The efforts mentioned by Dr. Lazarus are among the matters "high on the list for AMA advocacy," but are just a small part of the AMA’s activities.
"We’re also looking at the big picture in terms of the health care system in this country to try to lead a major effort on the big issues," he said.
Among the concerns are the "tremendously overburdened system," with 50 million individuals uninsured and $2.7 trillion in annual spending (18% of gross domestic product) with outcomes that are poorer than those of other developed countries – and with an estimated increase of spending up to $4.6 trillion (20% of GDP) by 2020. The fragmented delivery system, with a lack of coordination of care and an epidemic of chronic conditions that account for 75% of the spending, also are among the concerns being addressed by the AMA.
Facing these tremendously complicated and difficult situations, the AMA decided to "take our years of training on addressing major issues, and put them to work on what amounts to an AMA policy triathlon," Dr. Lazarus said, referring to the three-pronged plan of enhancing physician satisfaction, improving health outcomes, and accelerating needed changes in medical education.
"We’ve committed to finishing this race," he said, noting that it will be a long one.
Efforts to improve care delivery models include collaboration with the RAND Corp. to conduct field research at 30 diverse practice settings across the country to identify factors associated with success and satisfaction.
Results are forthcoming, but initial findings suggest that what physicians care most about is the ability to deliver high-quality care.
The plan is to create tools to help physicians choose the best model for meeting their particular needs, and to advocate both federally and locally to promote adoption of models that improve physician and patient satisfaction, he said.
The AMA will continue to work to remove regulatory barriers that get in the way of providing quality health care, level the playing field with health insurers, help facilitate relationships with hospital and other payers to ensure a physician leadership role in emerging care models, and explore solutions to improve electronic health record platforms, he added.
As for improving health outcomes, efforts include several initiatives and partnerships designed to reduce disease burden and the cost burden associated with some of the most pervasive and troubling health conditions, such as diabetes. As for medical education, the AMA has issued $1 million in grants to 11 medical schools to advance new ways of teaching – such as through more flexible and individualized learning plans – to better prepare students for practicing in the changing health care environment.
"Just imagine the possibilities if we are even partially successful with this strategic plan – if we have increased quality of care, healthier patients, lower costs, and physicians working in a sustainable health environment that they have created themselves and that they think works for them, and if we have medical students trained for 21st-century medicine," he said. "It will take a lot of work and a lot of effort and a lot of focus, but at the end, we think there will be a healthier future for our health care system ... physicians, [and] ... our country as a whole."