Much to be thankful for and hope for a better tomorrow
November 25, 2009
As I reflect on where America as a nation has evolved to, we have much to be thankful for -- our freedoms as individuals, and as physicians, the opportunity to provide cutting-edge science to those who need it. We all know that any society will continue to change as none in recorded time on this planet has lasted forever. How long will America last?... Read More

Even a diverse nation -- when focused on a common goal -- can achieve reform
November 24, 2009
It was a wonderful opportunity last night to visit the Hattiesburg Clinic and meet with its Board of Directors and the whole medical staff to discuss the value of the AMA to the life of a physician. As a result of the Mississippi State Medical Association voting to deunify from the AMA over differences of opinion on strategy with federal health system reform, the leadership of the Hattiesburg Clinic invited an AMA representative to present the case on why they should remain AMA members after this year.... Read More

Now the American political process of debate can continue
November 23, 2009
When the Founding Fathers created the structure of American government, the House of Representatives was to be the closest to the citizens with the whole body being elected every two years and thus more accountable for their actions. The Senate, being modeled after the House of Lords, had more permanency with six-year terms and only a third of the body elected every two years.... Read More

A courageous House vote—and by one physician in particular
November 20, 2009
When a patient is critically ill and shows the first sign of stabilizing, as physicians we know that cautious optimism is the prudent emotion.... Read More

Congress must show courage to repeal the flawed SGR formula
November 19, 2009
Today we anticipate a vote on H.R. 3961 in the House of Representatives to permanently repeal the fatally flawed Medicare physician payment formula.... Read More

Medicine’s future physicians still have the fire to serve
November 18, 2009
Last night I had the opportunity to present the AMA's position on health system reform to a group of students who will inherit the medical profession in a decade. The packed room of those in the Texas A&M Pre-Med Society ranged from freshmen to seniors who are in the process of interviewing for medical school.... Read More

"Numbers crunchers" need to look beyond the cost of reform and consider lives saved
November 17, 2009
As with most clinic days, the unexpected paperwork (e.g., consents for procedures, DME reauthorizations, formulary change authorizations from PBMs, and getting lab results for patients who have insurers with disease management companies that are not linked to our electronic medical record) caused a delay in getting on the road to the airport Monday. Luckily, there were no major traffic issues so I was able to make the drive from Temple to Houston in three hours and enjoyed an uneventful flight to New Orleans.... Read More

Congress can no longer ignore flawed payment system
November 16, 2009
The House of Representatives should vote this week on H.R. 3961, the Medicare Physician Payment Act of 2009. The AMA and state and specialty societies sent a letter Friday urging swift passage to stabilize Medicare and TRICARE. The next step is in the hands of the House. More steps are needed, but a journey must start with those first steps. Go here for information on calling your representative.... Read More

Panel discussion explains physician payment problems
November 13, 2009
I was back in Houston last night participating in a panel discussion on the Business of Health: Expert Insights and Perspectives. It was hosted by the Mays Business School of Texas A&M and held at the Houston Branch of the Federal Reserve Bank.... Read More

Tell your representatives to support H.R. 3961
November 12, 2009

Yesterday allowed me to take a deep breath after what was a whirlwind of a week, highlighted by the U.S. House’s passage of health reform legislation last weekend and the AMA’s reaffirmation of its commitment to reform during its Interim Meeting. Now we’re building up to next week’s U.S. House vote on H.R. 3961, the “Medicare Physician Payment Reform Act,” and we need your help.

