There is a lot of privilege and responsibility that comes with being a physician advocate, outgoing AMA President Jesse M. Ehrenfeld, MD, MPH, said in his final remarks to the assembled AMA House of Delegates while holding the highest office in organized medicine. There is a responsibility to speak out against injustices, stand up for science and give voice to the real-world challenges physicians experience.
But it comes with personal costs too, ones Dr. Ehrenfeld hadn’t completely understood before taking office. From late-night meetings and extended travel itineraries crisscrossing time zones and continents to prepping for TV appearances, podcasts and other interviews.
These demands take a toll on anyone, but as a husband and father to a 5-year-old and 17-month-old, the weight of his “decisions are magnified,” said Dr. Ehrenfeld in his address at the opening session of the 2024 AMA Annual Meeting in Chicago.
Before another early flight, Dr. Ehrenfeld’s eldest son, Ethan, asked, “Why do you have to be AMA president?” But that wasn’t the first time that question had been asked. Before taking the oath as president, he had a conversation with his husband, Judd, in which they wondered: “Why do this now?”
“It's a question perhaps many of you have asked yourselves over the years as you’ve juggled your work, home and AMA responsibilities with this difficult job of physician advocate—a job that seems to get more complicated and challenging with every passing year,” Dr. Ehrenfeld said. “For me, I keep coming back to the same answer: This moment in health care demands my attention—this is my fight. This moment in health care demands all of our attention. It is all of our fight.”
“The stakes are high. The risks to patients are growing. The demands on physicians are unrelenting. The world around us is mired in uncertainty, misinformation and mistrust,” he said. “And so, we summon our strength and speak out. We use our voice. We lean on one another for support and encouragement.”
“We fight for what we know is right. A better health care system. A more accessible health care system. A more equitable health care system. A more financially sustainable health care system,” Dr. Ehrenfeld said. “I do this work … because the future of our profession and our nation’s health cannot be left to chance. This is why we fight.”
Days before his term as the AMA’s 178th president comes to a close, Dr. Ehrenfeld offered reasons why physicians fight on behalf of their patients and their profession. (Read the complete remarks.)
Reducing physician burnout
“We do more than just combat problems. We’re also driving the change we are striving to create,” said Dr. Ehrenfeld. For example, “AMA recognized 72 hospitals and health systems through our Joy in Medicine program last year, creating an unmatched understanding of the best practices and solutions to solve the physician burnout crisis that health systems across the country can learn from and implement.”
“Solving the burnout crisis and ensuring that medicine remains a highly desired profession—this is why we fight,” he emphasized.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine™.
Reforming Medicare payment
“Medicare reimbursement has plummeted 29% since my first year in medical school … and that’s after we were able to claw back half of the planned cuts for 2024,” Dr. Ehrenfeld said. “Medicare reform is our top advocacy priority because it’s crippling the sustainability of physician practices, it’s threatening patient access to care and it’s choking the pipeline for future physicians.”
But “momentum is shifting toward significant reform. And our AMA is changing the conversation,” he added, noting “thanks to the AMA’s comprehensive Fix Medicare Now campaign, multiple hearings, media visibility, grassroots outreach and our extremely persistent lobbying efforts, there is now broad acceptance that the current Medicare payment models don’t work.”
There is also growing support in Congress for Medicare reforms that align with the AMA’s models.
“But we’ve got to keep the pressure on, because our current system is unsustainable and nobody should have to worry about how they’ll keep the lights on,” Dr. Ehrenfeld said.
The AMA is leading the charge to reform the Medicare payment system.
Fighting scope creep
“Protecting our patients from unsafe scope of practice expansions by nonphysicians—that’s another reason why we fight,” Dr. Ehrenfeld said, noting the “AMA helped defeat more than 100 of these outrageous scope bills last year, and dozens in 2024.”
These include legislative efforts to permit optometrists to perform eye surgery and give naturopaths the authority to prescribe medication. And more are sure to pop up.
“Scope expansion directly impacts our most vulnerable patients, including my fellow veterans, which is why I testified in a Congressional hearing on veterans’ affairs to discuss how these expansions threaten the quality of care that our veterans, my shipmates and I receive,” Dr. Ehrenfeld said. “Our patients’ health: this is why we fight.”
The AMA is fighting scope creep, defending the practice of medicine against scope of practice expansions that threaten patient safety.
Fighting for Physicians
Get updates on how the AMA is fighting for physicians on critical issues—delivered to your inbox.
Fixing prior authorization
“Eliminating physician busywork: this is why we fight,” Dr. Ehrenfeld said, recognizing that physicians “have horror stories to share about the overused prior authorization process that results in delay after delay until, too often, patients just give up and abandon necessary testing and treatments altogether.
“We as physicians and our patients deserve better,” he added. “That’s why we welcomed news last year that United Healthcare and Cigna each reduced the volume of their prior authorization requirements by at least 20%.”
Another win was a Centers for Medicare & Medicaid Services “final rule that makes long-overdue changes to prior authorization for all government-regulated health plans and reduces decision times,” Dr. Ehrenfeld said. “These changes will save physician practices and our health system an estimated $15 billion over the next 10 years—never mind the countless hours and incalculable frustrations of physicians and patients. This simply would not have happened without AMA advocacy.”
The AMA is fixing prior authorization by challenging insurance companies to eliminate care delays, patient harms and practice hassles.
Closing gaps in care
Some of the country’s largest chain stores and pharmacy retailers had previously entered the health care market. But that work has scaled back or ended entirely, and they have closed their walk-in clinics.
“Despite their stated goal of expanding health care access to patients with limited options, these corporations were unable to create a health care model that was financially viable,” Dr. Ehrenfeld said. “And now, their closures are creating gaps in care for thousands of who came to rely on them.
“Think about that. These are some of the largest for-profit companies in the world, and they can’t make today’s primary health care model sustainable,” he added. “If they can’t make it work, how can we possibly expect physicians to? That’s a challenge I am going to continue to prioritize as I leave the presidency.”
“This is why we fight. Our families are why we fight. Our patients are why we fight. Our colleagues and our profession are why we fight. And why we’re going to keep fighting,” Dr. Ehrenfeld said.
Read about the other highlights from the 2024 AMA Annual Meeting.
