Adnan Munkarah, MD, views his work with the AMA Integrated Physician Practice Section (AMA-IPPS) as an ongoing journey.
The section uses policy and education to advance the interests of multispecialty, physician-led, integrated health care delivery systems, as well as groups working toward similar systems of coordinated care. Dr. Munkarah, care delivery system president and chief clinical officer for Henry Ford Health, is the current chair of the AMA-IPPS governing council.
"If there is a problem, complaining about it is not going to solve it," he said. "We need to be part of the solution. That is what we have done with the IPPS and with the help of the AMA staff."
Dr. Munkarah and Narayana Murali, MD, a nephrologist and chief medical officer of medicine services at Geisinger, discussed the section and its priorities in a recent episode of “AMA Update.”
Geisinger and Henry Ford Health are members of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Bridging the gap to guide AMA policy
The House of Delegates reviews and approves policies and should be thought of as "the heart of the AMA," Dr. Murali said. The AMA Integrated Physician Practice Section is one of 12 interest-based groups that offer members the opportunity to shape AMA policy, increase relevant knowledge and skills, and interact with peers with similar interests or backgrounds—with the AMA LGBTQ+ Section being the newest.
Members of AMA-IPPS are both physicians and leaders within independent and large-sized health systems. That dual perspective is critical, Dr. Munkarah said.
“Health care is a continuum. We cannot differentiate and separate between what happens in the ambulatory setting in a private physician's office with what happens in the hospital, with what happens in postacute care," he said. “The reality is … that we have segregated these in silos in the past, and this has led to lack of coordination of care and finger pointing of where quality lies, where cost lies."
In recent years, the section has initiated a number of policy suggestions that went on to be adopted, and ultimately advocated for by the AMA. For example, the section helped lead the AMA to develop policy on prospective payment models.
That inspired a report on current trends regarding value-based care as well as the development of two playbooks on best practices on data sharing and value-based care payment models designed for different audiences and practices. Because of the IPPS members’ expertise on value-based care, it worked closely with the AMA on both playbooks.
More recently, the section formed an Ad Hoc Committee on Augmented Intelligence and invited a group of chief medical information officers from various health systems to review the AMA’s Board report on augmented intelligence (AI)—often called artificial intelligence—and ambient technologies in medicine. The AMA-IPPS’s committee recommended that the report be referred back for revisions which is subsequently the action recommended by the Board and adopted by the House of Delegates
“We really believe that the IPPS is very well situated to be able to bridge those gaps that existed in the past and promote that dialogue that we believe is very important for us to advance health care, bring the cost down, maintain quality and [boost] outcomes up," Dr. Munkarah said.
Improving the future of medicine
"All of us agree that health care, at the present time in the United States, is not sustainable with the cost that it's driving," Dr. Munkarah said. "Not pointing fingers to who carries the blame for that, but we collectively need to be part of the solution to bend that curve down, to start to decrease the pace at which the cost of health care is increasing."
This aligns with the four major priorities of the AMA-IPPS, which are:
- Promoting sustainable payment models that enhance health care delivery.
- Ensuring quality health outcomes for patients and communities.
- Securing the future of the physician workforce.
- Leveraging AI in the future of health care.
The COVID-19 pandemic demonstrated how at-home care can, in some instances, improve quality health outcomes for certain patients with specific conditions. Such at-home care helps patients feel more comfortable and can cut the overall cost of care.
Additionally, the focus of section members on the physician workforce is understandable. Nearly two-thirds of doctors experienced burnout during the winter of 2021–2022. Meanwhile, one in five physicians surveyed during the pandemic said they planned to leave the field within two years. And nearly half of all practicing physicians are over 55 or nearing retirement.
Those statistics do not bode well for the future of medicine.
“We want to elevate the joy of medicine," Dr. Munkarah said. “We want to make sure that physician satisfaction … continues to be where it used to be. It is not only a matter of financial compensation. It is not a matter of working hard or not working hard. It's a matter of people feeling that they are doing what they are enjoying, which is taking care of patients."
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