The task in front of us: passage of H.R. 3961
November 11, 2009
An historic Interim Meeting of the AMA House of Delegates concluded yesterday in Houston, where delegates from across the nation voted on policy that the Board of Trustees and AMA staff now will work on implementing for the next seven months, until the House reconvenes again in June 2010.... Read More

AMA House reaffirms commitment to reform, but there’s still much to do
November 10, 2009
Yesterday was a defining moment for the AMA as its House of Delegates confirmed its commitment to health system reform and continuing to work to make changes that will improve the health care system for physicians and their patients.... Read More

Reference committee testimony reflects passion, differing ideas
November 9, 2009
Full debate begins today on resolutions in the AMA House of Delegates after yesterday's testimony in the reference committees. Resolutions pertaining to health system reform were heard in Reference Committee B. That committee began at 9 a.m. Sunday and concluded at 5 p.m., with only one 10-minute break to attend to biological functions. I was there except for a brief time to appear on Fox's American HQ over the noon hour.... Read More

House passes reform bill, now must repeal SGR
November 8, 2009
Late last night, the House of Representatives took the first step on health system reform that will benefit patients and physicians by passing H.R. 3962 by a 220-215 vote.... Read More

Historic Interim Meeting tops off a busy day
November 7, 2009
My 45-minute presentation to the Harvard Business School on Friday expanded to 90 when the White House representative had to cancel to remain in Washington, D.C., for today's crucial vote in the House of Representatives on health system reform.... Read More

As reform takes shape, medicine comes together
November 6, 2009
The future looked brighter for patients yesterday with two distinct activities in which I participated: the Doctors Back to School program in the morning and the AMA’s press conference in the afternoon announcing support for House bills H.R. 3961 and H.R. 3962. Read yesterday’s post for some of the details on the Doctors Back to School program.... Read More

Health insurance is a good first step, but more needs to be done
November 4, 2009
I am writing this from San Francisco, where later this morning I will participate in the 32nd annual National Diversity Conference hosted by Kaiser Permanente.... Read More

Health care delivery, prevention remain a local challenge
November 2, 2009
Once Congress concludes whatever it finally does with health system reform, the reality is that all health care will continue to be local, delivered across the nation in unique communities, each reflecting the rich diversity of the United States.... Read More

Focus on our seven key principles as politics heat up
October 30, 2009
When traveling, I try to pick a book to read on the plane. Thanks to the House of Representatives, I now have the 1,990 pages of H.R. 3962, the Affordable Health Care for America Act, to read in detail.... Read More

Policy forum brings out various viewpoints on reform
October 28, 2009
Yesterday, the American Bar Association Health Law Section held a policy forum devoted to educating its members on the changes the health system will undergo should reform be enacted this year.... Read More

Ophthalmologists get a glimpse of 21st century medicine
October 27, 2009
When traveling by air, inclement weather can create havoc to the schedule, especially for connecting flights. Trying to get to the airport in time to catch a flight may mean having to leave a meeting early. It upsets both me and my audience when I have to cut  the time short for questions and answers. ... Read More

Back on the road again
October 26, 2009
After finishing an interview for a segment on Fox Business News, I began my AMA travels again across the nation. Yesterday, I spoke about the AMA’s "Heal the Claims Process"™ campaign and presented the AMA’s 2009 National Health Insurer Report Card to attendees of the Western Section of the American Urological Association Health Policy Forum in Las Vegas.... Read More

The code is broken
October 22, 2009
As I listened to comments being made by senators over the last few days regarding S. 1776, it became clear to me that the promises made by some people in the past to fix the sustainable growth rate (SGR) formula have been hollow. According to yesterday’s vote, 53 senators do not believe that security and stability of the Medicare and TRICARE programs must be enacted. The partisan politics have been disappointing. Besides all of the Republican senators, Democratic Sens. Evan Bayh, Ind., Robert Byrd, W.Va., Kent Conrad, N.D., Byron Dorgan, N.D., Russ Feingold, Wis., Herb Kohl, Wis., Claire McCaskill, Mo., Bill Nelson, Fla., Jon Tester, Mont., Mark Warner, Va., Jim Webb, Va., Ron Wyden, Ore., and Independent Sen. Joseph Lieberman, Conn., voted against cloture.... Read More

