AMA's Steven Stack: Physicians are 'excited about change'

BOSTON—New payment delivery models are “this generation’s opportunity,” said American Medical Association President-Elect Steven Stack, MD, speaking at Medical Informatics World 2015.

The Affordable Care Act has changed things, he said. “I would assert that it has changed some things very much for the better,” he said, referring to the 10 million who now have health insurance. Considering that occurred in the face of five years of “unrelenting obstruction, that is astounding.” There will be challenges with all those new people trying to access care but “getting these people into the system of care is profoundly important.”

Like AMA President Robert Wah, MD, who spoke about the organization’s top three priorities during a symposium held during the recent HIMSS 2015 conference, Stack also addressed these goals.

AMA wants to improve the practice environment because “we believe that a happy workforce leads to a happier customer.” A survey conducted with the RAND Corporation in 2013 found that physicians are most fulfilled when they feel that their work helped their patients and they felt they were supported in doing that work. “Most physicians feel very besieged and unsupported,” he said. “’Do this. Do that.’ If they don’t do it, they’re castigated for not being team players. There is a cacophony of conflicting priorities.”

AMA also has learned that physicians “nearly universally hate their EHR vendor.” They don’t want to go back to pen and paper but Stack said the Meaningful Use program overreached. Essentially, the sector “tried to redesign the entire healthcare experience through one software program. Now our records are perfectly legible but utterly incomprehensible.”

Health IT is not just EHRs, he noted. There’s also telehealth, digital health and more. “If we can get telehealth right, get it to scale, we can get things people need where they need it.” A lot of payers don’t yet cover telehealth but providers are being told to use it so the industry must find ways to pay for the resource.

AMA also is highly focused on chronic conditions. With 100 million Americans with diabetes or pre-diabetes and 70 million with high blood pressure, the two conditions are contributing to more than half a trillion dollars in healthcare costs. “If we can bend the curve, we could have a profound impact both on the cost of care and the burden of diseases and profoundly improve population health. One approach is the AMA’s collaboration with the YMCA on a lifestyle modification program that has been proven to reduce by 71 percent the likelihood of an individual going from pre-diabetes to diabetes.

The third priority is changing undergraduate medical education. Future physicians are being trained with the same structure that was created in 1912, Stack said. AMA is funding 11 medical schools with $1 million each over five years and created a learning consortium. He cited Indiana University which has a fully functional EHR set up for students to practice on. Most medical students aren’t allowed to touch an EMR, he said.

Stack finished his talk by asking for support. “There are physicians who are excited and thrilled about the change and want to embrace it. Don’t suffer our bad behavior. Please help support us.”