How do you move medicine forward in trying times? Focus

The AMA is working to stop Medicare physician pay cuts, reform the Medicare payment system, right size prior authorization, reduce physician burnout and protect patients from inappropriate scope of practice expansions.

While the American Medical Association is doing a lot, one reason there have been strong signs of progress is because these efforts are focused, aligned and coordinated as part of a long-range strategic plan—and also because the AMA has carefully selected its priorities.

“One necessary aspect of strategy is choosing what not to do,” said AMA Executive Vice President and CEO James L. Madara, MD, during his speech at the opening session of the 2023 AMA Interim Meeting in National Harbor, Maryland. (Read Dr. Madara’s speech.)

Dr. Madara was quoting noted Harvard Business School economist Michael Porter, PhD, who famously said that organizations aiming for impact “can’t be all things to all people.”

“In other words, a coherent strategy relies not only on selecting the most important areas on which to focus, but also choosing the areas of lesser importance that will not be pursued,” Dr. Madara said.

At last year’s AMA Interim Meeting, Dr. Madara noted in his address that it was the 10-year anniversary of the AMA strategic plan’s implementation, and he said then that the plan was developed with two main goals in mind: That the actions of the AMA more strongly reflect the organization’s mission, and that those actions have a strong, positive impact.

“The first step was to create a process to apply the tools of strategy—establishing priorities—isolating issues of lasting importance, while also deciding what not to do,” he explained.

This led to development of a three-pronged strategy aimed at confronting chronic disease, driving the future of medicine by transforming medical education and removing obstacles that interfere with patient care.

That strategy is then powered by cross-cutting “accelerators” of advocacy, equity and innovation.

In an AMA Leadership Viewpoints column posted earlier this year, Dr. Madara highlighted how this strategy was key to meeting both the short- and long-term needs of physicians.

Today, the “removing obstacles that interfere with patient care” strategy incorporates the AMA Recovery Plan for America’s Physicians, which has targeted reforming prior authorization and developing a sustainable Medicare payment model as top priorities, Dr. Madara said.

This strategy includes AMA support for the Strengthening Medicare for Patients and Providers Act, a bipartisan bill in the House of Representatives that would link adjustments in Medicare physician payments to the Medicare Economic Index. The AMA is asking that physicians contact their representatives through the Fix Medicare Now website and urge them to support the bill.

Dr. Madara also highlighted the AMA’s focused efforts to curtail uncontrolled hypertension—the nation’s No. 1 cause of death and disability.

This includes development of the AMA MAP™ Hypertension six-month program that incorporates evidence-based strategies, practice facilitation, peer-to-peer learning and performance metrics and reports. It’s built around three key elements:

• Measuring BP accurately to obtain actionable data.
• Acting rapidly to make effective treatment decisions.
• Partnering with patients to support self-management.

“We have created the MAP program that results in improved blood-pressure control, have piloted this product, and can actually now see a pathway to diminish adverse cardiovascular events and stroke,” Dr. Madara said.

The AMA strategy is to confront chronic diseases that account for 90% of the more than $4 trillion the U.S. spends annually on health care,

The AMA’s work to transform medical education has grown into a consortium of 37 medical schools dedicated to developing new and innovative ways to teach aspiring young physicians.

It expanded with an additional consortium of 11 integrated health systems focused on reimagining physician residency training. And it then evolved even further with the creation of the AMA Ed Hub™ to meet the ongoing educational needs of physicians.

In addition to its long-term strategy, the AMA has been able to respond to urgent needs and short-term environmental challenges that includes “regular fiats from courts, federal and state agencies, as well as shifts in societal direction,” he said—and the COVID-19 pandemic as well.

“It’s critical that we respond to immediate challenges but also maintain a long-term vision for the future—a vision rooted in House [of Delegates] policy, committed to taking on large challenges over time,” Dr. Madara said.

“That is what our decade-long journey has been about—the ambidexterity of addressing needs in the moment while simultaneously engaging in a focused long-term vision of success,” he added. “And, by these combined means, promoting the art and science of medicine and the betterment of public health.”

Read about the other highlights from the 2023 AMA Interim Meeting.