American Medical Association's Long-range Strategic Plan

Lara C. Pullen, PhD

June 18, 2012

June 18, 2012 (Chicago, Illinois) — The policy-making body of the American Medical Association (AMA) convened Saturday for its annual meeting, which involved 504 physician delegates speaking on behalf of their peers from 177 medical societies and groups. The legislative process will consider policy recommendations from 250 reports and resolutions.

Each report and resolution is assigned to 1 of 8 reference committees, such as medical service, public health, and science and technology. In the initial days of the meeting, open hearings were held during which physicians offered testimony on the reports and resolutions. This year the House of Delegates will consider resolutions as varied as taxes on beverages with added sweeteners, bioengineered foods, and balancing the risks and benefits of screening mammography.

James L. Madara, MD, executive vice president and CEO of the AMA, opened the annual meeting by describing his vision for the AMA, which is "a long-term strategic plan aimed at changing the world for patients and physicians. It is a plan focused on improving health outcomes, accelerating change in medical education, and shaping payment and delivery models that ensure high-quality care and value while enhancing physician satisfaction and practice sustainability."

He went on to describe these 3 areas of focus, acknowledging that much of the work that the AMA currently does falls into these 3 areas. He described the strategic shift as a focus on outcomes as opposed to process — a transition from convening to partnering and doing.

He explained that the AMA intends to engage in and demonstrate leadership in the quality arena. The AMA-convened Physician Consortium for Performance Improvement has shown a decade of leadership in developing quality and performance measures. Future AMA efforts will focus on demonstrating improvements in clinical and patient-reported outcomes, ensuring health equity, and reducing unwarranted variation in care.

The gap between how physicians are currently being trained and the future needs of the healthcare system continues to widen. The AMA intends to work to strategically reshape and accelerate physician education in the United States. The plan is to focus on partnerships that create, implement, and evaluate new methods of medical student education; to focus attention on flexibility, individualized and social learning, and achievement of competencies and professionalism in physician education; and to promote exemplary methods of achieving patient safety, performance improvement, and patient-centered team care in medical training.

The AMA recognizes that satisfied physicians produce more satisfied patients. It therefore aims to improve physician satisfaction by identifying, promoting, and shaping delivery and payment models. These models will include improved patient outcome, diverse payment policies, and physician choice when opting into delivery and payment models.

Dr. Madara concluded his talk by emphasizing that "this strategic direction is informed and driven by the wide-ranging discussions and activities of this House." His presentation was well received by the delegates. The strategic plan, however, left some delegates confused the next day.

Delegates discussing resolutions in the public health reference committee on Sunday were unclear whether some of the AMA's longstanding public health efforts qualified under the new strategic plan. For example, when discussing the AMA's Annual Update on Activities and Progress in Tobacco Control, delegates noted that significant reorganization at the AMA has left the AMA's tobacco forum without staff to support its efforts.

In addition, although the actual vote won't occur until Monday or Tuesday, a preliminary recommendation has been made that the House reject a resolution to form a task force on medical disaster response and indigent care. Robyn F. Chatman, MD, from the Ohio delegation, noted that "this resolution is of critical importance." She described it as creating "a single repository for information about volunteering during times of disaster."

Mitchell Miller, MD, from Coastal Family Practice in Virginia Beach, who represented the Virginia delegation, noted that the recommendation to not adopt was made primarily because disaster response is no longer a strategic priority: "We were just concerned about the commitment of AMA funds."

Kevin Riley, MD, chair of the disaster medicine caucus, explained that "there has been a drastic cut in staffing at the AMA."

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