To change or not to change? That is not the question

AMA Leader Commentary. By D. Ted Lewers, MD, chair of the AMA Board of Trustees. May 1, 2000.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all physicians from D. Ted Lewers, MD, chair of the AMA Board of Trustees.

Like you, the Federation leaders who attended this year's National Leadership Development Conference in Miami need not be convinced that the pace and impact of change on medicine are accelerating at breakneck speed.

They received a crash course in how to prepare for what Ian Morrison, the Canadian health care consultant-futurist and a conference keynoter, called a coming period of "tremendous challenges."

Another keynoter, Tom Peters of In Search of Excellence fame, quoted the founder of Visa International, Dee Hock, as saying, "The problem is never how to get new, innovative thoughts into your mind, but how to get the old ones out."

Much to do

Displacing what old ideas I could, I have compiled a series of action items I want to pursue in the coming weeks, and I thought you might like to compare your "to-do list" with mine.

Link up with your allies. Ann Hansen of San Luis Obispo, Calif., president of the AMA Alliance, invited us all to join in the Alliance fight to Stop America's Violence Everywhere -- SAVE -- with "partner power," as Ann calls it, and utilize the grassroots persuasive army she heads up as a collaborator in our ongoing battles with Congress and the managed care industry.
Encourage medical leaders around you by nominating someone for next year's Pride in Profession Award. In a conference filled with highlights, perhaps the highest were those dedicated to the five outstanding physicians who are making a difference in countless thousands of lives. Find their equals among your peers and nominate them when next year's competition opens.
Look for win-win situations with health plans and insurers, regulators and agencies, and other areas of potential conflict in your professional life. The health care delivery system won't change by edict but by a steady assault at the grassroots level on inequities as physicians all over America find new solutions to the problems in the system.
Prepare for even more change. Morrison documented just a few of the facets of change that are on the horizon. If only a small percentage of the fundamental changes he predicted actually occur, your professional and personal lives will change dramatically as smarter, better-informed patients, new technologies and changing payment and delivery systems come into play.
Innovate. The only antidote to change is innovation. Nancy W. Dickey, MD, our immediate past president, eloquently advised us all to embrace change -- in technology, new standards, new ways of building a bond of collegiality in all your relationships.
Petition government. The battle for a real patients' bill of rights is far from over. House-Senate conferees are ironing out the vast differences between the two versions passed in the separate chambers last year. Write, phone or e-mail your senator and members of Congress now -- not on your own behalf but on behalf of your patients.
Vote. Fewer than half of eligible voters routinely cast ballots, yet there are so many vital health care issues to be decided in both Washington, D.C., and the state capitols.

It is more important than ever to get out and vote and to encourage everyone you know to get out and vote this November.

As I told our fellow conferees, you -- the physicians back home -- are the people to attack problems in the health care sector, to fill any leadership vacuums, to make positive things happen.

Sweeping changes are coming, not just to our profession and the health sector in particular but to society as a whole.

A new, universal symbol of change is the Internet. But the symptoms of change are right in your own back yard -- in shops, at the mall, in the media, throughout the schools, even in the home where you live.

That means that it really is up to you. Be a leader. Talk with your colleagues, friends and neighbors.

Use the AMA's Grassroots Action Center (http://congress.nw.dc.us/ama/) resources available on the AMA site. Use the center to communicate directly with your senators and representatives in Washington, D.C.

Alfred North Whitehead, philosopher and mathematician, wrote, "The art of progress is to preserve order amid change and to preserve change amid order."

Who better than physicians to turn that definition into reality?

For all of the change, the AMA remains fixed on the principle that made it great in the first place -- good stewardship in asking again and again: Is it good medicine?

Those are my views. E-mail me yours.

Dr. Lewers of Easton, Md., a nephrologist and internist, was AMA board chair during 2000-01.