Over the past year, AMA President Barbara L. McAneny, MD, has traveled the country talking to physicians from all specialties, age groups and practice settings. While representing the AMA in the World Medical Association, she heard firsthand how medicine is practiced around the globe and learned that physician burnout is pervasive. Doctors in the U.S. and internationally are feeling the effects of burnout, but the root causes appear to be different in other countries.
“Abroad, it seems to stem from the insufficient resources to get people the quality care they need and deserve. One comment I heard again and again from our international colleagues was: well, at least their health system isn’t as bad as ours,” Dr. McAneny told delegates at the opening session of the 2019 AMA Annual Meeting in Chicago.
The American health delivery system is ailing, she said.
“I’m afraid for the future of health care in our nation unless policymakers, with physician guidance, make necessary changes,” said Dr. McAneny, a board-certified medical oncologist-hematologist from Albuquerque, New Mexico, who became the AMA’s 173rd president last June.
Dr. McAneny outlined examples in medicine in which patients and physicians have been put behind some other priority, and highlighted the powerful voice the AMA brings to the table to fix what’s wrong.
Access to insurance. “In America, the entry ticket for our health system is an insurance policy, which is why I am proud the AMA continues to fight on the side of patients, fighting to ensure people have the coverage they need—at a cost they can afford—and pushing back on efforts in Congress to take insurance away.”
Delaying care until it becomes an emergency is not the way to manage chronic diseases that account for nearly 90% of health care spending because “by that point it is too late and too expensive,” she said.
Administrative burdens. “Health care is now the largest employment segment in the U.S. economy, driven largely by new hires focused on administrative tasks instead of clinical care,” Dr. McAneny said, noting AMA research showing that physicians spend two hours entering data for every hour with a patient.
“How many of you enjoy spending part of your nights recording patient data to improve your hospital’s star rating for higher payments—a task that does nothing to improve patient care?” she asked the crowd.
But the AMA, she noted, “is focused on reducing this ever-increasing bureaucracy. Prior authorization drives us all crazy and the AMA has engaged some of the largest players to right-size that process, easing physician frustration and ensuring that patients receive the care they need in a timely manner.”
Health industry consolidation. The AMA also has fought—and won—battles to stop mergers of major health insurance companies. Now the battle continues by challenging the CVS-Aetna merger.
“We’re seeing the same anti-competitive consolidations across health care, including in the hospital market where they seem to think that the only way to combat consolidation in the insurance market is to consolidate themselves and acquire physician practices,” said Dr. McAneny. “The promise is that efficiencies of scale will lower prices for patients, but the facts don’t bear that out.
“Instead, choices go down, costs go up, and staff input on hospital operations is diminished—adding to physician frustrations.”
Interference in the patient-physician relationship. The AMA also has made its mark in pushing back against government overreach. The AMA joined “forces to sue the federal government to protect millions of women who receive reproductive care through Title X,” while preserving physicians’ ability to have open conversations with patients about all health care options.
“I’ve never been more proud of the AMA,” Dr. McAneny said.
“Any law or regulation that prevents us from fulfilling our ethical duty to give our patients complete and honest information is unacceptable and will be challenged by the AMA,” she said, adding that it is also unacceptable for laws or regulations to criminalize medically sound health care, interfere with the patient-physician relationship or undermine that trust.
“After a year in office, I depart with a greater understanding of the depth of our country’s challenges and the forces—political and otherwise—that threaten to derail our progress,” Dr. McAneny concluded. “But I’m also as confident as I’ve ever been in the collective will of physicians and the House of Medicine to continue this fight—to come together on the issues that truly matter.”
“As I stand here as your president, I’m reminded of the immense power in our collective hands. Together we are not just stronger. When we join hands, and speak up for our patients, we are unstoppable.”