HONOLULU — In his address at the American Medical Association (AMA) Interim Meeting, AMA President David O. Barbe, M.D., on Saturday recapped an aggressive year of advocacy and accomplishment, highlighting significant victories that protected patients and physicians, with the primary goal of improving the health of the nation.

Dr. Barbe highlighted the dedicated drumbeat by the AMA throughout the health reform debate — a push to protect insurance coverage gains on behalf of millions of Americans: “From the beginning, we have fought for nine key principles — including affordability, accessibility, protecting safety net programs and patient protections, and one overarching goal: maintaining and expanding health care coverage for Americans. Throughout this debate, the AMA has been a voice of reason, asking Congress to put Patients Before Politics, and urging Congress to work on bipartisan, sustainable solutions.”

He also highlighted the AMA’s successful work to prevent the Anthem-Cigna and Aetna-Humana insurance mega-mergers, and he provided an update on the AMA's robust efforts to rein in chronic disease, type 2 diabetes and cardiovascular disease, to fight the opioid epidemic, and to lead the way in building the medical school of the future. 

Dr. Barbe touted significant victories in the regulatory realm, including helping physicians avoid penalties under the new Medicare payment program if they report one quality measure on one patient for one year; and significant efforts to improve physician satisfaction.

“We are fighting to prevent IT vendors from blocking information or making it expensive for physicians to share data, and we are making progress,” said Dr. Barbe. “We are fighting physician burnout and the time crunch by working to improve EHRs, mobile devices, and interoperability, and again, those efforts are showing signs of success. Our work to improve physician satisfaction by reducing these headaches and making the practice environment more satisfying is at the heart of the AMA’s shared strategic vision, as we: provide practice and payment resources; foster lifelong professional development, and improve the health of the nation.”

Additional information about AMA’s efforts can be found online:

• Helping physicians transition to Medicare’s new Quality Payment Program
• Working to address the nation's opioid epidemic
• Helping physicians alleviate burnout and restore joy in medicine
• Helping medical students prepare for careers in medicine
• Creating the medical school of the future

To learn more about these and other efforts, visit www.ama-assn.org

The complete transcript of Dr. Barbe’s speech, as prepared for delivery, is below. To see video, click here.

The Team That Wins

David O. Barbe, MD, MHA

President

American Medical Association

Madame Speaker, officers, delegates, physician colleagues, honored guests: I appreciate the opportunity to address you again today as your president.

Before I begin, I, too, would like to thank all of our active duty military members, veterans, and their spouses and other family members who are with us today.  Thank you for your service! 

At our Annual Meeting in June, you may recall, I talked about physician leadership.  I talked about how we are all leaders in a variety of contexts:  in our practices, in our communities, and as members of organized medicine.  Our patients, our colleagues and our communities look to us for leadership.

And I challenged all of us to ask ourselves, continually:  What kind of individual leaders will we be? 

Now, I’d like to take that concept a bit further and talk about what it takes to put together  . . . the team that wins. 

What is the formula for a winning team?

• A formula that keeps soldiers committed to each other and to their mission, even under enemy fire;
• A formula that propels companies to the top of their field and keeps them there:  think Apple, Nike, Amazon. 
• A formula that sustains winning sports teams. 

Winning teams recognize that the greatest success comes not from the effort of one or more individuals but from a team effort.  One of the greatest individual talents in baseball, George Herman “Babe” Ruth put it this way, “The way a team plays as a whole determines its success.  You may have the greatest bunch of individual stars in the world, but if they don’t play together, the club won’t be worth a dime.”

Every member of the House of Delegates is a physician leader and each committed to our “group mission” of promoting the art and science of medicine and the betterment of public health.  However, our success will be determined by how well we play – or work together, as a team, to achieve our common goals. 

I submit to you -- it is that shared purpose, that common vision, and our willingness to work together to fight aggressively for it, that moves medicine forward. 

So, the team that wins shares a common vision, and works aggressively to achieve it.

The AMA has worked relentlessly to WIN, not only for our members, but for all physicians and for patients, achieving a direct, positive impact as we move medicine forward. 

When physicians ask, ‘What has AMA done for me lately?” which they often do, I tell them, “plenty.”  It’s almost hard to know where to start. 

1. The AMA fought back against insurance mergers that would have decreased competition, weakened our negotiating power, and the Anthem-Cigna merger alone, would have cost physicians an estimated $500 million dollars in reduced payments . . . every year.  And we won.

2. Some of our most significant wins have come through our advocacy on behalf of physicians as we transition to a new Medicare payment system, the MACRA-Quality Payment Program.

We fought for a simple way for physicians to avoid a four percent payment cut in 2019  . . . and won.  Physicians can avoid penalties by simply reporting one quality measure for one patient this year.  If you have not already taken steps to avoid a penalty, be sure you take advantage of this option before the end of 2017. 

