CHICAGO — Barbara McAneny, MD, president of the American Medical Association (AMA), lauded her organization’s achievements in preserving patients’ freedoms and fighting for physician autonomy, during the AMA House of Delegates meeting.
In opening remarks, McAneny described the AMA’s role defending women’s reproductive rights from being chipped away at by the Trump administration.
“I’ve never been more proud of the AMA than I was this spring when we joined forces to sue the federal government to protect millions of women who receive reproductive care through Title X,” said McAneny.>/p>
The lawsuit also helped to protect physicians’ rights to “open conversations” with patients about all of their reproductive health options.
In March 2019, the AMA sued the Trump administration over a final rule that stated that any health clinic providing abortion services would no longer receive Title X funding (federal dollars dedicated to family planning and other services such as cancer screenings). The rule, often dubbed the “Trump-Pence gag rule,” also prohibited “referral for abortion as a method of family planning.”
The AMA/Oregon Medical Association/Planned Parenthood Federation of America lawsuit filed in the U.S. District Court, District of Oregon, aimed to block the rule. In April 2019, U.S. District Judge Michael McShane released a written opinion declaring his plan to issue a nationwide preliminary injunction against the “gag rule,” according to The Oregonian.
“Let me be clear: 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. Any law or regulation that criminalizes medically sound healthcare is unacceptable and will be challenged by the AMA. And any law or regulation that interferes with the patient-physician relationship, or that undermines that trust, is unacceptable and will be challenged by the AMA,” McAneny said to applause at the meeting.
The AMA also successfully pushed back against consolidation in healthcare, particularly against mergers and acquisition of health insurance companies. McAneny said.
“Now we’re challenging the CVS-Aetna merger,” she said, referring to the deal CVS Corp. and Aetna, announced in November 2018, according to Modern Healthcare.
When she asked the AMA audience how many believed out-of-pocket drug costs would fall if the CVS-Aetna merger were allowed, the only response was muffled laughs.
McAneny also spoke of the dangers of consolidation in the hospital market, as more health systems acquire physicians practices.
“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,” she said.
McAneny also highlighted the AMA’s success in the sphere of public health.
She characterized the AMA as a “leading voice for common sense gun violence prevention policies” and a key force in battling opioid epidemic, noting that because of the AMA’s advocacy, dozen of states have removed prior authorization for medication-assisted therapy, enabling more timely treatment for substance use disorders.
Taking a 30,000-foot view, McAneny shared her reflections on the current state of U.S. healthcare.
In a country that spends $3.5 trillion each year on healthcare, physicians are often frustrated by how healthcare dollars are wasted, she noted.
During her national travels on behalf of the AMA, she’s often invited on tours of state-of-the-art new building and hospital wings, she noted, but questions the value of such enterprises. “How many health clinics could we embed in high-risk communities or small towns with that [same] money?,” she stated. “How many primary care doctors could work rent-free in those clinics to handle diabetes and heart disease cases for the enormous cost of a new hospital wing?”
The lack of input hospital-employed physicians have on such projects can be tied to burnout, she said. For instance, physicians will identify a clinical need, but find that they can’t persuade hospital leadership to invest in the intervention, she noted.
In addition, private practice physicians grown increasingly annoyed with their shrinking resources and ever-growing administrative requirement.
“We cannot afford to provide social workers or dietary consultations because the physician fee schedule doesn’t cover it,” she said, adding that as physicians work longer and longer hours, Medicare and Medicaid reimbursement is falling below the cost of keeping the lights on.
McAneny recently lobbied Congress or “positive updates,” in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)/Quality Payment Program (QPP) to keep up with practice expenses. She said she continues to advocate for more alternative payment models.
“Resilience training might help you get through a bad day, but to cure this disease, we actually have to fix short-sighted policies and truly pay for value.” she said.
McAneny called her year in office the second most “remarkable” moment of her life (the first being meeting her husband), and said she’s very confident in the collective power that physicians hold.
“Together we are not just stronger … when we join hands and speak up for our patients … we are unstoppable,” she stated.
‘A Strong Voice’
Also at the meeting, Sue Bailey, MD, an allergist and immunologist from Fort Worth, Texas, was chosen as the new president-elect unopposed. Bailey is the third woman to hold the top position in AMA leadership.
“Challenging times remain for our healthcare system and as AMA president-elect, I pledge to serve as a strong voice and dedicated advocate for patients and physicians on the pressing healthcare issues confronting our nation,” she said.
Bailey, now speaker of the House of Delegates, has served as vice-speaker and in several other leadership role, including two terms on the AMA council on medical education. She was also a member of the “precursor” committee to what is now known as the AMA women’s physicians section, according to an AMA press release.
Bruce Scott, MD, an otolaryngologist from Louisville, Kentucky and the current vice-speaker, will become speaker-elect. Scott has served as vice-speaker for 4 years and has also served as chair of the AMA residents and fellows section and a delegate for the AMA young physicians section. Scott is the current president of the Kentucky Medical Association.
Lisa Egbert, MD, an ob/gyn and a delegate of the Ohio State Medical Association, and Corey Howard, MD, an internist and delegate of the Florida Medical Association, are vying to be the next vice-speaker of the House of Delegates.