Integrity should be guiding force in finding SGR fix

AMA Leader Commentary. By Cecil B. Wilson, MD, Aug. 7, 2006.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all AMA members from the chair of the AMA Board of Trustees, Cecil B. Wilson, MD.

Among the frustrations our profession faces on a daily basis, none is more irritating than the seeming indifference of government leaders to the fatal flaws in the Medicare physician payment process, notably the ill-named sustainable growth rate.

In my view, the frustration stems from a fundamental principle to which we all should adhere -- the principle of integrity.

Defined as firm adherence to a code, especially a moral code, integrity is easy to understand and vital to maintain. It is the honesty, the reliability, the very legitimacy of medicine. Some would even call it the soul of medicine.

Without integrity, there can be no workable patient-physician relationship, with all the negative effects a fractured relationship implies. Without integrity, we all might as well fold our tents and steal away into the night.

More to the point, integrity in the SGR discussions involves a series of honesty factors, not least of which is an honest day's pay for an honest day's work. For a decade, the AMA patiently and firmly has presented Congress and the Health and Human Services Dept. with practical, workable solutions to the SGR problem. Yet the annual payment crisis recurs with the regularity of the seasons.

Beyond the obvious moral imperative at stake, the annual threat of Medicare payment cuts casts a cloud of doubt over every planning decision a physician treating Medicare patients must make.