Preparing now to weather health care's "perfect storm"

AMA Leader Commentary. By Timothy T. Flaherty, MD Feb. 4, 2002.

AMA LEADER COMMENTARY

A few words about current events in medical practice

SEE ARCHIVES

A message to all physicians from Timothy T. Flaherty, MD, chair of the AMA Board of Trustees.

Remember the blockbuster movie "The Perfect Storm" from a couple of years ago? Hurricane winds of more than 100 mph. Ten-story-high ocean waves. The sea completely white from driving spray. Visibility at virtually zero. And the swordfish boat Andrea Gale struggling straight up an exploding mountain of raging water. The worst possible forces erupting all at once, ripping everything out of control, and nowhere to turn for shelter or safety.

Sound familiar? It sure should if you're fighting to keep your medical practice above water.

A powerful storm is sweeping across the health care horizon, with several fronts converging at once. Insurance premiums are soaring. Small companies are slashing medical benefits. The recession has swelled the rising tide of unemployed -- as well as the ranks of the uninsured. Hospitals are trying to cope with the cost of preparing for a biological assault -- even as state and federal funding evaporates.

Physicians are not finding any safe harbor. In fact, we stand to be among those hardest hit by the storm. In many states, our colleagues are confronting a wave of rising liability costs -- and some medical practices may well go under. Managed care abuses continue to buffet us. Regulatory burdens overburden our medical practices.

A perfect storm indeed. Among Washington, D.C., decision-makers and commentators, it has become a catchphrase, a term of art.

Too often, we physicians try to ride out rough waters alone. In the process, we miss the opportunity to shore up the ship of health care -- and protect the practice of medicine and the health of Americans. Physicians need to participate in the debates that shape our livelihoods -- and our lives. Membership in the AMA is the way to play a part.

Consider the work we have already done -- and how you can help:

The AMA's House of Delegates has pushed physician liability reform to the top of its 2002 agenda. Staffers are working nonstop on both long- and short-term strategies, in conjunction with state and medical specialty societies. If you have a liability insurance horror story to share please e-mail me (tim_flaherty@ama-assn.org). Your stories matter. They are the cornerstone of reform.
Our Washington lobbyists are working in overdrive to get retroactive relief from the 5.4% Medicare payment cut that just went into effect -- and to change the faulty conversion factor that made the cut possible in the first place. Last year we won strong support in both the House and the Senate for legislation that would do both: the Medicare Physician Payment Fairness Act of 2001. Our push for similar legislation will continue this year -- and you can help us move it forward by writing, phoning or contacting your representatives in Congress through the AMA's Grass Roots Action Center Web site (http://www.ama-assn.org/grassroots).
Physicians experiencing problems with managed care should make the Private Sector Advocacy Web site (http://www.ama-assn.org/go/psa) mandatory reading. The site is filled with information vital to addressing physician concerns -- from understanding managed care contracts to figuring out capitation equivalents to fee-for-service rates. Also available on the PSA Web site is the just unveiled Health Plan Complaint Form. For years, physicians reported problems to insurers and state agencies, only to see their complaints dismissed as "anecdotal." The complaint form will enable us to track state and national trends -- all while ensuring online privacy and security. But again, we won't get the information we need, unless you let us know when you're experiencing abuse.
Thanks to an aggressive AMA grassroots campaign, the House of Representatives passed the "Medicare Regulatory and Contracting Reform Act of 2001" by a vote of 408-0, as noted in last month's column (See column, Jan. 7). We feel confident that we will get this legislation passed into law. It's not a matter of if. It's a matter of when.

And it's all because we have felt the strength of America's physicians standing behind us.

As the health care storm gathers new and terrible strength, we'll need all hands on deck to face down those hundred-foot waves -- and keep the ship of medicine from breaking on the rocks.

To the members out there, I say only this: Stay informed and stay active. To the nonmembers, I say: Join forces with us. We need your voice -- your participation -- and your strength. Now more than ever.

Dr. Flaherty, a board certified radiologist from Neenah, Wis., was AMA board chair during 2001-02.