Decision day in the Senate; cloture vote on S. 1776 will determine patient access
October 21, 2009
I have found this week to be educational on how easy those who do not directly pay for health care and those who do not deliver health care can be removed from the impact of their decisions. As I see the increasing personal attacks against the AMA and its leadership, I have been reminded of a verse from a Good Book that starts: "Blessed are those who are persecuted for righteousness sake..."... Read More

Time for action—not preaching—on repealing the SGR
October 20, 2009
When I arrived yesterday in Washington, D.C., the day soon filled with media opportunities, including phone interviews with the AP, the L.A. Times, The Hill, HealthLeaders Media and TV appearances on Bloomberg and Fox. In spare moments, I tried to make phone calls to senator's offices but found lines busy. Keeping up the attempts to contact your senators on S. 1776 is very important. If phones are busy, try e-mail or fax as alternatives.... Read More

Hawaii experience highlights need for reform
October 19, 2009
I am writing this while in the security line waiting for my trip to Washington, D.C., where I’ll represent the AMA as it urges senators to pass S. 1776 and ensure that Medicare and Tricare patients have the stability and security of access to care that they deserve.... Read More

Now is the time: Urge your senator to support S. 1776
October 16, 2009
Flexibility is the key, as you don't know when the next critically ill patient will keep you up all night caring for him and then have another full day of work to accomplish.... Read More

Repeal of Medicare’s SGR formula is in sight; your help is critical
October 15, 2009
There's some big news to report on the health reform front. Earlier this week Sen. Debbie Stabenow (D-Mich.) introduced S. 1776, the "Medicare Physicians Fairness Act of 2009," which the Senate leadership announced will serve as the Senate legislative vehicle for eliminating Medicare's sustainable growth rate (SGR) formula and laying the foundation for establishing a new Medicare physician payment update system through subsequent legislation.... Read More

Multi-ethnic gala celebrates a mix of cultures for a good cause
October 13, 2009
I was honored to be the chief guest at the inaugural charity gala hosted by the American Association of Physicians of Indian Origin, the Texas Indo-Physicians Society Southwest Chapter and the India Association of San Antonio. The San Antonio event, entitled "Dancing for the Millions-Jai Ho," was a mix of Indian cultures with the Southwest.... Read More

A new generation wants individual voice and vote
October 12, 2009
Friday I drove to San Antonio to present to the Joint Annual Meeting of the American College of Obstetricians and Gynecologists District VII and XI an update on health system reform and the role of the AMA.... Read More

From students to physicians, medicine unites for reform
October 9, 2009
One of the benefits of living in Bryan-College Station is being in an academic community that allows opportunities to speak to college students at Texas A&M University. I was honored to be asked again to participate in the Wiley Lecture Series.... Read More

Health system reform legislation in Senate on hold
October 8, 2009

While anticipation of the U.S. Senate Finance Committee's health system reform package has been building for weeks, physicians and patients are adding a few more days if not a week to a long-awaited verdict on the committee's final vote.

How we look at data—and how we can use it more effectively
October 7, 2009
Data can be used in many ways. It is noted that the continuum is taking data, converting it to information, then processing it to knowledge and hoping that it eventually becomes wisdom.... Read More

Cooperation can help solve obesity problem
October 5, 2009
Yesterday I had the opportunity to join the opening panel discussion at the 2009 Southern Obesity Summit held in Austin, Texas. This was the third annual summit that brought together representatives from the 16 southern states to share ideas and strategies to deal with the prevalence of obesity in the South (27.3 percent), though the Midwest (26.5 percent), Northeast (24.4 percent) and West (23.1 percent) are not far behind.... Read More

Medicare payment reform sorely needed in South Dakota
October 2, 2009
I had a productive visit with colleagues at the South Dakota State Medical Association Annual Meeting. Cold rain greeted me at the airport, but I felt the warmth of being hosted by AMA delegate Mary Carpenter, MD, as she brought me to the meeting and made sure I was able to seamlessly interact with physicians and medical students.... Read More

Program demonstrates vital role academic health centers play in medicine
October 1, 2009

One of the challenges academic health centers have is to explain their tripartite mission to elected officials. The intersection of medical education, patient care and research, along with being a safety net for the uninsured, strains academic health center budgets. And attempts to balance those missions become more challenging as federal and state financial support decreases.

