Trust is crucial to physicians -- and to the Association

AMA Leader Commentary. By Yank D. Coble Jr., MD June 16, 2003.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all physicians from AMA President Yank D. Coble Jr., MD.

If you're anything like me, some of the most memorable moments in your practice of medicine were first moments. Like the first time you delivered a baby, performed surgery or wrote a prescription with your name printed on the top of the pad. These are the moments when we truly comprehend what a great privilege -- and trust -- it is to be part of the healing profession.

This past year, as AMA president, I have been privileged to experience many "first moments," as I participated in events of national, even historic, significance. Time and again, I have been amazed by the regard that so many people and organizations have for our AMA, especially the public's trust in us.

A few years ago, the AMA conducted a survey to gauge public opinion of our work. We found that approximately three-quarters of Americans believe that the AMA is a leader in the health field; that the AMA educates the public about important health issues (78%); and that the AMA has done a lot of good for patients (74%). That's a powerful testimony of the public's regard.

During my time as president, I have become increasingly convinced that this regard is directly inspired by the trust our patients (the public) have for you, the physicians of America. Just as patients trust you with their health, so, too, do they trust the AMA to put the good of patients first.

This trust is crucial to our work as an organization. Trust makes possible our leadership in national debates about medical liability, Medicare payment, the uninsured, medical quality and alcohol advertising, among others. Trust makes us a valued source of information about science, public health and health care policy. Trust enables our AMA to do its best for medicine and America's patients.

This past year, I witnessed, firsthand, what trust makes possible for our AMA.

At the AMA's National Advocacy Conference, I met and introduced the president of the United States. I watched as he told physicians to "seize the moment" and fix America's broken medical liability system, as he spoke about major Medicare issues.

Why did President Bush, along with many Washington movers and shakers, choose the AMA as their audience? Indeed, why do top administrative aides, senators and congresspersons meet so often with AMA leadership? Because decision-makers understand how much the AMA is respected and trusted.

I saw, with a new sense of immediacy, how important this trust was when Congress fixed the Medicare mistake for 2003 and when the House of Representatives passed medical liability reform legislation. Like the 72% of American voters who want caps on noneconomic damages, decision-makers in Washington trusted the thousands of men and women who rallied in white coats, united in their fight to protect patient access to health care.

This past year, I also served on the U.S. delegation to the World Health Organization's World Health Assembly, at the request of the Dept. of Health and Human Services Secretary Tommy Thompson. As the result of the department's regard for our AMA, I was privileged to be present when our country announced its support of an unprecedented, international public health treaty aimed at reducing tobacco use all over the globe. I was also there when Thompson described the U.S. commitment to the Global Fund, and to fighting HIV, tuberculosis and malaria worldwide.

Trust and credibility also helped the AMA make global health history on another front, when we hosted a meeting of the World Medical Assn. There, the AMA guided passage of a groundbreaking declaration called "Responding to the Growing Threat of Biological Weapons." This declaration will help physicians and physician organizations across the world as they coordinate initiatives to monitor and respond to potential acts of bioterrorism, as well as naturally-occurring outbreaks of disease.

The AMA's stature as an international icon also inspired the National Institutes of Health to invite me to serve as co-host and speaker at the 35th anniversary of the John E. Fogarty International Center. The Fogarty Center sends American physicians, fellows and students all over the world to participate in medical education, research and care, training them to contribute to global health. As AMA president, I was also invited to co-host the National Institute of Health's 50th anniversary celebration of the discovery of the structure of the human genome, where attendees also marked the completion of the human genome sequence.

Our AMA's credibility also allowed us to reach out to the public through the media, as we met with the editorial boards of major news publications. As AMA president, I also had an unprecedented opportunity to bring medicine's messages directly to patients, by speaking to citizen groups and health professional associations, and at dedications and graduations.

Best of all, I had the chance to listen to and speak with many of you, America's physicians, when I visited state, county and specialty associations as well as many of the most respected teaching hospitals and medical schools in the country.

These are just a few examples of what trust and credibility made possible for the AMA -- and for me -- this past year. These experiences have served as a powerful reminder of how trust is the cornerstone of all we do.

In previous columns, I've asked you to take many actions on behalf of patients and our profession -- many of which involved calling your representatives in Washington.

Now I ask you to do this: Treasure the trust the public has placed in our profession and our AMA the way you treasure the trust of your patients. Protect it. Enhance it. Build on it. The public's trust is as crucial to our efforts to shape health care policy as the patient-physician relationship is to our individual practice of medicine.

If I've learned anything as your AMA president, it's that leadership is about inspiring trust -- and hope. Hope for America's patients and physicians. Hope for the health of the world.

Thank you for giving me, and the entire AMA leadership team, your trust and hope this past year. Serving as your president has been one of the greatest honors of my life.

Dr. Coble, an endocrinologist in private practice in Jacksonville, Fla., was president of the AMA during 2002-03.