AMA leaders present current course, future direction of the Association

Honolulu In a speech on Nov. 10 at the opening session of the American Medical Association's House of Delegates, AMA President Jeremy A. Lazarus, MD, detailed how the Association is making progress on a wide range of initiatives. The accomplishments, he said, show how physicians are working together as a unified voice to shape health care.

The AMA persuaded the Centers for Medicare & Medicaid Services to revise rules on accountable care organizations to reduce financial risks and use relevant quality measures, he said. The Association, working with other organizations, got a one-year delay to Oct. 1, 2014, on implementing the ICD-10 diagnostic coding system.

Joining together with state medical societies, the AMA has won more than 100 legislative victories in 2011 and 2012, including the preservation of medical liability reforms on the state level. The Litigation Center for the American Medical Association and the State Medical Societies helped overturn a gag order that prevented doctors in Florida from asking patients and families about gun ownership. The AMA has partnered with the Medical Assn. of Georgia against a move by insurers to overturn a law that requires payment of medical claims in a timely manner, Dr. Lazarus said.

“For students, independent physicians, or those in a group, or those employed — we've got your back,” he told about 400 delegates gathered at the opening session of the Interim Meeting at the Hawaii Convention Center.

Days after President Obama won re-election, Dr. Lazarus told delegates that the AMA would continue working with Congress and the White House to implement health system reform and protect the interests of doctors and patients. “In the last four years, we've built the key relationships to help us to continue our progress,” he said.

In October, the AMA and 110 state medical and specialty societies sent a letter to Congress outlining principles to transition to a new Medicare delivery system.

“It was a unified message only the AMA could deliver — and because of that unity it got the attention of Congress and the White House,” Dr. Lazarus said. “We told them delivery reform is needed to offer patient choice and options, that Medicare must support the infrastructure that reform demands, and that payment reflect the costs of providing services as well as progress on quality and cost.”

AMA Executive Vice President and CEO James L. Madara, MD, gave delegates a progress report on the AMA's five-year strategic plan. The plan's three areas of focus are improving patients' health outcomes, accelerating change in medical education, and shaping delivery and payment models that promote professional satisfaction and practice sustainability. Photo by Ted Grudzinski / AMA

Dr. Lazarus also talked about the importance of physicians embracing team-based care and how such collaborative approaches can lead to better results. A new Integrated Physician Practice Section is joining the house to address issues that doctors face in integrated and group practices. AMA delegates are scheduled to meet through Nov. 13 and discuss resolutions and reports on issues such as genomic sequencing, principles for physician employment, and opposition to penalties for nonadoption of electronic health records.

The AMA's strategic direction

After Dr. Lazarus spelled out the Association's recent accomplishments, AMA Executive Vice President and CEO James L. Madara, MD, updated delegates on the AMA's five-year strategic plan. Dr. Madara first presented the plan to the house in June at the Annual Meeting in Chicago, describing three areas of focus: improving patients' health outcomes; accelerating change in medical education; and enhancing professional satisfaction and practice sustainability by helping doctors navigate delivery and payment models.

At the Interim Meeting, Dr. Madara referred to the goals that drive the strategy as “moon shots” — ambitious targets that are reachable with focus and commitment. He said former President John F. Kennedy set in motion the original moon shot 51 years ago by announcing the goal of landing a man on the moon. Kennedy's vision sparked innovation and ideas, he added.

“Like Kennedy's challenge, our long-range strategy is aimed at mobilizing the AMA, this house, the thousands of physicians you represent and the larger medical community in support of something greater,” Dr. Madara said. “The achievements that are possible through the fulfillment of this strategy will not only shape a better future for patients and physicians, but for the country as a whole.”

AMA staff have been meeting with experts in health outcomes to assess the work being done in that area and determine where the AMA can contribute toward improving outcomes, he said. The Association will identify a few conditions and select long-term and intermediate outcomes to focus on those conditions.

To accelerate change in medical education, the AMA's actions will include developing new methods for measuring and assessing competencies for physicians at all training levels and promoting methods to achieve patient safety, performance improvement and patient-centered care, Dr. Madara said. At the annual meeting of the Assn. of American Medical Colleges in early November, he announced a process to select schools that want to revise their curricula around the AMA's targeted objectives. In spring 2013, five to 10 proposals will be picked, with selected schools implementing them in summer 2014.

Dr. Madara also said that the AMA is setting up research partnerships with 30 physician organizations in six states to begin enhancing professional satisfaction by shaping delivery and payment models. The effort will determine which practice design elements best support high-quality care, long-term doctor satisfaction and practice sustainability.

“Physicians want and need help in navigating a rapidly evolving health care environment, and through this initiative, the AMA will work to provide such,” Dr. Madara said.