Difficult times demand activism -- and membership

AMA Leader Commentary. By Donald J. Palmisano, MD, Aug. 18, 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 Donald J. Palmisano, MD

"Do your homework. Have courage. Don't give up." More than 40 years ago, my father offered this advice to me at a time when I wavered in my commitment to become a physician.

These wise but simple words reignited my desire to finish medical school and propelled me toward a future brighter and more blessed than I ever could have imagined.

Topic: Liability crisis

Today, I offer those words to you, as together we face one of the most challenging environments that modern medicine has ever faced.

Do your homework. Have courage. Don't give up.

Physicians all over America feel bruised, battered and beleaguered -- and no wonder. Consider just some of the problems afflicting our profession and our patients.

A health insurance system that leaves more than 41 million Americans without coverage. Unreasonable -- and unfunded -- government mandates and rules. A fatally flawed physician payment formula that threatens the very foundation of Medicare. Delayed, denied and downcoded claims. Stacks of paperwork. Diminished time for patients. And a medical liability system that defies common sense and reason. That threatens to push many of us out of high-risk services. That puts all of America's patients at risk.

The problems go on and on. Yet now is not the time to sit around the coffeepot and complain. Now is the time to fight for our patients and our profession. It's a fight we can win together -- provided we do our homework, have courage and never give up.

Take medicine's No. 1 legislative priority: medical liability reform. When we do our homework, it's clear to see that the facts are on our side.

The current system has driven 19 states into crisis, threatening the health and well-being of more than 140 million people. That's more than half the population of our country at risk.

America desperately needs a cure, not quackery. Fortunately, we have a proven treatment based on facts. The AMA-recommended reforms have worked, in many cases for decades, in the six states that are not experiencing medical liability problems.

The House of Representatives knows we've got it right. That's why they passed the HEALTH Act (HR 5), legislation based on California's Medical Injury Compensation Reform Act of 1975. A majority of the Senate knows we're right, too. That's why a minority of senators resorted to a filibuster last month, instead of debating the reform bill we support, the Patients First Act (S 11).

The White House also knows we've done our homework. That's why President Bush told us, "I want to sign good medical liability reform this year."

Most important, our patients know we've given them the facts, just like we always do. Polls have proven that a majority of Americans want medical liability reforms right now, including a strong cap on noneconomic damages. In fact, the AMA has helped get 30,000 patient activists involved in our cause. They alone have generated 100,000 contacts with key senators.

We can and must join these patients -- along with our activist colleagues. We must do our homework, have courage and never give up.

We'll need to have courage -- and persistence -- when fighting some in the trial bar. They have lots of cash. They have allies in high places. They have briefcases full of junk math and deceptive slogans. They're prepared for a knock-down, drag-out struggle.

Clearly, organized medicine needs all of the courage and endurance it can muster. But even more than that, organized medicine needs you. Yes, you. As members. As activists. Speaking out for patients and for medicine.

If you are not a member of the AMA, I challenge you to join today. No more excuses. You can do it by phone (800-621-8335) or online (www.ama-assn.org/go/membership). Ethical, science-based medicine is at risk right now, and we need to speak with one voice in its defense. For a little more than $1 a day, you can help the AMA fix this broken medical liability system -- and more.

Remember, if you don't determine your destiny, someone else will do it for you. Send me an e-mail saying you've joined and that you're ready to fight alongside your colleagues in medicine.

If you already are a member, I challenge you to sign up a physician who has not yet joined our ranks and help make the voice of our AMA louder and stronger than ever before. When you've succeeded, send me the name of your colleague so I can welcome him or her into the AMA fold.

Once you've recruited a fellow doctor -- or signed up yourself -- I challenge you next to become an activist for medicine. Pick up the telephone and call 800-833-6354. This toll-free hot line will connect you to your senators. Let them know that the medical liability debate won't be silenced with a filibuster. If the opposition has a proven course of action, better than ours, we want to hear about it. But we also want and expect to be heard, and we will be heard.

The three simple phrases I told you today -- do your homework, have courage and don't give up -- are more than just words that helped me through medical school. Although my father left this world in 1995, his memory and his advice have never left me.

In my time as your president, I renew my promise to fill each unforgiving minute with untiring effort. I won't stop fighting for patients and medicine until my 365 days in your service end -- and then just for a breather.

In the meantime, there's no time to waste. As one trial lawyer from Texas put it, "We plan to fight until the last dog dies."

The AMA plans to fight, too. But we don't need any dogs to defend us or to die for us. We have America's patients on our side -- and we have you.

So make it official. Join the fight. Join the AMA.

Dr. Palmisano, a general and vascular surgeon in private practice in New Orleans, as well as an attorney, was president of the AMA during 2003-04.