With a shrinking supply of physicians, a relentless rise in chronic disease, inefficient payment models and barriers to care often borne of bureaucracy, America’s health care system is under strain.
In a speech to delegates at the opening session of the 2025 AMA Interim Meeting in National Harbor, Maryland, AMA President Bobby Mukkamala, MD, explained how the AMA and its members can drive solutions.
“Tonight, I challenge every physician in this room,” said Dr. Mukkamala, the AMA’s 180th president. “Let us be healers, yes, but let us be warriors when necessary. Warriors when we need to fight. Fight for our patients. Fight for our colleagues. Fight for the future of medicine.” (Read Dr. Mukkamala’s speech.)
In the five months since Dr. Mukkamala began his one-year term as president, the AMA’s calls for change have grown more forceful and more frequent.
“When we last convened this House in June, you challenged us to speak louder, to be more resolute against the tremendous headwinds we face,” he said. “We heard you, and I’m proud to say that over the past five months, that’s exactly what we did.”
The AMA has raised its voice against:
- The continued decline in Medicare payment rates that intensify financial pressures for physicians on the front lines.
- The removal of physicians from the Advisory Committee on Immunization Practices.
- Government interference in the exam room.
- Changes to the H-1B visa program that include exorbitant fees for doctors that could worsen the physician shortage.
Value in collaboration
Solutions are not won alone. Dr. Mukkamala touted the AMA’s willingness to collaborate.
“Physician advocacy is not just about opposition we face,” he said. “It’s also about the progress we make and finding common ground to advance the goals of physicians for the good of our patients.”
Through collaboration, he said, the AMA made progress on:
- Modernizing e-prescribing, a persistent point of frustration for physicians.
- Shaping the creation of the Trump administration’s AI Action Plan, pushing for health technology must be ethical, transparent and led by physicians.
- “Long overdue prior authorization reforms that could, maybe, just maybe, actually work this time.”
“The AMA will work with anyone to fix the problems in health care that are driving burnout and physician shortages, that burden us with excessive paperwork and badly designed technology, limiting people’s ability to get the care they need and keep our country from being healthier,” Dr. Mukkamala said. “This is more than a commitment we share. It is a pledge we took to do what’s right.”
A personal perspective
Dr. Mukkamala’s presidency has been shaped by two factors: the health care realities he faces on the ground in his hometown of Flint, Michigan, and a startling diagnosis that took place nearly a year ago.
In November 2024, a magnetic resonance imaging (MRI) exam revealed an 8-cm temporal lobe tumor on the left side of Dr. Mukkamala’s brain. Three weeks after the startling discovery, the father of two underwent surgery.
The removal of 90% of the tumor was a best-case scenario for Dr. Mukkamala.
“I have no sorrow for what I am going through. In fact, oddly, I am grateful for the preparation God gave me before I took on this responsibility. I am thankful for being a patient challenged by the very things that I—that we—fight for as doctors,” Dr. Mukkamala said, as he began to choke up. The fight, he said, is for “improved access to care and a more responsive health care system.”
A lifelong Flint resident, Dr. Mukkamala—who shares an independent practice with his wife Nita Kulkarni, MD—has spent decades treating patients in a city that has weathered economic collapse and public health disasters.
“There are far too few doctors to meet my city’s needs and our country’s needs,” he said. “Wait times for specialists like us can be measured in months.”
Dr. Mukkamala said that Flint is hardly alone in its struggles to field an adequate physician workforce. He called attention to several AMA delegations contending with similar struggles.
- In South Dakota, there is one primary care physician for every 760 residents, among the highest gaps in the nation.
- In Mississippi, a significant shortage of ob-gyns is threatening to make matters worse in a state that is grappling with some of the nation’s worst rates of infant mortality and maternal health outcomes.
- In Nebraska, about two-thirds of its counties are considered medically underserved, with many rural hospitals struggling to stay open.
“How is this possible in a nation that spends more money on health care, a lot more, than any other country on Earth?”
The work begins with the creation of a sustainable payment model that supports both employed and independent physicians. Making that a reality requires sustained efforts for Medicare and Medicaid reform in Washington.
Other aspects of the fight include attracting the world’s most skilled physicians, pushing for increased emphasis on preventative care and better more efficient technology that makes the practice of medicine easier.
In laying out an idealized version of what the nation’s system of care could be, Dr. Mukkamala said that the people to take it from dream to reality were the physicians seated in the ballroom tonight.
“Our mission—restoring the joy, the meaning and respect that first drew us into medicine—our mission is worth every ounce of effort,” he said. “It is worth the fight.”
Read about the other highlights from the 2025 AMA Interim Meeting.
