Doc­tors should be cap­tain of the ship

Modern Healthcare - - Q & A -

Dr. Robert Wah is the new pres­i­dent of the Amer­i­can Med­i­cal As­so­ci­a­tion.

He serves as chief med­i­cal of­fi­cer for Com­puter Sciences Corp. and teaches at the Wal­ter Reed Na­tional Mil­i­tary Med­i­cal Cen­ter and the Na­tional In­sti­tutes of Health. He served as the first deputy na­tional co­or­di­na­tor in HHS’ Of­fice of the Na­tional Co­or­di­na­tor for Health In­for­ma­tion Tech­nol­ogy. Wah has ap­peared on Mod­ern Health­care’s list of the 50 Most In­flu­en­tial Physician Ex­ec­u­tives and Lead­ers five times. Mod­ern Health­care staff re­cently in­ter­viewed him. This is an edited tran­script.

Mod­ern Health­care: What hap­pened with this year’s effort to re­peal the Medi­care sus­tain­able growth-rate for­mula?

Dr. Robert Wah: We were very op­ti­mistic. We had both the Se­nate and the House work­ing on this, and we had bi­par­ti­san sup­port. At the last minute, Congress did a very un­usual voice vote to pass the 17th patch on this prob­lem. We’re hop­ing that at the end of the year we’ll be able to take that bi­cam­eral, bi­par­ti­san work and push it across the fin­ish line.

MH: What is your vi­sion for the use of health IT?

Wah: We see tech­nol­ogy as a tool that will help us take bet­ter care of our pa­tients, and this has to be physi­cian­led. We did a sur­vey last fall ask­ing prac­tices what are the frus­trat­ing things about the prac­tice to­day, and elec­tronic health records were high on that list. They wanted it to work bet­ter with the work­flow in their of­fice and help them, not hin­der them, in tak­ing care of their pa­tients. We’re go­ing to go to the EHR ven­dors and tell them about the prob­lems we found.

MH: You men­tioned that Dr. Leonard McCoy of “Star Trek” had a big in­flu­ence on you.

Wah: Dr. McCoy was a sim­ple coun­try doc­tor on a 23rd cen­tury star­ship. As we’re sur­rounded by all the tech­nol­ogy to­day, we need to not get dis­tracted by that tech­nol­ogy and re­mem­ber the core is the doc­tor­pa­tient re­la­tion­ship.

MH: Why has the AMA seen three straight years of in­creased mem­ber­ship af­ter a long pe­riod of de­clines?

Wah: With all the changes in health­care, physi­cians are real­iz­ing that we must come to­gether to stand up against all those forces that are com­ing against us.

MH: What is the AMA try­ing to ac­com­plish in med­i­cal ed­u­ca­tion?

Wah: We think it’s time to re­view the fact that med­i­cal school ad­vance­ment is based on time as op­posed to com­pe­tency. In grad­u­ate med­i­cal ed­u­ca­tion, when res­i­dents demon­strate com­pe­tency they move to the next level. So we’re just talk­ing about do­ing that same thing in med­i­cal school. That might free up room in the cur­ricu­lum to do things like train our med­i­cal stu­dents more about team-based care.

MH: Will con­tin­u­ing dis­agree­ments over Oba­macare within the AMA af­fect the as­so­ci­a­tion’s ef­fec­tive­ness as a lob­by­ing or­ga­ni­za­tion?

Wah: I think physi­cians within the AMA have a wide spec­trum of po­si­tions very sim­i­lar to the rest of society.

MH: Does the pri­mary elec­tion de­feat of House Ma­jor­ity Leader Eric Can­tor have any im­pli­ca­tions for health­care leg­is­la­tion?

Wah: Cer­tainly the pri­mary re­sults would say that there’s go­ing to be a change and we’ll see how that plays out in the gen­eral elec­tion.

MH: What is the AMA go­ing to do about states that have re­laxed the rules for physician su­per­vi­sion of nurse prac­ti­tion­ers?

Wah: We be­lieve in many cases a team-based sys­tem of care im­proves care for our pa­tients. Based on our years of ex­pe­ri­ence and ex­per­tise, I think it makes log­i­cal sense for physi­cians to be lead­ers of the team. The cap­tain of the ship model is one that many of our pa­tients ex­pect us to have.

MH: How would you de­scribe the mood of Amer­i­can doc­tors right now?

Wah: We’re in a time of change and un­cer­tainty, and cer­tainly some peo­ple re­spond to change and un­cer­tainty with un­ease and anx­i­ety. I be­lieve if we use the cur­rent en­vi­ron­ment of change to the ben­e­fit of our physi­cians and our pa­tients, we’ll make a lot of progress. But I do rec­og­nize there’s a high level of frus­tra­tion and anx­i­ety out there.

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