John Alexander McMahon was a longshot to take over the helm at the AHA when Edwin Crosby died unexpectedly in 1972.
McMahon had been president of Blue Cross and Blue Shield of North Carolina for four years, but his healthcare resume was not extensive. His charm and professional skill triumphed, however, and he became the AHA's first full-time president.
During his tenure at the AHA from 1972 to 1986, McMahon saw the organization through some of its most crucial times. He battled federal cost-control policies under two U.S. presidents; he expanded the AHA's presence in Washington by doubling the size of its office there; and he helped smooth the longstanding rivalry between the AHA and the American Medical Association.
Since his retirement from the AHA, McMahon, 76, has taught at his alma mater, Duke University. He now teaches part-time at Duke's Fuqua School of Business in Durham, N.C. He also served as chairman of the Department of Health Administration at Duke and was inducted into the Health Care Hall of Fame in 1995.
What were your major accomplishments as AHA president?
It was my sense all along that my biggest job was just to keep the field together and unified. . . . What the field wanted was a greater visible presence in Washington because they knew that's where all the decisions were going to be made. I knew that to have a greater presence it meant the AHA had to be seen as the voice of all the hospitals. It was an easier thing to do then because there weren't the bigger organizations and they weren't tending to go off on their own. . . .Once you've got the numbers, it's easier to get access.
What role does the AHA play in today's healthcare industry?
It's a much, much tougher one. . . . I think they're still following the precepts we developed back in the early '70s of representation, advocacy, information and education. (But) you can't always represent and advocate that which satisfies everybody. So in order to keep them in the AHA membership, there had to be a service of the educational component.
Where does the AHA have the greatest impact?
I think again the representation and the advocacy (and) the kinds of things that Dick Davidson is doing to get the field exerting itself to take care of those who don't have health insurance or health coverage. . . .That's the advocacy side, advocating to the membership, `Look, we've got a responsibility, and if we don't step up to it, the spokesmen for the poor and the uninsured are going to change things around and maybe not to our liking.'
What will that impact be in the future?
A lot depends on how things shake out with the provider-sponsored organization opportunity, the opportunity of hospitals and doctors coming together to provide a risk contract for the Medicare population. If that takes hold, then they're going to say, `If we can do it for Medicare, we can do it for Medicaid and we can do it for the regular employed group health insurance people.'
What problems does the AHA have?
I think it has challenges from the growth of some of the large hospital systems. Are the large hospital systems going to want to make their own presentations, their own voice heard in Washington? If so, we're likely to have a cacophony and nobody's voice will be heard, so the AHA will have to figure out a way to explain that fact of life.
What should the AHA do differently?
That gets back to finding out ways back to the service side, to convincing people-that means boards of trustees, administrators, the head nurse on the floor-that this careful attention to the customer is as important there as it is in the local shoe store. If you're treated cavalierly, you ain't gonna go back.
The AHA's presidents
1917-18 William Walsh, M.D.
1919-24 Andrew Robert Warner, M.D.
1925-27 William Walsh, M.D.
1928-42 Bert Caldwell, M.D.
1943-54 George Bugbee
1954-72 Edwin Crosby, M.D.
1972 Madison Brown, M.D. (acting)
1972-86 John Alexander McMahon
1986-91 Carol McCarthy
1991 Jack Owen (acting)
1991-present Richard Davidson
Source: AHA Guide