The American Medical Association broke with tradition last week by selecting a relative outsider to lead it into the next century.
E. Ratcliffe "Andy" Anderson Jr., M.D., a 58-year-old career administrator, takes the helm of the AMA after a management shake-up following a controversial endorsement deal last year.
Anderson, a dermatologist and former fighter pilot who served in Vietnam, is executive director of Truman Medical Center in Kansas City, Mo. He was selected following a five-month search.
He succeeds P. John Seward, M.D., who resigned last December after approving a licensing agreement with Sunbeam Corp. in which the AMA would have given products a seal of approval in exchange for a percentage of sales. The deal was viewed as a major ethical blunder by outraged members, and it provoked public ridicule of the association.
Anderson served from 1994 to 1996 as an AMA delegate by virtue of his position as surgeon general of the U.S. Air Force. In 1996 he won the AMA's Nathan Davis Award for promoting public health.
But unlike predecessors dating back to the 1960s, he did not rise through the ranks of county and state medical societies. Anderson will be the first modern AMA chief who didn't serve on the AMA board of trustees.
"He's a good fit for what the AMA needs," said Charles Van Way III, M.D., president of the Metropolitan Medical Society of Kansas City. "He comes in as an impartial mediator."
Many observers say the AMA needs a fresh approach. Its board of trustees had pledged not to pick one of its own. Members have questioned whether board members had prior knowledge of the Sunbeam deal. The controversy led to the departure of five top AMA executives, including Seward.
Although Anderson is not well-known nationally, reaction from healthcare leaders who work closely with the AMA was generally positive.
"He's got a neat balance of capabilities," said American Hospital Association President Richard Davidson.
Harry Greene II, executive vice president and chief staff officer of the Massachusetts Medical Society, was among the finalists for the job. "My sense is they were choosing more on the skill sets rather than where the person was or what affiliations he had," Greene said.
AHA second-in-command Jonathan Lord, M.D., was also a top candidate, according to sources.
Anderson's administrative skills were key to the decision, said AMA Chairman Thomas Reardon, M.D. As Air Force surgeon general, he oversaw more than 50,000 personnel at 87 medical facilities worldwide with an annual budget of nearly $5 billion, according to the AMA. From 1990 to 1994, he commanded the Air Force's flagship 1,000-bed Wilford Hall Medical Center at Lackland Air Force Base in San Antonio.
Anderson did not respond to a request for an interview. Connie Brockert, a spokeswoman for Truman Medical Center, said the AMA asked Anderson not to grant interviews last week.
By all accounts, Anderson is affable, honest and straightforward to a fault.
In August 1996 he jumped into a quagmire by taking the dual role of executive director at Truman Medical Center and dean of the affiliated University of Missouri-Kansas City School of Medicine.
Shortly after his arrival, Anderson angered some faculty members by pushing for changes at the medical school in response to criticisms from the Liaison Committee on Medical Education, which accredits medical schools.
Tensions between the medical school and its affiliated teaching hospital peaked last fall, when Anderson was fired as dean. He was accused of retaliating by attempting to fire three faculty physicians from their department chairmanships at the hospital.
Several people familiar with the situation said Anderson deserved credit for trying to do the right thing.
"He's certainly a person of integrity," said Nathan Stark, a founder of the hospital and the medical school who brokered an agreement to mend their ties last month.
Van Way, who is on the medical school faculty and the hospital staff, said, "He's a very straightforward guy-not everybody is enchanted with that style of management."
Reardon said the AMA's search committee investigated the matter. "He did what was right, and we admired that," Reardon said.
Robert Brown, president of the Mid-America Coalition on Health Care, a regional provider and payer group based in Kansas City, credited Anderson with taking over a public hospital when subsidies for serving the uninsured were drying up.
Brown said Anderson convinced the business community that Truman and the medical school could no longer be isolated, and he set an agenda to re-orient staff and services to the commercial market and managed care.
"He realized it would be a huge challenge, but he took it on anyway," Brown said. "He's a realist. I think he is going to be one of the nation's paramount health industry leaders."
Anderson will assume the job full-time Sept. 1 but has committed to attending meetings of the AMA's board and House of Delegates in June, Reardon said.
Reardon said Anderson was not asked during his interview with the board how he would have handled the Sunbeam affair, which is still being investigated by committees established at the House of Delegates' interim meeting last December. A lawsuit Sunbeam filed against the AMA after the association broke the deal is also pending.
Restoring confidence in the integrity of the nation's largest physician advocacy group will be one of Anderson's first tasks.
"He's used to difficult jobs," said Donald Hagen, M.D., executive vice chancellor at University of Kansas Medical Center in Kansas City, who worked with Anderson in steering the military's move to managed care. "Whatever the issue is, he'll put his whole heart into it."