New AMA president: Physicians must seek “more equitable tomorrow”

In his first remarks after assuming the highest office in organized medicine, newly inaugurated AMA President ​Jesse M. Ehrenfeld, MD, MPH, drew from personal experience to speak to the inequities that plague the American health care system.

As he looked down from the podium at his 4-year-old son, Ethan, Dr. Ehrenfeld recalled the 49 days the boy spent as a newborn in a Chicago neonatal intensive care unit. Delivered 10 weeks early, weighing less than 3 pounds, Dr. Ehrenfeld’s child battled for his life.

A few weeks after his birth, Ethan needed a blood transfusion, a procedure that Dr. Ehrenfeld, an anesthesiologist at the Medical College of Wisconsin, had performed on a routine basis. 

“Watching my son cling to life, I was struck by the painful reality that, even though I was a physician and now, a father, neither I, nor my husband, could donate blood simply because we are gay,” said Dr. Ehrenfeld, the first openly gay person to ascend to the office of AMA president. “Discriminatory policies—policies rooted in stigma, not science—barred us from doing the most humane of acts, donating our blood.”

Ethan recovered, but that helpless feeling is one that has stuck with Dr. Ehrenfeld.

Beginning his tenure as the AMA’s 178th president, Dr. Ehrenfeld spoke of inequity in care delivery. (Read Dr. Ehrenfeld’s speech.)

America is a country, he said, in which:

• Black women are at least three times as likely as white women to die as a result of their pregnancy.
• Black men are 50% more likely to die following elective surgery.
• LGBTQ+ teens and young adults suffer higher rates of mental health challenges that often go undiagnosed.

The AMA can play a role in addressing these inequities, as it has done in the case of blood-donation rules.

“Just recently, the FDA, thanks in large part to a decade of advocacy by our AMA and others, rescinded some of these discriminatory practices, making it possible, for the first time, for my husband and I to give someone else’s child a much-needed blood transfusion,” he said. “This kind of advocacy is why I am so proud to lead our AMA at this moment.”

In his two-plus decades within the AMA, Dr. Ehrenfeld he has seen tectonic shifts in policy and attitudes related to LGBTQ+ patients and physicians.

At his first AMA House of Delegates meeting in 2001, Dr. Ehrenfeld was awestruck by the pomp and circumstance. Yet, as a gay man, he felt alienated.

The climate at that time was a harsh one for the LGBTQ+ community. Marriage equality had yet to be achieved and federal hate-crime statutes didn’t include protections for LGBTQ+ people.

Within the AMA, Dr. Ehrenfeld said, openly gay physicians were rare and there was no AMA Advisory Committee on LGBTQ Issues to speak to the unique health care needs of the community. Dr. Ehrenfeld had only come out to close friends and family a few years earlier.

“As a medical student, standing in that room and watching the deliberative process of the House of Delegates unfold, I had well-founded fears about my place in society, never mind the profession of medicine,” Dr. Ehrenfeld said.

Dr. Ehrenfeld has seen organized medicine change in the intervening years. His election as AMA president embodies it.

“Standing on this stage tonight and accepting the honor of the AMA presidency is proof that our organization can evolve. This is why visibility matters,” he said. “This is why, when you have a platform like this one, you have a responsibility to use it for the greater good and to try and lift up those who haven’t yet found their voice.”

Dr. Ehrenfeld assumes the AMA president at an extraordinary time for the profession.

On one hand, scientific and technological advances can have transformative effects on the field of medicine. Conversely, in spite of those numerous advances, discouraging trends related to health outcomes—maternal mortality rates in the U.S. are more than double those of other well-resourced nations, for instance—are becoming more prevalent.

This is “why both physicians and the public look to the AMA for leadership, for guidance, for reassurance, and for help making sense of an increasingly complex world.”

Certain aspects of the country’s political climate have become dangerously polarized. Politicians and judges are making decisions about health care formerly reserved for patients and physicians and patients. Firearm violence and drug-overdose deaths continue at epidemic levels.

“We have to think about how we can engage in this increasingly divisive environment if we are to be successful in pushing for policy changes, advocating for what we believe in, and working to make a difference for our patients,” Dr. Ehrenfeld said. “On all of these issues, our AMA will continue to lead. We’ll continue to meet the needs of physicians—and the well-being of our patients—above all else.

“As your president, I pledge to do all that I can to ensure that your voices, and your priorities, are heard.”

In spite of increasing, and at times unforeseen, obstacles, Dr. Ehrenfeld urged his physician colleagues to stay above the fray.

“It is easy to be discouraged by the enormity of the task at hand, but as I begin my term as president, I choose to embrace optimism,” Dr. Ehrenfeld said.

Physicians have earned that optimism. It is evident in the way they have stepped up in the fight against disinformation, brought attention to the nation’s mental health crisis and worked tirelessly to address health inequities.

In addition to the collective willpower physicians have displayed in support of moving medicine forward, Dr. Ehrenfeld said his own path in organized medicine is another reason for that optimism.

“I choose optimism because even though I once stood in the back of this very room being very afraid of being rejected for who I was,” he said. “I now stand before you as the first openly gay president of our AMA, proudly representing everyone in this room, including everyone who has ever, or will ever, feel like an outsider.”

The changes the AMA has undergone in the 22 years since Dr. Ehrenfeld’s first Annual Meeting have been as staggering as they were unexpected. Considering that, the AMA’s 178th president asked the assembled delegates to imagine what the profession would look like two decades from now.

“Let us move forward with confidence and purpose,” he said. “Let us speak with conviction. Let us hold firm to science and the ethics of our profession. Let us serve with honor, with courage and commitment. And let us always fight for a more inclusive, and more equitable, tomorrow.”

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