A president's review of critical issues facing medicine

AMA Leader Commentary. By William G. Plested III, MD, June 11, 2007.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all physicians from AMA President William G. Plested III, MD.

It is hard for me to believe that the past year has gone and that this is my last opportunity to share some of my concerns and opinions with you in this column. I therefore want to review some of the issues that I feel to be of major importance to physicians and to highlight what I feel to be the most important single issue facing us.

I have not spent much time discussing medical liability reform, primarily because most physicians are extremely well informed about this issue. It remains the No. 1 legislative priority for the AMA. Our experience in the past several years has been that we have more success at the state level than at the federal. This is because of the cloture rule in the Senate that allows for senators who favor the status quo to block a floor vote by filibustering our MICRA-type bills.

We have thoroughly studied the concept of medical courts and are ready to support any state that is prepared to do a demonstration of this attractive alternative to the current tort system. If nothing else, the outrageous cost of the tort system makes change a critical component of any overall health system reform proposal.

Fair reimbursement, especially at the federal level, where Medicare physician payment is subject to the sustainable growth rate formula, remains of critical importance. Physician payment by Medicare today is the same as it was in 2001. This is in spite of Medicare Payment Advisory Commission recommendations to Congress that there be yearly increases that now should total at least 15% since 2001. Since other insurers now set contractual fees that discount from Medicare rates, the SGR travesty becomes even more pernicious.