. Recently, I began a presentation at CMA with a photo of our new board. This is the first time I have ever done that, but their wealth of ideas and enthusiasm is something I wanted to share with the largest physician audience. Several physicians came up to me afterward and said they are rejoining their colleagues in the AMA. Finally, membership. The AMA's new and ongoing membership efforts may well result in a small increase in membership this year. This is very good news, but we must continue to make more people aware of how the AMA connects with nearly all physicians in this country -- and not in a small way.

Many physicians have no idea that:

• More than 90% of America's physicians are represented by the over 520 delegates who sit in the House of Delegates, where AMA policy is set.
• AMA standards and guidelines for education, practice and quality are used by all physicians.
• More physicians read JAMA than any other medical journal in the world.
• AMA advocacy victories, such as the recent success in changing ACO rules, help all physicians.

Over these past months, I have really enjoyed my role as AMA chair, and have been heartened and energized by my experiences.

I am looking forward to the rest of my term as AMA chair. The challenges we face in the months to come will be no less than those we have faced and overcome in the past, but I have confidence that we will continue to find opportunities and maximize them as we move ahead. I also sense a new level of enthusiasm and optimism within the AMA and the medical community. And a growing recognition that not only are we stronger together, but that together, we can make a real difference.

With that in mind, I want to wish everyone the very best for this holiday season and look forward to a great new year.