My colleagues, my heroes! Reflections on a year on the road

My year as president of the American Medical Association has been extraordinary, and not only because the AMA saw so many victories in the march toward health system reform. While that is certainly noteworthy, what I will really remember about this whirlwind year are the hardworking, highly innovative men and women I have met with whom I share the title of “physician.”

Last June in my inaugural address, I said that my heroes have always been doctors. Today, after a year of travel, conversation and learning, that is doubly true.

The heading of my blog, “On the Road with Dr. Carmel,” is no joke. “On the road” is where I have spent most of the year, turning down invitations to meet with other doctors only when I had a significant conflict. This gave me the opportunity to interact with hundreds of physicians. (link)

About 14 months ago, when taking my first trips as an AMA leader, I must admit that I was apprehensive about some of those destinations. Certainly my predecessors Cecil Wilson, MD, and Jim Rohack, MD, had a tough time during the height of the debate over health system reform, especially when they traveled to their own home states of Florida and Texas.

However, my hesitancy was unfounded. In the course of my duties this past year, I have been to Florida nine times and to Texas half as often. Each time, I have been received with warmth, and colleagues in those places had a great deal of interest in what I’ve had to say.

During my visits with colleagues across our nation, I have seen much and learned more. And, to be honest, in some of those places I was treated like a rock star!

Yet the highlight of this year was not how I have been treated (although being treated like a rock star isn’t bad at all). The highlight for me has been the chance to see how doctors all over the U.S. are coping with our dysfunctional health care system and how, often against great odds, they have come up with bright ideas enabling them to cover many more patients efficiently and effectively.

Well-integrated systems, such as Henry Ford in Michigan, are based on long-standing primary care networks, with both suburban and inner-city hospitals. Another group, Crystal Run Healthcare in upstate New York, which is building a multispecialty group focused on quality and efficiency, has qualified as one of the new “shared savings” accountable care organizations just recognized by the Centers for Medicare & Medicaid Services.

As the months passed and my frequent-flier miles piled up, I began to have a sense that something had changed —— and that something unusual was happening in the world of medicine. Whenever I had a chance to meet with physicians, they kept me busy answering questions. They were very interested in what the AMA was doing in Washington and in the states, and they wanted to hear what I had to say. They could see that our work to advocate for physicians, provide practice support, and forge ahead in developing quality measures is important and making a difference.

Perhaps it is because the stakes are so high for all of us in these tumultuous times, but it was clear to me that the physicians I met were also taking note of AMA accomplishments. We have all benefited from the UnitedHealth settlement and payout, delay in the ICD-10 implementation until November 2014, the Supreme Court’s decision to invalidate Prometheus Laboratory patents (a case supported by an AMA amicus brief), and the ACO victory that gives doctors a leadership role in accountable care organizations.

In April when CMS came out with that first list of 27 shared savings ACOs — physicians led the majority of them. Physicians, not hospitals! It has been extremely gratifying to go to bat to advocate a position on ACOs to change health care and within a year to see that plan put in place, with physicians changing the way health care is being delivered.

Concomitant to those physicians’ interest in the AMA’s political and policy successes, I have been gratified by rising AMA membership. A small increase in the 2011 year is being followed by solid growth in our membership rolls this year.

Besides my U.S. duties, an unanticipated benefit of my AMA presidency has been other travels — these to the World Medical Assn. as well as other national medical associations abroad.

Through the World Medical Assn., I have spoken to many doctors from countries where national medical associations have high memberships, ranging from 72% to 90%. Yet none of those groups has nearly the same respect of the public, nor the influence on health care policy that the AMA has.

It has been a fascinating, exhilarating year, for the AMA and for me personally. I truly feel that physicians are beginning to see the valuable role that the AMA has played in health system reform. And that they recognize the importance of working together, and working hard, for the outcomes we must have.

Throughout these past months, I have also felt a greater sense of community among my physician colleagues than at any time.

Now, as I turn over the reins to Jeremy Lazarus, MD, I will spend less time in airports and on the road. I’ll miss the interactions and conversations with so many physicians, but my role as an advocate for our great profession and for AMA efforts to enhance it will continue. Because, as I told you a year ago, my heroes have always been doctors — and that has never been more true than today!