Delegates at the American Medical Associations 157th annual meeting last week tackled issues both weighty and light, with two items attracting more than their share of attention: the associations dwindling relevance among physicians, and physicians financial reliance on drug- and devicemakers.
The AMAs House of Delegates considered a slew of other issues, such as how to increase organ donation and to protect patients who seek medical care in foreign lands.
And the AMA chose a new president-elect, Bryan, Texas-based cardiologist James Rohack, and Nancy Nielson, an internist from Buffalo, stepped into the role of president.
But it was AMA Chief Executive Officer and Executive Vice President Michael Maves who noted in his address to delegates that the AMA needs to change its approach. Physicians are not buying our value proposition, Maves said. The AMA is seen as irrelevant to their daily lives.
To reverse this perception, Maves said that the AMA is working to develop tools physicians can use in the daily practice of medicine that will help their businesses thrive and allow them to make it home in time for their daughters dance recitals.
There is some good news on the membership front: Numbers were up slightly for the first time in seven years to 241,026 from 238,977, or 0.9%. But that boost was achieved with the help of a new program that resulted in 8,577 free memberships for first-year residents who had been student members the previous year. In fact, the AMAs annual report noted that revenue from membership dues fell 3.8% to $45.2 million from $47 million in 2006.
In his address, the AMAs immediate past president, Ronald Davis, a preventive-medicine specialist from Detroit, urged members to promote healthier lifestyles, a healthier planet and better communication in order to prevent medical errors.
Before the House of Delegates convened, the AMA Senior Physicians Group sponsored a panel featuring three former AMA presidents: Daniel Stormy Johnson (1996-97), Robert McAfee (1994-95), and Lonnie Bristow (1995-96). The three men, now in various stages of semiretirement, said that the heart of their careers was spent practicing during a golden age of medicine, when physicians enjoyed a high degree of autonomy and they had many opportunities to be advocates for their patients.
Now, however, interference from government and payers has reduced physicians role as patient advocates, and McAfee said that physicians standing in society has fallen as a result. To counter this somewhat, he and Bristow expressed support for acceptance of a report from the AMA Council on Ethical and Judicial Affairs that recommended ending the use of pharmaceutical and medical-device industry money to pay for professional education.
The next day, the CEJA report was discussed in committee; some 30 speakers spoke against it and only three spoke for its acceptance. The opponents, who formed what was described as a conga line that stretched to Gary, Ind., told of worthwhile programs that would be discontinued if industry dollars were withdrawn, and others claimed they knew the difference between clinically relevant information and promotional advertising.
Bristow said that its not important whether they think they know the difference between education and advertising, whats important is whether patients trust that physicians are acting in their best interest and not on behalf of a drug company, he explained.
The danger is: If we lose that trust, we have nothing, Bristow said. Were dead meat.
New president-elect Rohack said that the issues are how to be inclusive while offering fair representation. In 2008, 315 of the AMA delegates were representing state societies.
To have a voice in the House of Delegates, a specialty society must have at least 250 members with 35% of those members belonging to the AMA. Some specialty societies have said the 35% requirement is too high, especially in light of how only about 24% of U.S. physicians are AMA members. Rohack said the AMA Board of Trustees will start reviewing these requirements at its September meeting.
Also among the more than 250 reports and resolutions was an item concerning warning labels on Q-tips, the kind of topic some delegates found wanting. During a discussion on educating AMA members on Medicare audits and their legal rights, one exasperated delegate cried out: This is the meat of what we should be acting on! Lets not talk about Q-tips anymore.