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Featured topic and speakers
What does the American Medical Association do? Are private practices closing? When do Joy In Medicine applications open? What's the new CMS rule on prior authorization?
AMA President Bruce A. Scott, MD, joins to discuss the pressing issues facing physicians like Medicare payment reform, scope creep, prior authorization hassles, and the ongoing crisis of physician burnout. He highlights American Medical Association successes over the past year and how the AMA will fight for physicians and help patients in 2025. AMA Chief Experience Officer Todd Unger hosts.
- The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most—patients. We will meet this challenge together. Join us.
- Learn more about our AMA advocacy priorities, including:
- Reforming Medicare payment
- Fighting scope creep
- Fixing prior authorization
- Reducing physician burnout
- Making technology work for physicians
Speaker
- Bruce A. Scott, MD, president, American Medical Association
Transcript
Dr. Scott: I want to get prior authorization fixed for our patients as well. I really believe that if physicians unite, if we come together, that we really do have the power to fix these problems.
Unger: Hello and welcome to the AMA Update video and podcast. Today our guest is AMA President Dr. Bruce Scott, who's joining us from Louisville, Kentucky. And we're going to be talking about the progress the AMA made in 2024 and priorities for a year ahead. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Scott, welcome, and Happy New Year.
Dr. Scott: Well, thank you, Todd. It is a great new year, and I'm excited to be here with you today.
Unger: Well, lots of activity at the end of last year, and a lot on our plate for the coming year. Why don't we start by talking about the issue that's on every physician's mind, and that is Medicare payment reform. What do we need to know about that?
Dr. Scott: Well, Todd, I hate to start the new year off on a sour note. But unfortunately, for the fifth year in a row, Congress failed patients and failed physicians. At the end of 2024, they allowed yet another Medicare cut to go into effect. This is a 2.8% cut on top of the cuts that we've experienced since 2001, adding up to more than a 30% cut since that time. It's unsustainable. Physicians can't take it anymore.
Now, I understand that physicians are frustrated. I'm frustrated, too, as year after year it seems we come back with these cuts. We need a Medicare payment system that is based upon what it actually costs us to provide care to the patients.
Now, the good news is that over this last year, we have been able to spread the message. And now we actually have a majority of the people on Capitol Hill understand the urgency that we must fix Medicare now, or there's going to be a disastrous effect on the access of care for those patients who need it the most, the senior citizens and the vulnerable people who have disabilities. So we need to fix Medicare, and we need to fix it now.
Let me assure you that we're going to be up on Capitol Hill every day in this next Congress fighting for a reversal of these cuts and a reform of the Medicare payment system that's going to give physicians a payment update that is based upon the cost of providing care.
Unger: Well, thank you so much. And obviously, a huge priority for this year. Well, speaking of advocacy, we are also advocating a lot at the state and federal level last year on prior authorization and scope of practice, which we know are two very important topics to physicians. Talk to us a little bit about some of the big wins there.
Dr. Scott: Well, actually in this one, we had a big win starting at the beginning of the year. Back in the early 2024, we convinced CMS to add transparency and reduce delays, and add efficiencies to prior authorization in government-sponsored health care plans.
We weren't finished there, though. We worked with state medical associations to get reform of prior authorization in the states. And we were successful in over 12 states in getting new prior authorization reform.
We're not stopping there. We'll be going back to the federal legislation this next session, and we'll continue to work with the state medical associations to get more prior authorization reform. The bottom line is prior authorization delays needed care and harms patients. So it's one of our top priorities.
The other thing we were successful on in this last year was fighting the inappropriate expansion of scope of practice for nonphysicians. Again, here, we worked with medical societies all around the United States and were able to actually get over 80 legislative bills passed in order to protect patients from inappropriate scope expansion.
Again, here, our job's not done. And we'll be working in this next legislative session with the states all around the nation to make sure that patients are protected from inappropriate expansion of scope of practice by nonphysicians.
Unger: Now, Dr. Scott, these are not just theoretical topics to somebody like you. You've continued to work through your presidency as a practicing physician who's seeing patients in private practice. How do you see the results of this work that we're talking about impacting physicians, even you personally?
Dr. Scott: Well, as a physician who continues to practice in a small private practice, I can tell you that I live these issues every day. And frankly, our practice is struggling under the financial cuts of Medicare and the continuing waste of our time as we get on the phone and have to fight for our patients to get the care that together we've decided is in their best interest.
And I hate to even tell you this, but two of my partners have given up. And as of January the 1st, they're leaving private practice, and they're going to become employed. Not because they want to leave private practice, but because the challenges that we're talking about.
So for physicians all around the United States, as I travel, I hear that they're struggling. A close friend of mine, who's an obstetrician gynecologist in a rural area of Ohio, closed her practice tearfully after more than 20 years because she could no longer sustain the financial challenges and all the administrative burdens.
