A new year but continued resolve to reform pay system

AMA Leader Commentary. By Cecil B. Wilson, MD, Jan. 1/8, 2007.

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.

As we begin a new year, the temptation is to jot down a list of new year's resolutions and hope that willpower will prove sufficient to bring them all to fruition. Experience has shown otherwise.

For most of us, experience shows that we never quite lose the extra weight, consistently increase physical activity, read that great book or complete all the chores we set out for ourselves.

That being said, it is true, however, that January is the time to assess the past while opening the door into the future and looking at the opportunities before us.

The Romans named the month after their god of doors and gates, Janus. His image was that of a two-faced god, with one visage looking to the past and the other, to the future, at once contemplating the old year while anticipating the new.

The old year, 2006, particularly in the latter months, saw the AMA with a laser-like focus on "fixing" the problem of the sustainable growth rate formula that determines physician payments under Medicare.

This formula presages annual cuts over the coming nine years amounting in the aggregate to a 40% reduction in physician payments, not counting the impact of inflation. A 5% cut was on the books to take effect Jan. 1.

Seen only as a physician pocketbook issue, Medicare payment cuts do not capture the public's attention or concern. But as a poll of the public last year showed, once there was an understanding of the threat those cuts pose for seniors in coming years -- threats to access, threats to receiving quality care because physicians no longer can afford to accept new Medicare patients -- the issue crystallizes into calls for action.