AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts in medicine on COVID-19, medical education, advocacy issues, burnout, vaccines and more.
AMA Update
Reforming Medicare payment, fixing prior authorization and more milestones in 2023
Dec 22, 2023
Featured topic and speakers
In the final AMA Update episode of 2023, American Medical Association CXO Todd Unger reflects on this year of rebuilding and the key accomplishments of the AMA Recovery Plan for America's Physicians.
- Learn more about the AMA Recovery Plan for America’s Physicians.
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Speaker
- Todd Unger, chief experience officer, AMA
Transcript
Unger: Hello and welcome to our final AMA Update for 2023. It's hard to believe, but this marks the end of our fourth year of production on this series. What began as the COVID Update in March of 2020, filmed in our living rooms and bedrooms, has now become the AMA's award-winning production recorded in both studio and locations across the country.
Although a lot has changed since our first episode, the one thing that hasn't is this—our commitment to you and our fight to relieve the challenges that you face in patient care. All year, you have given to others. But now we hope that you'll take a moment to enjoy this small gift, a look back at 2023.
We began 2023 still in a public health emergency. And although hope was high that it would soon be over, Americans learned a new word—tripledemic.
Andrea Garcia: We know Dr. Walensky noted this past week that the simultaneous combination of viruses is straining our health care systems across the country.
Dr. Sandra Fryhofer: Flu season started early this year. And I can tell you that from being a practicing doctor, the phone's ringing off the hook.
Dr. Kirsten Bibbins-Domingo: I think this is hitting all of us hard. It's hitting every age demographic hard. Our hospitals are full. We are all fatigued. No matter what job we do during the day, we're all tired of being in year three of the pandemic.
Unger: The year was supposed to be about a fresh start. But once again, physicians were asked to give even more.
Dr. Christine Sinsky: One in five physicians are now indicating that it is likely that they will leave their current practice in the next two years. Many of these will leave medicine altogether.
Dr. Jesse Ehrenfeld: What really concerns me is that we're also seeing a significant amount of burnout among physicians who are still in training. A new report from the AMA shows that more than two out of five residents are burnt out.
Dr. Stefanie Simmons: Whenever I talk to a colleague and I say, you know, tell me about this time when you were burned out, the answer isn't, what do you mean? The answer is, which time?
Unger: That's when the AMA took its Recovery Plan for America's Physicians to the next level. We dug into root causes, looked at burnout by gender and specialty, and focused on solutions, helping physicians to recapture the joy in medicine.
Dr. Ehrenfeld: To make the lasting impact that we need across the industry, we must all come together around a shared standard of care and physician well-being.
Dr. Aman Sethi: This is all about all of us rolling up our sleeves, committing to a strategy and finding our way forward in an evidence-based way.
Dr. Sapna Singh: I can tell you, at the end of the day, if you do something to help build my relationship with the patient to the most optimal thing that I imagine in my mind, which is trust and care and being able to help, that helps us right there.
Unger: And in May, when the public health emergency finally ended, our efforts ramped up even more. We shifted from recovery to rebuilding, strengthening what worked.
Dr. Alexander Ding: Nearly 70% of physicians at the AMA surveyed said that they wanted to keep providing telehealth services post pandemic. We are now working with Congress and the Department of Health and Human Services to making these changes permanent.
Unger: And we worked even harder to fix what was broken, beginning with overused prior authorizations.
Dr. Debra Patt: Prior authorization has become a real challenge for patients to get the care they need.
Todd Askew: Physicians are doing something on an average of like 40 prior authorizations a week per physician.
Dr. Michael Burgess: What is the cost of the care delay? What is the cost of the care denied?
Dr. Patt: In late October, early November, when I initially wrote for the therapy, I had the anticipation that she would do well with that. But I had to write for something else, which she got in late November, early December. And she passed away two weeks ago.
Askew: When you can make the connection to that challenge that they faced with here's a solution and here's how you can keep other people from having to deal with that, that's really powerful. And that's what motivates Congress to make change.
Unger: We also continued our fight on Capitol Hill to reform Medicare payment, working to eliminate annual cuts and maintain access to care for millions of Americans.
Dr. Willie Underwood: Medicare payment has declined 26% since 2001, when adjusted for inflation. That is simply unacceptable and unsustainable.
Jason Marino: There's 65 million Medicare patients out there. And they paid all their lives into Medicare. And then when they get on Medicare, they want to be able to see a physician. And this is going to prevent that. And this is a big threat to access.
We've been campaigning on Medicare payment reform on all fronts. That means we're engaging directly with members of Congress, House members, senators, their staff. We're participating in media interviews. We're amplifying physician voices.
Jennifer Hananoki: At the same time, the AMA and our partners in organized medicine are advocating on the Hill for congress to pass HR 2474.
Dr. Bruce Scott: This is legislation that would tie the Medicare physician payment to an annual update related to inflation.
Marino: Physicians are tired of coming every year back to stop a cut. You want us to go away? Fix the problem.
Dr. Underwood: Now is not the time to sit back and say I'm going to expect someone else to solve this problem for me. We need Medicare payment reform. And we don't need it tomorrow. We need it now.
Unger: We also broadened our efforts to stop inappropriate scope of practice expansions in states across the country.
Kimberly Horvath: We have been tracking hundreds of bills actually since that time. The AMA has been involved in many of them, again working really closely with our colleagues at the state level, providing a national perspective, providing our resources, writing letters as necessary to lawmakers, giving them AMA's opinion on the issues.
Dr. Katherine Gantz Pannel: With the partnership with AMA, we were able to do billboards. We gave lawmakers educational material that specified the differences between physician and midlevel training.
Horvath: And overall, it's been really successful.
Unger: Now, as we turn to what's next in 2024, we'll continue to address the problems we face right now. But we'll also look to the future.
Dr. Ehrenfeld: We can get this right. We can work to heal our nation. But this is only going to happen if we let physicians practice medicine.
Dr. Underwood: We are stronger together. There are 1.2 million physicians in this country. And it's time for our voices as 1.2 million strong to be heard.
Unger: Nearly 750 episodes in, it has been an absolute honor to talk with and work on behalf of our nation's physicians. We're making such a difference in so many lives. We hope you have a happy, safe and healthy holiday. We'll see you back here 2024.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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