Medicine’s dedication to reform becomes evident in San Antonio
September 30, 2009
I started yesterday off with a presentation to Scott & White surgical residents, faculty and medical students, updating them on health system reform. General surgery is a specialty with predicted increasing work force shortages, so the interest of what might be in the congressional bills was of keen interest. I reminded them that the AMA was fighting to lift the caps on graduate medical education slots based on 1997 numbers and to provide additional support for those needed specialties, including general surgery and primary care.... Read More

Indiana visit reinforces principles for reform
September 28, 2009
I spent this weekend at the Indiana State Medical Association Annual Meeting in Indianapolis. I had many opportunities to visit with physician colleagues and have meaningful dialogue on health system reform, talking about why the AMA has been actively involved and the strategies the AMA has used to ensure our principles for reform are incorporated as part of any final bill. ... Read More

On the road again: Sharing the AMA’s vision across Texas
September 25, 2009
I started off yesterday with a 6:30 a.m. TV appearance on the local KBTX "Brazos Valley Morning" program answering questions sent in by viewers. The five-minute segment provided an opportunity to remind people why health system reform is needed and to emphasize the AMA's principles of freedom of choice, freedom of practice and universal coverage in a pluralistic system.... Read More

Catching up, and a rich Interim Meeting in Houston shaping up
September 23, 2009

I spent most of yesterday at Scott & White Clinic in Temple, Texas, with some of my normal "day job" responsibilities.

Baucus bill markup begins; SGR formula must be repealed
September 22, 2009

The Senate Finance Committee's long anticipated markup of health system reform legislation begins today when it debates "America's Healthy Future Act," legislation unveiled by committee Chair Sen. Max Baucus, D-Mont., last week. The bill will serve as the vehicle for the committee's deliberations, and committee members submitted more than 500 amendments for consideration during the markup, which is expected to last several days.

Back to the clinic - and more paperwork
September 21, 2009
Today finds me back at Scott & White (S&W) Clinic in Temple, Texas, with a full clinic day and catching up on paperwork. Even though S&W has an electronic medical record system in place, paperwork that has to be done for patients continues.... Read More

Payment disparities, our "blame-shame" culture, and a "thank you" to a fine leader
September 18, 2009
One of the opportunities I get in traveling across the country to attend state and specialty medical association meetings is the ability to listen to physician and medical student concerns and find common themes. "How can I provide the best care for my patient" is a constant theme regardless of where I visit. But, as a diverse and rich nation, we still have some unique issues based on geography.... Read More

Process measures in reform should lead to better outcomes
September 17, 2009
I arrived in Rochester, Minn., on Wednesday to participate in the Minnesota Medical Association (MMA) Annual Meeting, which concludes on Friday.... Read More

Reminding congressmen of key AMA principles for reform
September 16, 2009
I was in Washington, D.C., yesterday to present the AMA perspective to the House Democratic Steering and Policy Committee Forum on the Urgent Need for Health Care Reform. The three-hour meeting was held in the House Ways and Means Committee Room with two separate panels.... Read More

As number of uninsured rises, need for health reform is clear
September 14, 2009
President Obama's Sept. 9 address to Congress overshadowed another major news item from last week: the U.S. Census Bureau's announcement that the number of uninsured patients grew to 46.3 million last year. Given the economy's turbulence during the past year, it's no surprise that the ranks of the uninsured swelled in 2008. For too many American families, losing a job also means losing health insurance.... Read More

The challenge of governance
September 10, 2009
As I watched President Obama speak before the joint session of Congress last night on the need for the nation to address the rising costs of health care and assure all Americans have access with affordable health insurance, I was reminded how Congress has to work together at times to achieve common goals for our nation.... Read More

