AMA can win the race to a better health care system

A message to all physicians from AMA President Jeremy A. Lazarus, MD.

By — Posted July 2, 2012.

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Those of you who know me are all too aware that I am a marathon runner. And you must know that when the Olympic torch is lit in London in late July, I will be paying attention. I love watching athletes compete. At the Olympic level, they inspire a pride of accomplishment in each of us, and each of us feels part of their success.

When we watch the Olympic athletes on the podium sporting their shiny new medals, we are all up there with them wearing medals of our own.

In the years since I joined the AMA, I’ve learned that just like the Olympic athletes, when one of us wins, we all win.

I’ve been with the AMA and in the medical profession long enough to understand and respect the differences we have. But I have also been witness to how powerful we are when we work together to fulfill our mutual interests.

One recent example is the $200 million returned to physicians because of AMA leadership in the UnitedHealthcare settlement. Or the needed delays the AMA won in implementing costly and confusing ICD-10 measures. Those achievements were the result of combined efforts of people joined together to work on behalf of a cause we all believe in.

For the medical profession, the years ahead are a new race to be run. However, to finish on the podium, we need more physicians on our team. In this 21st century, the AMA can be successful for the medical profession only by incorporating the insights and talents of physicians from all specialties, cultures, practice settings, states and regions, and ideologies.

And this race —— we already know that it’s not a sprint — is going to be at least a marathon. A double marathon.

Today, our health care system is at a crossroads of technology, and innovation, and patient need.

The Affordable Care Act was passed, in part, to address this.

The law was written to provide investment in quality, prevention and wellness. And it started us down the road to a very different system of payment and delivery. (At the deadline for this column, the Supreme Court has yet to announce its decision on the law. However, whatever the ruling, the ACA’s impact will continue to be felt.).

Today, a physician may text a patient on an iPad, view the patient’s medical history, and then coordinate a team of physicians and other health care professionals for that person’s care —— all electronically.

Physician-led teams such as accountable care organizations and medical homes are crucial components of medicine’s future. As more patients live longer and accumulate more complex medical conditions, their care will require more coordination, more use of clinical data and professionals working together.

For a physician, being on a team — and following guidelines and best practices — doesn’t mean you’ve lost your ability to think and act on behalf of your patients.

In my field of mental health, a good example is the DIAMOND Initiative in Minnesota. Psychiatrists there are paid to consult with primary care practices on the best way to manage patients with depression. It has resulted in dramatic improvements in patient outcomes.

The current system discourages this, since specialists are paid for face-to-face visits with patients, but not when they advise the primary care physician.

In 2008, the AMA House of Delegates adopted principles that support this approach.

The AMA also has backed the medical home model for mental illness and the principle of parity for mental health coverage — and is part of the Coalition for Fairness in Mental Illness. We’ve made tremendous progress, but we can do more.

As the 167th president of your AMA, I will champion the need to better integrate mental health care into other aspects of medical care — to provide more resources to treat more people, because it is no more possible to separate the heart from the mind of a person than to separate the heart from the lungs and expect them still to function.

I also will highlight the health impact of violence on both the mental and physical health of those abused. And I will push for everyone in the AMA to be part of our Joining Forces Initiative to help our returning troops, our veterans and their families with traumatic brain injury, posttraumatic stress disorder or postcombat depression.

And in my term as your president, while we will continue to deal with situations that already exist, we also will be proactive.

This means that I will work toward seeing that the AMA provides education on exercise, preventive health and nutrition starting in early childhood that continues through a lifetime. These efforts will help create a healthier society with less obesity, cancer and the other illnesses that debilitate the very people we care about — and which exact a staggering societal and financial cost.

I will remind everyone that we physicians must be the role models for our patient’s health — and for each other’s. We have a duty to our patients to care for our own health, both physical and psychological.

I also will continue to work for changes that we long ago pinpointed as being necessary for good medicine: medical liability reform to end frivolous lawsuits and a demand that the sustainable growth rate be scrapped and replaced with a system that recognizes reality. Further, I will advance the AMA’s campaign to encourage private contracting legislation, and physician-led delivery and payment reforms.

Throughout the next 12 months, I’ll be in the race alongside every physician, the AMA staff and the AMA House of Delegates working for a health system that this nation and our patients deserve.

But to win, I need you to join me. We must all run this race together.

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