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What policies does the American Medical Association support? What does the American Medical Association fight for? What are the biggest struggles doctors face today? AMA Chief Experience Officer Todd Unger hosts.
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Speaker
- Bruce Scott, MD, president, American Medical Association
Transcript
Dr. Scott: As the miles grow long, and the hours grow deep, and the delays seem to be endless, and sometimes the victories seem so far away, never give up. Continue to work towards the goal because our patients are worth it. Our profession is worth it.
Unger: Hello and welcome to the AMA Update video and podcast. Today, I am joined by outgoing AMA President Dr. Bruce Scott in Louisville, Kentucky. We'll take a look back at some of the defining moments of his presidency and hear his thoughts on the future of medicine.
I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Scott, it's always a pleasure to have you with us.
Dr. Scott: Thank you. It's great to be with you.
Unger: Well, I guess it's cliché to say, but time does fly, and your year as president seems to have gone very fast. It's been so busy. And as always, there's been so much that's happened since we talked at the start of your presidency. And so I'm eager to get your view. As we look back on that now, why don't we just start with, what do you think are some of your proudest accomplishments as AMA president?
Dr. Scott: Well, Todd, you're right. It's been an incredible year, and it's gone by really fast. I'm still a practicing physician, juggling the duties of the AMA president and still keeping my practice here, my private practice, in Louisville, Kentucky, alive. And so I've really tried to focus my year on those issues that affect the practicing physician, the things that get in the way, if you will, of us taking care of patients.
And that begins with the financial struggles to actually be able to keep your practice alive. Then there's the administrative hassles that we face that take time away from our patients. And one of the other things we've been working on is ensuring that patients get their care by a physician, or at least by a physician-led team, and then finally trying to restore the joy in medicine.
And I'm proud to say that we've made advances on each and every one of these areas. We haven't been able to accomplish a complete Medicare fix. But we've moved the ball forward, and we've changed the conversation in Washington. We've been successful in 14 states in getting prior authorization reform change, and we're continuing to work on it on a national level.
In over 40 states, we've been able so far this year to fight back expansion of scope-of-practice bills. And we've seen improvement in the burnout level of physicians. It's come down two years in a row. And we think part of that is that we've been able to work successfully with the majority of state licensure boards and over 500 hospital-credentialing organizations to remove stigmatizing language.
And along that same lines, we have a record number of hospital systems applying for our Joy in Medicine program, where we recognize and reward hospital systems for reducing the stress that, unfortunately, has been driving the unacceptable physician burnout rates.
Unger: I've always been moved by how your personal stories of running a private practice and trying to confront a lot of what you just talked about, all those burdens, that really comes through in your voice. Do you feel like you've been able to channel some of those personal frustrations, the things that get in the way of joy in medicine, as you talked about it, into your work and your accomplishments?
Dr. Scott: Well, absolutely, Todd. It's the stories. It's the patients. It's the reality of practice life, the struggles.
As I travel across the nation, I hear from other practicing physicians that they're facing the same struggles. And in some cases, they're closing their practice. They're not able to sustain it anymore.
My core message this year has been that we need to unify as a profession. There's so much that brings us together. We need to stop concentrating on the things that divide us. We're surgeons and primary care doctors, and we're specialists, and not specialists. Heck, we're even conservative and liberal. But at the end of the day, we're all in this profession together, dedicated to taking care of our patients. And that needs to be our core.
Unger: Now we're at a really interesting time. And of course, we had you, Dr. Suk, Todd Askew from our advocacy team talking about what's going on right now, what the agenda is for the AMA and advocacy. As you look ahead, let's say, just for the next few months, what do you think is number one on the front burner here?
Dr. Scott: Well, as a practicing physician trying to keep my private practice afloat, I'd have to say Medicare payment reform. You see, Medicare payment trickles through everything that we do. Medicaid rates are tied to Medicare. Every single private practice insurance contract that I have is tied to Medicare rate.
So we need to fix this broken Medicare system. For the last 24 years, physician reimbursement is actually down 33%. It's unsustainable. And we finally are getting through to the government that something has to be done, that the current system is no longer something that's going to be able to sustained on the back of private practice and even nonprivate practice physicians.
Unger: And one of the other things that we've talked about over the course of your presidency—personal stories about prior authorization. Tell me a little bit more about where you see that fight coming in the coming year.