I can also tell you that my patients feel this problem. They're frustrated, and they're growing angry. Just two weeks ago, I had a patient in who had a tumor in his throat that we were concerned about that it might be cancer. And he has now waited over two weeks for his insurance company to approve the biopsy so he can find out whether he has cancer of his throat or not. Imagine the stress that he is experiencing.
And this is the sort of stress that patients all around the United States, in my practice, and in other practices, are experiencing simply because insurance companies want to save their profits. It's unacceptable.
Unger: That story is just harrowing. And you talked about the burden that physicians are facing. It's no wonder that we see numbers we do regarding physician burnout. Another huge part of what we were fighting for for physicians last year is about reducing physician burnout. And they had a big year for those efforts, including the AMA Joy in Medicine™ Health System Recognition Program. Tell us a little bit more about what you see the program achieving.
Dr. Scott: Absolutely. I'm so proud of all the work that we've done on the area of improving physician well-being, a very important issue. Last year, the Joy in Medicine Program recognized 62 organizations for their efforts within their organization to help physician well-being, to reduce burnout within their organization. That's in addition to the 72 organizations that we recognized last year. This program keeps growing, and that's a tremendous impact on physician well-being.
On January 10, the application cycle for next year's awards will open. And I encourage every physician and every system to get involved and submit an application and to contact for more information in that regard.
In addition to that, the AMA is also working hard to remove stigmatizing language from licensure and credentialing applications. Last year, we were able to convince 27 state medical licensure boards and over 300 hospitals to remove these stigmatizing questions from their applications.
Imagine if you were a medical student or a resident, and you needed to seek mental health care years ago because maybe a loved one died, or there were other stresses in your life. And now, 20 or 25 years later, you're still having to answer questions on these licensure and credentialing examinations that stigmatize you in regards to your previous health care issues. That's just not right. We need to work further to remove these questions. That's exactly what the AMA is going to do.
At the same time, we're working to facilitate the availability of confidential mental health care for physicians to help with their burnout and with other stresses that occur in our lives.
Unger: You can find out more about that Joy in Medicine program at ama-assn.org/joy. And I encourage you to find out more, as Dr. Scott said.
Dr. Scott, we may be entering a new year. But for you, you are halfway through your term as AMA president. I'm curious, when you look at the past six months, is there anything that really stands out to you?
Dr. Scott: Well, Todd, the obvious answer is my inauguration. I mean, what an incredible moment to be inaugurated as the president of the AMA, with all my family and friends and colleagues there to celebrate with me.
But beyond that, the other thing I would tell you, which might be a little surprising, is that one of the great joys that I get is converting naysayers and cynics who say to me, I don't know what the AMA does. And hopefully, after I talk to them, either from a podium or one on one, they have a different answer.
And when they come up to me and say, you know, I'm going to get involved now. I understand that together we can hopefully fix these problems that are facing our profession, and in some cases, actually tell me that they're going to join the AMA after years of quitting. And so those are the things that really bring me joy as I travel around the United States.
Unger: That's great. When you look ahead to the next six months, what do you see as the top priorities for 2025?
Dr. Scott: Well, all the issues we've already talked about—reforming the Medicare payment system, fixing prior authorization, stopping the unacceptable expansion of scope of practice, and all of that coming together to hopefully reduce burnout among physicians. Those are all going to remain top priorities for us because those are really the issues that impact our patients and physicians all around the United States every day.
If there's one other issue that needs our attention that we're going to be definitely focusing on, it is technology, and to make sure that digital medicine and AI and all of technology is something that helps physicians provide quality care, not become another burden for us in our clinical practice. We believe that physicians should be involved in the development and the foundation and the implementation of these new technologies. So that's going to be a focus as well.
Unger: Would you say that's one of the things you're most looking forward to this year?
Dr. Scott: Well, what I'm really looking forward this year hopefully is fixing Medicare. Call me overly optimistic or a dreamer, but I'm hoping we can push this across the finish line. And I want to get prior authorization fixed for our patients as well.
I really believe that if physicians unite, if we come together, that we really do have the power to fix these problems that are plaguing our medical system right now. I want everybody to join us, become a member, be part of the solution. Get involved.
Unger: That's so important. I appreciate you saying that. These are big problems. They're not going to fix themselves. But by working together with the AMA, we can make progress.
Dr. Scott, thank you so much for joining us and for always being such a strong advocate for physicians and their patients. If you'd like to learn more about AMA's accomplishments last year, we encourage you to check out the episode description for a link to our latest progress report and to help us continue fighting for physicians. Again, please consider becoming an AMA member at ama-assn.org/join.
That wraps up today's episode, and we'll be back with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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