We fought for—and won—retroactive policy changes to align Medicare’s old reporting programs with the new MIPS program, helping doctors avoid millions of dollars in penalties under prior law.

In the 2018 MACRA rule released just last week:   we fought for greater flexibility for small physician practices . . .and we won . . . with special scoring rules, hardship exemptions, bonus points and other provisions to level the playing field with larger practices. 

And, we successfully fought to postpone a mandate for physicians to upgrade their EHRs. 

3. We are working to make sure every physician—in every practice setting and every specialty—is prepared to make the successful transition to the MACRA-QPP, and we’ve posted multiple resources on our website including:  tools, tutorials, podcasts and education modules.

4. The AMA continues to fight against burdens imposed by government and private insurers, and we are winning:

• We fought to allow physicians to refuse virtual credit card payments from insurers, because they carry fees that reduce our reimbursements . . . and we won. 
• We are fighting to reform the prior authorization process, and starting to see results … some insurers are beginning to reduce or eliminate their prior authorization requirements. 
• We are fighting to prevent IT vendors from blocking information or making it expensive for physicians to share data… and we are making progress
• We are fighting physician burnout and the time crunch by working to improve EHRs, mobile devices, and interoperability . . . and again, those efforts are showing signs of success.                                 
• Our work to improve physician satisfaction by reducing these headaches and making the practice environment more satisfying is at the heart of the AMA’s shared strategic vision, as we: provide practice and payment resources; foster lifelong professional development, and improve the health of the nation. 

Colleagues, these are major wins for our profession!

This is the value of the AMA.

5. In addition, we are fighting high drug prices through our Truth in Rx campaign.  More than 150,000 people have signed our online petition calling for increased drug pricing transparency.  We are encouraged to see Members of Congress now also calling for transparency.  

6. We continue to fight the great public health crisis of our time:  opioid misuse and addiction.  We have not won this battle yet, but we are making progress.  Opioid prescribing is decreasing in every state, and physicians are becoming better educated and better prepared to assist their patients with pain management and addiction. 

The opioid crisis is a public health emergency and everyone—from state and federal government officials… to insurers… to physicians and others— everyone has a role to play in reversing it.

Physicians must continue to lead in their own practices and advocate for more resources, more treatment options and coverage for those alternatives, better access to multi-modal pain care, and to combat the stigma that often prevents patients from seeking treatment. 

As you can see, we are not only advocating aggressively for physicians, we are advocating aggressively for patients. 

Nowhere is this more evident that in the renewed debate over health system reform. 

From the beginning, we have fought for nine key principles – including affordability, accessibility, protecting safety net programs and patient protections -- with one overarching goal:  maintaining and expanding health care coverage for Americans.

Throughout this debate, the AMA has been a voice of reason asking Congress to put Patients Before Politics, and urging Congress to work on bipartisan, sustainable solutions. 

We have worked with other well-respected advocacy organizations representing patients, hospitals, and the AARP, to magnify our collective voice to maintain coverage, patient protections and safety net programs.

In fact, the AMA has been the leading voice among non-partisan organizations in this debate.   Listen to this - An analysis showed that we achieved a 48 percent “share of voice” in the media for leading the national conversation.  That is more than AARP, the American Hospital Association and the insurance industry lobby (AHIP) combined.  

So far, leadership from the AMA and like-minded groups has kept Congress away from the edge of the cliff.  We have kept them from passing proposals that would eliminate coverage for millions of Americans.

And in addition: the Medicaid safety net and patient protections have also been preserved.  Sometimes, for winning teams, it’s all about the defense. 

And, while it’s impossible to predict where the debate will go from here, our steadfast commitment to putting patients before politics and our unwillingness to be drawn into the partisan quagmire will continue to reassure the public that the AMA -- as the House of Medicine-- is a voice of reason in Washington.

The team that wins also creates partnerships that make us stronger

Along with our advocacy partnerships, the AMA is working with outside organizations to strengthen and increase the momentum behind our top initiatives.  Those partnerships are exponentially increasing the reach of the AMA and our ability to solve health care challenges.

Similarly, we know the AMA alone, cannot solve the burden of chronic disease that affects half of American adults and consumes more than 75 percent of the $3 trillion dollars per year in health care spending. 

But, working with partners like the Centers for Disease Control and Prevention, the American Diabetes Association, and the American Heart Association, we can have a meaningful impact.

• Nearly half a million people have completed our online prediabetes test at DoIHavePrediabetes.org;
• We are also pleased to report more insurers are moving to cover the proven Diabetes Prevention Program;
• Medicare has announced it will begin covering the Diabetes Prevention Program for seniors beginning next spring; and
• Just this week, the AMA announced an expansion of our statewide prevention efforts -- to eight more states – in an effort to reach more of the 84 million American adults with prediabetes –  most of whom don’t even know they have it. 