Poll: Status quo not acceptable for American patients
September 9, 2009
I will begin a busy day today in Washington, D.C., with a satellite media event with the AARP and the American Nurses Association (ANA) releasing some interesting poll data... Read More

Congress is back; AMA holds steadfast to its principles
September 8, 2009
Congress is back in session today. And tomorrow, President Barack Obama will be addressing the joint session of Congress. These next several months are crucial to our profession and the future of health care as our nation looks for final passage of legislation on health system reform. Before the debate heats up once again, I want to take a moment to reflect on what exactly it is that we as a profession need.... Read More

Your comments, my responses
September 4, 2009
So far this blog has received many interesting-and candid-e-mails in the few days it's been online. We're working to incorporate a mechanism in which your comments will be posted publicly. In the meantime, I'd like to share portions of a few of your e-mails and provide responses.... Read More

A full day with the present and future leaders of medicine
September 3, 2009
Wednesday was a day of continuum. One event that took place was the Doctors Back to School program, which the AMA Minority Affairs Consortium started a few years ago, and the Commission to End Health Care Disparities incorporates into its biannual meetings.... Read More

Genuine commitment of El Paso’s physicians shines through during visit
September 2, 2009
I arrived Tuesday in El Paso, Texas, for four days of activities, including the Commission to End Health Disparities Fall Conference.... Read More

Traditions, togetherness make us stronger
August 31, 2009
One of the traditions that I have found interesting when I attend some state medical association annual meetings is the invitation to bordering state medical associations to send their respective presidents to the installation.  I guess Texas is so large that tradition never really took hold. After all, having physicians come from Amarillo, El Paso, McAllen and Beaumont to a central city like Austin involves almost as much travel as the state presidents made from Ohio, Pennsylvania, Indiana, Illinois, Virginia, Kentucky and Maryland to attend the West Virginia State Medical Association annual meeting, Aug. 27 through 30.... Read More

New commercial lays out the facts about health system reform
August 28, 2009
There's still a lot of misinformation circulating about what health system reform really would mean. To help set the record straight, Americans for Stable Quality Care (ASQC) is airing a TV commercial that explains why health system reform matters to all Americans.... Read More

Mourning the death of true champion for America’s patients
August 27, 2009
I would like to take this opportunity to remember and honor the life of one of the Senate's most skilled and tenacious legislators-Sen. Edward Kennedy.

Sen. Kennedy was chairman of the Senate Health, Education, Labor and Pensions Committee, and represented his state of Massachusetts for more than 45 years. Throughout his career, he showed sincere dedication to public service and support for our nation's most vulnerable citizens. He fought to make health care accessible to every American. He paved the way to expand access to health care for children and to secure fair health care coverage for the mentally ill. And he demonstrated true bipartisanship throughout his unwavering leadership to bring about change.... Read More

Last night’s White House call: Keep the dialogue going
August 26, 2009
Three thousand physicians last night called the 800 number to receive an update on health insurance reform that was hosted by the White House. As the request was to have the conversation be "off the record" and not recorded, I will have to honor that and won't be able to go into details.... Read More

Health system reform conference call tonight
August 25, 2009
I hope you’ll join me in participating in a conference call about health system reform that the White House is hosting tonight. The call, scheduled to begin at 8:30 p.m. EST, will be a unique opportunity to get the facts about what reform would mean, get involved and join the discussion. I’m looking forward to listening in to what is sure to be an informative exchange.... Read More

AMA outreach on health system reform continues
August 24, 2009
Welcome to my blog. It’s a bit of a work in progress, but I hope you’ll find reading it to be as enjoyable and informative as I think writing it will be. I’ll be posting updates periodically as well as continuing my weekly eVoice and monthly American Medical News columns, so I welcome your thoughts, feedback and questions.... Read More