AMA Wire

Wednesday, June 19, 2013

For Physicians

Physician satisfaction aim of delivery, payment focus

What makes physicians professionally satisfied and enables their practices to thrive? Jay Crosson, MD, updated physicians Friday during the Annual Meeting of the AMA House of Delegates on an AMA initiative that will provide research-based answers to this question and solutions for improving physicians' practice environments.

Speaking at the inaugural meeting of the AMA Integrated Physician Practice Section, Dr. Crosson explained that recent surveys have measured physician professional satisfaction in the range of 15–50 percent. The AMA intends to turn those figures around.

"We're aiming to bend that curve, so that in five years, only 10 percent of physicians will say they wouldn't recommend a career in medicine to their children," said Dr. Crosson, who is the AMA's group vice president of physician satisfaction and care delivery.

The AMA has partnered with the Rand Corporation, a national nonprofit research institution, to produce reliable, real-time data from around the country. In-depth field research is underway with 30 practices carefully selected to represent the diversity of physician practices, including different sizes, ownership models, specialties, geographic locations and demographics.

The AMA will use the data gathered to identify, support and disseminate models of care delivery and payment that promote long-term sustainability of practices and physicians' satisfaction with them.

Dr. Crosson said the AMA plans to construct multiple recommended models and provide options for physicians across the spectrum of practice types. In particular, the AMA will work to change the health care environment so that physicians are empowered to participate in new models. Among the examples he gave were advocating to change any laws or regulations that may prevent the implementation of new models and identifying practical ways for insurers to accommodate new payment models.

"We need to help practices that want to change make that change happen," Dr. Crosson said. "We can do it."

Community-doctor ties key for diabetes prevention

With an estimated 79 million U.S. adults living with prediabetes, what should be done to slow the rapid increase in cases of type 2 diabetes? An education session Monday during the Annual Meeting of the AMA House of Delegates provided some answers.

The 26 million Americans with diabetes today is only the tip of the iceberg in terms of the broader public health problem, Ronald T. Ackermann, MD, associate professor of medicine at Northwestern University Feinberg School of Medicine, said. As many as 40 percent of people with prediabetes will develop type 2 diabetes without greater intervention.

"Prediabetes is a marker of elevated health risks," Dr. Ackermann said. "One could imagine also calling it pre-cardiovascular disease, pre-cancer … or pre-disability."

Helping patients address their prediabetes before it leads to more serious conditions will require increased screening efforts, counseling and referrals to intensive lifestyle change programs, he said.

Community programs such as the Centers for Disease Control and Prevention’s National Diabetes Prevention Program have been proven as effective pathways to help patients with diabetes and prediabetes adopt lifestyle habits that can keep their conditions in check. The YMCA of the USA has implemented this program in nearly 600 locations across the country with great success.

"We help people look at ways to change eating and physical activity habits in a way they can sustain over the long run," Heather Hodge, manager of the YMCA’s chronic disease prevention programs, said.

Hodge encouraged physicians to direct their patients to these community-based programs. "The more we work on helping people learn and understand their risk, the better these efforts all will be," she said.

As part of the AMA’s Improving Health Outcomes initiative, the AMA is partnering with the YMCA to launch several pilot programs around the country that will provide the essential links between physicians and community programs to help stop diabetes before it starts.

Following the session, delegates could get free prediabetes screenings by allied health professionals using a point of care A1c non-fasting finger-stick testing kit.