Docs vie for AMA president-elect

Besides the standard playing of the national anthem, opening prayer and speeches by the executive vice president and the outgoing president, the 159th annual meeting of the American Medical Association House of Delegates kicked off June 12 with something different: a candidate debate between the three men seeking to become the organization's next president-elect.

Also on the ballot for the AMA's Tuesday morning election are eight candidates vying for four board of trustees seats. Each was given a few minutes to speak and most criticized the Patient Protection and Affordable Care Act healthcare reform law the AMA supported. “I am dissatisfied with the work product,” said trustee candidate Richard Frankenstein, former president of the California Medical Association. “I want to be part of the team that gets it right.”

While many of the other lesser leadership-post vacancies featured unopposed candidates who were then elected then and there via voice-vote acclamation, interest in the contest for the three open seats on the AMA Council on Medical Service—which studies the social and economic aspects of medical care—should be intense as vocal free market-healthcare advocate David McKalip is among the five candidates on the ballot. McKalip, a St. Petersburg, Fla.-based neurosurgeon, printed an excerpt from Ayn Rand's 1957 novel Atlas Shrugged on the back of his campaign flier.

The three president-elect candidates are all sitting trustees and, while acknowledging its shortcoming and the anger it generated among AMA members, each spoke well of the healthcare reform law they helped pass. Their general message was that, while it lacks medical malpractice reform and the repeal of the sustainable growth-rate Medicare payment formula or “SGR,” it included many positive aspects for patients.

“This bill has more of our policy in it than any bill I've seen since I've been in the House since 1986,” said candidate Joe Heyman, a former AMA board chair. “On balance, we did the right thing.”

Another candidate, Peter Carmel, echoed this sentiment and said doctors are at a disadvantage when negotiating with Washington politicians because “we are hardwired to be honest, they are not.”

“Why are so many angry? Because we failed to get physician items in the bill,” Carmel said. “We wound up with a bill that had none of our major items for physicians. Let's go back and get them.”

The third candidate, Edward Langston, who also is a former AMA board chair, explained that he was driven to support health system reform by the need to extend coverage for more people because the uninsured “die earlier, liver sicker and seek care later.”

Langston and the others said they would work to increase the AMA's dwindling membership by rebuilding physician trust, improving communication, using technology to offer online practice tools to members, and reaching out to younger doctors.

Carmel noted how face-to-face meetings are less important to younger doctors who prefer communicating over the Internet. He added that, for those who feel large-scale meetings are the best way to communicate, “our day is over.”

Heyman said the best thing the AMA could do to rebuild both membership and physician trust was to “Dump the SGR once and for all.”

The candidates received a standing ovation at the conclusion of the debate.

According to the AMA's 2009 annual report, membership dropped about 3.4% to 228,000 from 236,000 in 2008. In his address, AMA Executive Vice President and CEO Michael Maves said that—based on current figures— a 5% to 7% decline in member ship is projected for 2010.

“It's been a challenging time for the AMA and more challenges lie ahead, but we don't run from them,” Maves said. “We embrace them. We look at them as opportunities.”

In his address, outgoing AMA President J. James Rohack defended the organization against the harsh criticism it received on the Internet where instant communications “can shift emotions into overdrive.”

“And then there's the ultimate dissonance: Electing known and respected individuals from the House of Delegates to the Board of Trustees—who then continue to practice medicine—only to hear soon afterwards that he or she no longer represents the practicing physician,” Rohack said.

Quoting John F. Kennedy, Rohack added “We enjoy the comfort of opinion without the discomfort of thought.”

AMA President-elect Cecil Wilson will be inaugurated the evening of June 15.