Since the AMA’s House of Delegates last met in person in 2019, there have been stimulus checks, the CARES (Coronavirus Aid, Relief, and Economic Security) Act, and the U.S. 2021 bailout, along with several other related COVID-19 relief efforts sent from Washington.
The AMA has now developed its own plan to help doctors and their practices recover from the difficulties of the pandemic.
“It’s the doctors who reach that moment, day in and day out,” said AMA President Gerald E. Harmon, MD, in his remarks at the opening session of the 2022 AMA Annual Meeting. (Read Dr. Harmon’s speech.)
“These are the doctors our nation turns to — for answers, for treatment, for help,” said Dr. Harmon, a family physician in South Carolina. “You have cared for our nation – at great personal sacrifice – and it is time for our nation to renew its commitment to you.
“We need a recovery plan for American doctors, and the AMA is ready,” he added.
Dr Harmon detailed how, under the plan, WADA is:
When medical practices closed and care deemed non-emergency was postponed, patients still needed management of their chronic conditions and treatment for acute needs. Dr. Harmon recalled how physicians have stepped up their efforts, with 90% offering a telehealth care modality.
“Then a funny thing happened: Doctors and patients found out that wasn’t such a bad idea in a lot of circumstances,” Dr. Harmon said. “Telehealth is here to stay, and we are fighting to update our laws and regulations to reflect that fact.”
Dr. Harmon then noted how the AMA lobbied Congress to pass legislation that averted Medicare payment cuts for doctors by nearly 10%.
“It was a major win, but we shouldn’t have to go through this annual cliffhanger,” Dr Harmon said.
Since Medicare physician payments are the only component of health care delivery subject to budget neutrality requirements, these payments have fallen by 20% since 2001, an average – after adjusting for inflation – of about 1% per year.
“We need a permanent solution to end the annual battles that threaten the economic survival of medical practices,” Dr. Harmon said.
The AMA laid the groundwork to address this problem by developing principles for reform that were included in “Characteristics of a Rational Medicare Physician Payment System” (PDF) and accepted by 120 medical and national specialty societies. .
“We need to be able to predict financial returns with some confidence in order to invest in expensive infrastructure like new technologies and new treatments,” Dr Harmon said. “In short, we’re done with short-term fixes and impending cuts.”
The next element of the plan is to stop dangerous extensions of the scope of practice of non-physician health professionals.
Dr. Harmon noted that to his medical practice and that of other physicians, these professionals are invaluable in the effort to provide quality care as a team. But patients want these teams to be led by doctors.
“Patients need to trust that a physician is directing their care and leading the team,” Dr. Harmon explained. “We have years more education and thousands more hours of clinical training than other team members, and we are better prepared to handle complex cases and complications.”
Removing dangerous delays from the pre-clearance process is an important part of the plan. Dr. Harmon noted that four years ago, the AMA and other national organizations representing health plans and clinicians developed a “Consensus Statement on Improving the Prior Authorization Process” (PDF ).
“Unfortunately, since then insurers have done very little to implement the agreed improvements,” he said. “It’s time to hold them accountable.”
The final part of the plan aims to reduce physician burnout and strengthen physician mental health. To that end, the AMA supported passage of the “Dr. Lorna Breen Health Care Provider Protection Act,” named after a doctor who died by suicide early in the pandemic.
“Shortly before his death, Dr. Breen was concerned and concerned that the stigma of seeking help would permanently damage his career,” Dr. Harmon said. “My friends, if we’re being honest, some of us might have felt the same at times.”
Dr Harmon described the plan as ambitious but achievable, and said that is what is needed to put the medical profession on a solid footing to prepare for the next health crisis.
In special remarks delivered before his keynote address, Dr. Harmon described gun violence as a “scourge” and the AMA House of Delegates paused for a moment of silence for its victims.
“Almost every day in this country we witness the shocking brutality of the weapons of war unleashed on society: on elementary school students, on moviegoers, on grocery shoppers, on people in cult – about doctors and health care givers in hospitals and clinics,” Dr. Harmon said.
“This cannot be the new normal. Gun violence is out of control. Enough is enough,” he said, to delegate applause.
The AMA recently renewed its call for gun violence prevention following the targeted killings of doctors in Tulsa, Oklahoma. Also read Dr. Harmon’s statement in response to the school shooting in Uvalde, Texas.