Fla. docs stay with AMA

State group had joined oth­ers to protest re­form

Modern Healthcare - - The Week In Healthcare - Andis Robeznieks

The schism be­tween physi­cians who op­posed the Pa­tient Pro­tec­tion and Af­ford­able Care Act and the Amer­i­can Med­i­cal As­so­ci­a­tion lead­er­ship, which sup­ported the law, does not ap­pear to have nar­rowed.

Af­ter lengthy de­bate, the physi­cian mem­bers of the Florida Med­i­cal As­so­ci­a­tion re­cently de­cided against a pro­posal to end re­la­tions with the AMA. The 20,000-mem­ber FMA is just the lat­est med­i­cal so­ci­ety to vent its anger.

Last Oc­to­ber, for ex­am­ple, the Mis­sis­sippi State Med­i­cal As­so­ci­a­tion held a spe­cial meet­ing and voted to “de-unify” with AMA, a move that ended a joint mem­ber­ship ar­range­ment be­tween the state and na­tional or­ga­ni­za­tions. Ac­cord­ing to Anna Mor­ris, the MSMA’s di­rec­tor of ex­ter­nal re­la­tions, about 80% of the group’s 4,200 mem­bers chose not to re­new their AMA mem­ber­ship when they re­newed with the state or­ga­ni­za­tion. Up un­til then, re­newal forms and pay­ments were pro­cessed to­gether.

“We still have a good work­ing re­la­tion­ship,” Mor­ris said. “It’s just that par­tic­u­lar ar­range­ment is no longer in ef­fect.”

The Florida and Mis­sis­sippi med­i­cal as­so­ci­a­tions are also part of the Coali­tion of State Med­i­cal and Na­tional Spe­cialty So­ci­eties, a coali­tion of mostly South­east­ern state and sur­gi­cal spe­cialty so­ci­eties that pro­motes freemar­ket al­ter­na­tives to the more gov­ern­ment­driven pro­vi­sions of the health­care re­form law (See com­men­tary, p. 22).

The closed-door de­bate in Florida oc­curred dur­ing the FMA’s an­nual meet­ing held Aug. 13-15 in Or­lando, and the del­e­gates were con­sid­er­ing a pro­posal for the FMA to cease its par­tic­i­pa­tion in the AMA’s an­nual meet­ings.

In­stead, St. Peters­burg neu­ro­sur­geon David McKalip, who spoke at a Tampa Bay Tea Party event in April, pro­posed send­ing a let­ter of no con­fi­dence to the AMA lead­er­ship in­stead. McKalip said that, as the de­bate went on, it be­came clear that there was a de­sire among mem­bers to change the AMA rather than sever the re­la­tion­ship with it.

“The AMA does not speak for medicine right now,” McKalip said. And the FMA “doesn’t have con­fi­dence in AMA lead­er­ship or con­fi­dence in their abil­ity to pro­tect the pro­fes­sion of medicine in Amer­ica.”

The FMA’s new pres­i­dent, Made­lyn But­ler, said in a news re­lease that it’s im­por­tant “that Florida’s physi­cians stay en­gaged as we de­velop fed­eral pol­icy and ad­vo­cacy po­si­tions on be­half of or­ga­nized medicine,” and so “the FMA will con­tinue to send a del­e­ga­tion to the AMA’s an­nual and in­terim meet­ings.”

One of the at­ten­dees of the FMA meet­ing was Tampa or­tho­pe­dic sur­geon Michael Wa­sy­lik, who also served as an al­ter­nate del­e­gate at the AMA House of Del­e­gates meet­ing in June. Ul­ti­mately, Wa­sy­lik said, FMA mem­bers did not want to lose their voice in the op­er­a­tion of what is still the nation’s largest physi­cian or­ga­ni­za­tion: the 228,000-mem­ber AMA. “The AMA is still the brand name and Congress does lis­ten to what the AMA says,” Wa­sy­lik said.

Also in at­ten­dance was AMA Pres­i­dent Ce­cil Wil­son, an in­ternist from Win­ter Park, Fla., and Wa­sy­lik said Wil­son “heard doc­tor af­ter doc­tor lam­baste the AMA lead­er­ship.”

In a state­ment re­leased by the AMA, Wil­son said his group is pleased that the Florida as­so­ci­a­tion re­mains part of the “fed­er­a­tion of medicine.”

“By work­ing to­gether as a united house of medicine, we will con­tinue to im­prove our health sys­tem for pa­tients and physi­cians, in­clud­ing fix­ing the bro­ken Medi­care physi­cian pay­ment sys­tem and en­act­ing med­i­cal li­a­bil­ity re­forms to keep physi­cians car­ing for pa­tients,” the state­ment said.

Jay Mill­son, ex­ec­u­tive vice pres­i­dent of the Du­val County Med­i­cal So­ci­ety, said the de­bate il­lus­trated the dis­con­tent Florida doc­tors had with the AMA lead­er­ship for sup­port­ing health­care re­form. Mill­son noted that the AMA put forth prin­ci­ples for health­care re­form and the fi­nal leg­is­la­tion con­tained most of those prin­ci­ples. It did not con­tain tort re­form or chang­ing the Medi­care re­im­burse­ment for­mula.

“It’s hard to get them all,” Mill­son said. “Some felt like we needed them all, but I didn’t think there was enough sup­port to break away.”

Wil­son: “We will con­tinue to im­prove our health sys­tem.”

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