AMA’s prediabetes campaign has been so successful that the Improving Health Outcomes team is again working with the Ad Council and the American Heart Association on another public awareness campaign, this time focusing on hypertension. 

This new campaign targets adults who have been diagnosed with high blood pressure but are not adequately controlled.

In fact, I’ll be stopping in Los Angeles on the way back from this meeting to do a series of media interviews about this campaign . . .

If, working in partnership with patients and outside organizations, we can slow the progress of these chronic diseases or prevent them altogether, that will be a significant victory for public health. It will mean a much brighter future for our patients.

Dr. Madara will discuss our efforts to create an Innovation Ecosystem for the profession.

This includes partnerships with organizations, venture capitalists and tech developers that are bringing the physician perspective to the development of new health technologies.  And, I can tell you from my recent experiences speaking at the Samsung developers conference and at the Connected Health conference, these industries are very eager to partner with physicians to make these products better.

As you will hear, exciting projects are underway that will transform patient care and the physician workflow --- projects that would not be possible without our outside partners.

Which brings me to my next point.

The team that wins prepares for the future.

Here at the AMA, we are not just concerned about our patients and our professional lives.  We are working hard to be sure the physicians of the future are prepared to care for the patients of the future. 

Our Accelerating Change in Medical Education (ACE) Initiative has made amazing progress just in the four years since its creation. 

From recognizing that the curriculum needed to be modernized . . . to the implementation of promising innovations in our thirty-two ACE Consortium schools . . . to the spread of these innovations to dozens of other schools . . . we are succeeding in our original goal of Changing Medical Education. 

Among the most promising developments:  schools are not just focusing on helping students become excellent clinicians . . . they are helping them understand the health system and training them to become physician leaders and innovators. 

In fact, an increasing number of medical schools across the country have now incorporated the AMA’s health systems science textbook into curricula.

Future physicians will be called on to lead the way in solving countless health care challenges.  Thanks to the ACE initiative, they will have the skills they need to do that. 

Teams that win also prepare for the future . . . by understanding they need to mentor and encourage younger colleagues.  

In sports, we might call this “developing the farm team.” Or simply, “recruitment.”

In recent years, the AMA has made a concerted effort to recruit medical students to membership. 

This has been a win-win – not just because students are joining, but because of the enthusiasm and commitment they are bringing with them.   They are helping to shape a new, vibrant, forward-looking AMA . . . 

… certainly no longer “your grandfather’s AMA.” 

Maybe not even your father’s—or your mother’s—AMA.

Medical students are asserting their perspectives and it’s having a strong impact on policy.

At our Annual Meeting in June, several resolutions passed the House that originated in the Medical Student Section. 

Among the concerns they have made sure we address: 

• Protecting immigrants and DACA-status individuals;
• Simplifying and improving the USMLE exam; and
• Addressing the serious problem of burnout, depression and suicide among students and residents. 

These medical students who are so enthusiastic about policy will one day carry the torch for this organization, and with our continued mentoring, I am confident the AMA will be in good hands.

And residents, we know you also feel pressure and stress like never before as you start your careers in medicine. I encourage you to stay with us as you make the transition into practice and stay active.  We need you and, in turn, have much to offer you!

So, we’ve talked about the importance of 1) preparing for the future, 2) partnerships to make the team stronger; and 3) commitment to shared goals and working aggressively to achieve those goals. There is, however, one more ingredient for a winning team:  enthusiastic fans. 

In the past few minutes I’ve described just a few of the AMA’s recent wins on behalf of physicians and patients. 

Together we are moving medicine forward.

In the past few months, I’ve had the opportunity to interact with our colleagues across the country to update them on all the AMA is doing.  In every instance the response has been extremely positive.  Members are encouraged, and many non-members tell me they are going to join based on what the AMA is doing for them and for their patients. 

We need to get our message out so more will know and will join us.

I opened with a quote by Babe Ruth on the importance of working together as a team.  He made another observation that I think is equally important: “It’s hard to beat a person who never gives up.”  Your AMA leadership will never give up in our efforts to advance our policies, achieve our common goals, and get our message out.

However, as AMA leaders, we can only reach so many physicians . . .  

That’s why we need YOUR HELP to get the message out.  Fans attract new fans, so there is a huge multiplier effect when each of us reaches out to physicians in our own circle. 

Just outside this ballroom, at the AMA membership booth you will find this brochure, which includes 13 examples of what the AMA has to offer physicians.

These are the kinds of proof points I challenge each of you to share with your colleagues.  Help them understand the value of today’s AMA.

We know that Membership Moves Medicine. 

Let’s help our colleagues become part of our winning team . . . part of our AMA. 

Thank you.