AMA: Prescription for the future of medicine

AMA: Prescription for the future of medicineA guest column by the American Medical Association, exclusive to

As our nation’s health care system undergoes historic reforms, the American Medical Association (AMA) has embarked on a long-term strategic plan that seeks a better future for medicine – both for the physicians who make it their profession and the patients who count on us for care. Our focus is anchored in the belief that there is a national imperative to improve both the delivery of health care and the health of the nation.

This strategy is centered on three core areas that are critical for optimizing 21st century health care – areas that must be shaped through physician leadership. These core areas seek to improve patient health outcomes, accelerate change in medical education and shape payment and delivery models that ensure high quality patient care and value while enhancing professional satisfaction.

The AMA has been a leader in health care quality improvement since its founding. Our future work toward improving health outcomes will build on and complement our past work as we seek to demonstrate improvements in clinical and patient-reported outcomes, ensure health equity, reduce unwarranted variation in care, advance the quality and safety of health care and help define the appropriate use of finite health care resources.

To achieve measurable improvement in patient health outcomes, the AMA is examining data and literature, as well as speaking to leaders in the field, to identify clinical conditions that impact a large segment of the U.S.population. Beginning with two targeted high impact health topics to be selected later this year, we will develop a national dashboard for clinical and patient-reported outcomes and collaborate with other experts to implement strategies with an overall goal of reducing the disease and cost burden associated with each. By improving health outcomes, we can help our patients live healthier, more productive lives while reducing the enormous costs associated with these diseases and conditions.

In keeping with the AMA’s historic leadership in physician education at all levels, we are working to strategically reshape physician education in the United States. We will work to promote change that better aligns education outcomes with the changing needs of our health care system. We seek to accelerate changes occurring in medical training, moving from calendar-driven to competence-driven assessments, fostering professionalism and continuous learning and focusing on the content and skills needed to work in teams. Medical education must also help students understand how health care is financed and delivered so they are prepared to assume future leadership roles.

In just a few months, the AMA will invite medical schools across the country to submit proposals outlining specific projects to accelerate their ability to implement these needed changes in medical education. Over the next five years, the AMA will work with these national health care leaders to help develop innovative new education models that can be emulated in medical schools across the country. In short, we’ll be doing everything within our power to align 21st century medical education with 21st century health care needs.

Finally, to help physicians navigate the transformation in delivery and payment models, we will identify and promote models that demonstrate high quality care and value while preserving professional satisfaction and practice sustainability for physicians. To achieve this goal, we are working with physician groups and other health organizations to identify viable, working solutions that provide reasonable stability for physicians during coming transitions. A one-size-fits-all approach isn’t the answer, as we know that models that work best for large, multi-specialty practices in a city may not work for a small practice in the country. Physicians are seeking help in navigating the current environment, and through this initiative, the AMA will provide that assistance.

The AMA believes that physician leadership is critical to the successful evolution of health care in a patient-focused delivery system. The lofty goals of our strategic plan can be achieved with collaborative leadership focused on improving health care to ensure that our nation’s patients live healthier lives and that physicians are trained to deliver 21st century medicine and thrive in sustainable practices.

Jeremy Lazarus is President, American Medical Association.

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  • kjindal

    If the AMA wants to regain its long-lost position as representative of physicians, may I suggest the following:
    1- Be clear and strong about the organization’s position on tort reform. The response to this administration’s clear position against malpractice caps was disappointingly neutral, or even lukewarm.
    2- Take a firm position against scope of practice expansion for mid-levels.
    3- Advocate for LESS paperwork, rather than expansion of the “team” which inevitably leads to more signatures for the MD who cannot possibly read and absorb everything from every paraprofessional involved in a patient’s care. This particularly applies to inpatient care.
    4- Take a position against Medicare’s push for not paying for some things that are out of the MDs control, e.g. patient noncompliance w/resultant poor outcomes.
    5- Advocate for a UNIVERSAL electronic records system (e.g. VA’s Vista, which was good even 10 yrs ago) rather than multiple crappy systems from companies with big lobbying dollars that essentially pay our politicians to force small practices with thin margins to buy in. Then mandate that anyone who bills medicare & medicaid must use such a system. If you want to eliminate waste & duplication, and enhance quality, this is an easy fix (except politically).
    6- Allow AMA membership FOR FREE! Yes, that’s right. So many of us are so disillusioned with your organization and lack of leadership/representation that you now misleadingly represent a tiny minority of practicing physicians. Then after a few years if you get your footing, ask for voluntary contributions, then as things maybe improve ask for a membership fee.$420/yr is steep, especially for primary care MDs, in addition to state & county dues which are around $800/yr.
    7- Give yourself and your senior staff a pay cut. When Citibank was losing it’s footing, it’s CEO took a salary of $1.
    All these things would show average physicians on the ground, like myself, that you’re at least TRYING to right the ship.

  • southerndoc1

    Strategic plan . . . core areas . . . national imperative . . . high quality value . . . transformation . . . is there an English translation available anywhere?

  • Tom Keeling

    kjindal, your suggestions should be published far beyond this venue.

  • American_Medical_Association

    Kjindal, thank you for the opportunity to share more about how the AMA, the
    nation’s largest physician organization, helps the physicians of America. The
    AMA House of Delegates, comprised of physician leaders from all states and
    virtually all medical specialties, creates AMA policy through a democratic
    process. The AMA continues to fight to fix the broken
    medical liability system, supporting H.R. 5, a medical liability reform bill
    that passed the U.S. House. At the state level, we’re pursuing medical liability
    reforms and defending previously enacted reform laws as they are challenged. The
    AMA’s Scope of Practice Partnership has focused the resources of organized
    medicine to oppose scope of practice expansions by non-physician providers that
    threaten the health and safety of patients while we work to support
    physician-led health care teams. To help physicians spend more time with
    patients and less on paperwork, our Practice Management Center helps
    physicians with the business side of their practices. To keep physicians from
    being penalized by actions over which they have no control, we’ve made it clear
    to Congress that any Medicare
    transition plan that comes after the repeal of the Sustainable Growth Rate
    must tie incentives to physicians’ own actions, not the actions of others or
    factors beyond their influence. We agree wholeheartedly that interoperability is
    the key to truly meaningful use of electronic health records, which is why we
    have repeatedly
    urged regulators to resolve interoperability issues to remove a major
    barrier to physician use of health IT. We will continue to work hard to help
    physicians thrive as we move medicine forward together.

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