As 2017 unfolds—a year when MACRA begins, lawmakers take steps to dismantle the health reform efforts of the past eight years, and political uncertainty is the rule—it is imperative that the ACR leverage its advocacy agenda by maintaining its seat at the American Medical Association’s (AMA’s) House of Delegates (HOD), says Gary Bryant, MD, FACP and chair of the ACR’s delegation to the HOD.
AMA: The Largest Voice
“The AMA is the largest physician organization and convener of all physician voices. It leverages the voices of the rheumatology community, on behalf of the specialty and our patients,” says Dr. Bryant. “We wouldn’t be able to do that ourselves given our size. It gives us a seat at the table for making policy.”
The HOD is the policy-making arm of the AMA, driven not by politics and ideology, but by the policy priorities represented by its members. The HOD comprises representatives of all 50 states, several U.S. territories and more than 170 specialty societies. The ACR has two delegates to the AMA, including Dr. Bryant.
A Megaphone for the ACR
As the country’s largest and most visible physician society, the AMA provides the ACR, a relatively small subspecialty, a megaphone to amplify our voice at federal and state levels. The HOD meets twice a year, and each year, the ACR’s delegates bring at least one or two resolutions to the table. Resolutions have the potential to become official policy of the AMA or directives that determine where the AMA focuses its efforts.
In recent years, the ACR has, through the AMA HOD (and in concert with RheumPAC and the ACR’s Government Affairs Committee), helped achieve several high-priority goals, such as:
- Exempting small rheumatology practices from some parts of MACRA;
- Protecting individualized compounding in physicians’ offices from the FDA’s definition of a compounding facility; and
- Blocking the Medicare Part B Demonstration Project.
Not Your Grandfather’s AMA
In order to keep our seat at the HOD table and participate in other vital activities of the AMA—including the Relative Update Committee (RUC) and the CPT Advisory Committee—at least 1,000 ACR members must also be members of the AMA.
This year, the AMA will conduct its five-year review of the ACR’s membership. Thus, ACR members should renew their membership in or join the AMA, Dr. Bryant says. He recognizes ACR members may have mixed feelings about the AMA or have had negative experiences with the organization in the past; however, “this is not your grandfather’s AMA,” he says. “In my 15 years [as part of the ACR AMA delegation], I have seen a significant evolution of those elected to AMA offices and who is sitting on the dais at the AMA HOD meetings.”
For example, current AMA Board of Trustees Chair Patrice Harris is an African-American female psychiatrist from Atlanta, Dr. Bryant says, adding that one of the two candidates vying to be the next president elect of the AMA is a woman, like two of the five who came before.
In conversations Dr. Bryant has had with many AMA leaders over the past decade or more, he has observed that although no large membership organization can please everyone at all times, the AMA values its members and believes “everyone’s voice should be heard and respected.”
A Controversial Move
Recently, Dr. Harris announced the AMA’s support for the nomination by President Trump of Rep. Tom Price (R-Ga.) to lead the U.S. Department of Health and Human Services. Dr. Bryant acknowledges that some in the rheumatology community may consider this controversial, but in his experience working with the AMA, he sees it as evidence that the AMA hopes to have “a prominent seat at the table” and “perhaps more clout” as Congress debates repealing and replacing the Affordable Care Act.
“I also assume they feel that he is at least inclined to listen to the AMA point of view,” says Dr. Bryant. Indeed, Rep. Price, an orthopedic surgeon, served as an AMA delegate for many years. “This would extend the AMA’s influence with recent HHS secretaries.”
In her announcement published Dec. 1, 2016, Dr. Harris wrote, “The AMA will actively engage Dr. Price, other leaders in the incoming Trump administration and Congress in discussions on the health system’s future direction. We remain devoted to improving health insurance coverage so that patients receive timely, high-quality care, preventive services and other necessary medical treatments. And for us, a core principle with regard to any proposed health system reform is that it should not cause anyone who has health insurance coverage now to lose it.”
Other core principles of the AMA include:
- Improving health outcomes;
- Accelerating change in medical education; and
- Enhancing physician satisfaction and practice sustainability by shaping delivery and payment models.
AMA Actions
In weighing whether to help the ACR achieve its goals on behalf of the rheumatology community through membership in the AMA, Dr. Bryant says, “Obviously the proof is in the actions that the AMA is taking now and in the future. Every ACR member should make their individual choice whether to support the AMA or not. I hope most will keep an open mind. By having as many members as possible, we can we increase our voice.”
How to Join/Renew Membership
To join or renew membership in the AMA, ACR members can go online or call the AMA at 800-262-3211. The ACR needs members to specify the ACR as their specialty organization by “voting” for the organization. This confirms to the AMA that members want to be counted toward rheumatology’s seat at the table.
Choose rheumatology as your specialty society representation in the HOD now. Vote for the ACR.
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Kelly April Tyrrell writes about health, science and health policy. She lives in Madison, Wis.
