Time to flip construct and put patients, doctors first: AMA CEO

Andis Robeznieks
Senior Staff Writer
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The AMA has refined its strategic approach, focusing on three big ideas that are aligned with the changing needs of patients and physicians, said AMA Executive Vice President and CEO James L. Madara, MD. He outlined how the Association is moving forward on these initiatives that are “flipping the current construct” so that physician perspective and experience drives medical innovation.

Dr. Madara spoke during the opening session of the 2018 AMA Annual Meeting in Chicago, and he reported on progress made to reimagine medical education, improve the nation’s health and increase physicians’ professional satisfaction and practice sustainability.

The AMA Accelerating Change in Medical Education Consortium experienced a major milestone this spring as students from Consortium member schools celebrated their graduation.

“These tech-savvy physicians entered their residencies with new skills and competencies proven by measurement, knowledge of what electronic health records could and should deliver, a deep understanding of the social determinants of health, of population health, and teamwork within the health care environment,” Dr. Madara told delegates. “We’ve produced new physicians who are adaptive learners, capable team-leaders, with a greater awareness of policy. This is a major shift in medical education.”

He added that the AMA will soon launch a digital education hub and recently debuted a new open-access clinical research journal, JAMA Network Open.

Major strides also have been taken to improve the nation’s health, as the AMA has teamed up with high-profile partners on efforts that have the potential to improve the lives of millions of patients.

Partnerships with the American Diabetes Association and the Centers for Disease Control and Prevention have contributed to  more than 1 million people self-screening for prediabetes. And a goal has been set to have 20 million Americans measure their own blood pressure by 2020 through a partnership between the AMA and the American Heart Association.

“Partnerships are essential in advancing the work” of the AMA, Dr. Madara said. That is true, “whether we’re creating new strategies around medical education and training, confronting the rise of chronic disease, or helping develop the technologies that reduce the dysfunction that so frustrates us.”

IT that avoids the old approach

The AMA’s broad effort to extract greater meaning from health data through the Integrated Health Model Initiative launched last fall, has, like similarly pioneering work in technology, been built through partnerships with some of the industry leaders in information and technology—including IBM Watson, Accenture, Google and Samsung.

“Key in these relationships is that we define problems that need solutions from the vantage point of the patient-physician interface—not from the vantage of administrative level,” Dr. Madara said. “Executives are starting to understand the importance of engaging and incorporating the physician perspective into new technologies, new strategies and new systems that will define the future of medicine.”

He highlighted the work of a company of which the AMA was a founding investor, Health2047 Inc., named for the year the AMA will celebrate its bicentennial. The Silicon Valley company’s approach “avoids the problems created by solutions which start at the administrative level and “then thrown over the transom to the site where medicine actually occurs,” Dr. Madara said.

“Physicians need to be educated for this century, not the last century,” Dr. Madara concluded. “Electronic clinical data needs to be much better and more meaningfully organized. Such organized clinical data needs to flow through an interconnected utility that decreases, not increases cost and, in the face of the still-rising burden of chronic disease, we need both prevention and control approaches that are evidence-based and scalable.”

Read more news coverage from the 2018 AMA Annual Meeting.

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Great to hear that our doctors are becoming more data-driven and technologically savvy. But what happens when so much of the data is produced by the very firms that stand to benefit financially from its use, particularly corporate giants in the food, pharmaceutical and telecommunications industries? For starters, why doesn’t the A.M.A. acknowledge the roles of these industries in making the U.S. the most medicated, vaccinated, overfed and fattest country on earth, and one of the least fit. We consume most of the world’s barbiturates, anti-depressants and other drugs both legal and illegal. Kids are so engaged in electronics that they get little exercise and have forgotten how to relate and empathize with others. More than half of our high school graduates do not have sufficient mental capacity or physical fitness to enter the military. Children from countries with far less resources are healthier and more fit than most of ours. We do a terrible job treating mental illness, and we have difficulty acknowledging that many of the U.S. government’s food and environmental policies are making us sicker, witness the alarming amounts of … § Opioid/drug abuse § School shootings § Mental health breakdowns § Suicides § Chronic diseases (Alzheimer's, Parkinson's autism, diabetes, etc.) § Lower sperm counts and reproductive difficulties, § Sexual misconduct, § Bullying and school disciplinary incidents, § Addiction to social media, just to name a few. What is the medical profession saying about the quality of the food we ingest and our over-exposure to chemicals from pesticides and fertilizers, meats laced with herbicides, antibiotics and hormones, and genetically engineered foods that lack sufficient testing to ensure their long-term safety? Why is it that so few physicians have studied nutrition and food production even though this knowledge is essential for both diagnosing and treating their patients? How can the medical profession continue to stand by the number of vaccines it recommends for children, soldiers, foreign aid workers and immigrants when evidence is accumulating that their health is being endangered by so much exposure to vaccines and their aluminum and mercury-derived preservatives? How many physicians are aware that excessive amounts of electro-magnetic radiation (EMR) and information-carrying radio waves alter the chemical structure of certain brain proteins and prevent our cells from detoxifying? Inability to detoxify is especially serious for young children and those recovering from illness. Indeed, exposure to high EMR levels increases recovery times from disease and are strongly associated with sleep disorders, attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), autism, cancer, heart disease and even allergies. Electronic fields and waves are emitted in varying degrees by microwaves, cell phones, WiFi routers, cell phone towers, smart phones, smart meters, cordless phones, computers/laptops and IPADs. EMR hotspots include airports, shopping centers, schools, areas close to high tension wires, workplaces and apartment buildings with lots of WIFI connections and electronic security devices. The vast majority of studies claiming that collective dosages of EMR from these devices are safe have been funded or conducted by the electronics and telecommunications industries. Yet evidence from independent sources has been accumulating that a sizable segment of our population, particularly the youngest and sickest, suffer from excessive levels of EMR. It would seem overdue for public health authorities and the medical profession to recommend audits in our schools, hospitals and shopping centers to determine the EMR hotspots their patients should avoid. And then collect and analyze data to see if such an intervention helps patients recover. So, by all means, embrace technology and data science. But you have to ask the right research questions and ensure the independence of investigators from industries that stand to benefit financially from particular answers to research questions. As they say, “follow the money” and you will understand the world.
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Oct 08, 2018
Find out why the AMA is committed to health care reform that expands insurance coverage and provides more access to high-quality care.