Dr. Scott: Well, you're right, Todd. It is a burden on physician practice. It wastes my time. It takes me away from taking care of my patients. But the biggest thing about it is that it harms my patients. It results in delays, and in some cases, denial of care.
AMA surveys show clearly that over 90% of physicians say that prior authorization has harmed the clinical care of their patients, and that's simply unacceptable. To have an insurance company who's never seen the patient, never done the examination, and many times hasn't even gone to medical school, step in between a patient and their physician's decision of what is best for that patient, it's just wrong and it needs to stop. We're working on a federal level, and we're working on a state-by-state level as well.
Unger: That work that we've been doing at the federal level, at the state level, at least from my years and what I read in the papers, seems to be paying off. Does that feel gratifying that the AMA and so many of our partners have been able to put this issue in focus?
Dr. Scott: Well, it's interesting. I mean, the public—the patients, if you will—have clearly become aware of the problem. And I think now that we have the patients on our side and the public on our side, I think we're set to win this battle. I really do.
I think that there's more and more awareness that it's not reasonable to allow the insurance companies that are making record profits make those profits on the back of patients' needed care that's being denied. We got to keep pushing, but I think we're getting closer and closer to the victory line. And we've already pushed this issue over the victory line in many states. And we're out there working with our state medical associations on a state-by-state basis in order to rightsize prior authorization.
Unger: Dr. Scott, one of the things that you talked about in our recent fireside chat, you ended it by saying, in uncertain times, one thing that you can be certain about is the AMA is going to be working on behalf of you physicians and your patients. Any further thoughts about that particular statement?
Dr. Scott: Well, I think everybody is aware that we have a new administration, and with a new administration comes a lot of change. And with change comes challenges. And from a different perspective, each change also presents an opportunity.
And, really, what we've been trying to do is focus our strategic plan, focus our advocacy on those issues that are most important and those issues that are achievable. And we've been working behind the scenes. Just because you don't see the AMA in the headlines does not mean that we're neglecting an issue.
That unity that I spoke of, that focus that we've been pushing, is more important now than ever. But let me assure all of our members, all those listening today, that we remain totally focused on the policies as adopted by our House of Delegates, the democratic process that gives us the policy that guides our advocacy. And you can rest assured that the AMA will stand behind those policies. Even in the most uncertain times, you can believe in your AMA
Unger: Well, thank you. That's well put. Now that the end of your presidency is near, you're going to be officially passing the reins to the next AMA President, Dr. Bobby Mukkamala. In this moment, what's giving you hope for the future of medicine?
Dr. Scott: What's giving me hope is I know that the people behind me, the people who work around me are very talented people, and they will continue the message. And I think the thing that gives me the most hope is I think patients are now engaged. I think patients have heard.
Patients want their doctors' practices to stay open. Patients want doctors involved in their care. Patients want doctors' time spent taking care of them, not moving paperwork around and talking to insurance companies.
And patients want happy doctors, doctors who are not burned out. We know that happy doctors provide better, more compassionate care. These are the things that give me hope. And I'm also hopeful because I know the individuals coming behind me will continue this message, and we're going to continue to push it forward until we can heal the health care system.
Unger: Dr. Scott, thank you for all your leadership over the past year. I feel lucky to have been working with you for every one of the eight years that I've been here at the AMA. I'm just curious, in closing, if you have any words of wisdom for our next president and future leaders of the AMA.
Dr. Scott: Well, let me tell you, Todd, that it has been an incredible honor and the highlight of my professional year to lead the American Medical Association, the organization that have dedicated much of my life to because I really, truly believe that the AMA is the voice of American medicine and that we need to continue that voice for our profession and for our patients.
My words of wisdom, if there is any wisdom, would be that as the miles grow long, and the hours grow deep, and the delays seem to be endless, and sometimes the victories seem so far away, never give up. Continue to work towards the goal because our patients are worth it. Our profession is worth it.
Unger: Dr. Scott, that is a fantastic note to end on. Thank you so much for your service to the AMA and to our nation's physicians over the past years, and we really appreciate you sharing your experience with us today.
Dr. Scott: Well, thank you, Todd. It's been a pleasure to be with you and help spread this message that's so important for our health care system.
Unger: And for all of you listeners out there, we encourage you to support that ongoing work of the AMA on the issues we talked about today and more. So please consider becoming an AMA member at ama-assn.org/joinnow.
That wraps up today's episode. We'll be back soon with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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