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Hospitalists Stand Up at AMA and in D.C.

A week before the American Medical (AMA) Association House of Delegates met in Chicago this past June, the SHM leadership became aware of the AMA Board of Trustee’s Report 19 to be debated at the AMA meeting. The report, “Corporate Practice of Medicine,” and its recommendations included the following provision:

The Board of Trustees recommends that the following be adopted: That our AMA develop model legislation prohibiting lay corporations, including hospitals, from directly employing physicians, and make this model available to state and national medical societies.

Because more than 50% of hospitalists are currently either employed by hospitals, health systems, or corporations this policy—had it been enacted—would have adversely affected hospitalists.

Mobilize the Troops

Rewind to last June: As the clock ticked, SHM leadership sprang into action. SHM developed a letter (see “Letter from SHM to the AMA,” at right on p. 7) to the AMA president, chairman of the board of trustees, and the executive vice president, expressing strong opposition to this policy. SHM senior leaders also made direct, personal appeals to individuals on the AMA board.

In addition SHM sought the counsel and advice of the American College of Physicians (ACP), especially the ACP’s Washington, D.C., senior staff, including Bob Doherty, senior vice president of governmental affairs and public policy, and Jack Ginsburg, director of health policy analysis and research. SHM also consulted the leadership of the ACP delegation to the AMA. In this effort ACP allied with SHM to defeat this resolution.

SHM’s Tosha Wetterneck, an AMA delegate from Wisconsin and the Young Physicians Section, was prepared to give testimony against this report and recommendations at the AMA Reference Committee and, if necessary, on the floor of the AMA House of Delegates.

All this happened in a matter of days as delegates headed to Chicago for the AMA meeting.

The very turbulence and reinvention of the healthcare system in this country that’s driving the growth of hospital medicine may fuel a response from traditional professionals, such as those in the AMA, concerned about change and evolution.

The Decision

Through the efforts of SHM, ACP, and others, the AMA board wisely decided to withdraw the report and recommendations from the business of the House of Delegates and contacted SHM to thank us for our comments and participation.

Hospital medicine is a relatively new specialty, and SHM is a young organization compared with the AMA and the many specialty societies represented at AMA meetings. In addition, hospitalists tend to be generally younger physicians, who may feel that participation in national medical organizations such as ACP and AMA are not relevant to their professional lives.

In reality, though, the very turbulence and reinvention of the healthcare system in this country drives the growth of hospital medicine and may fuel a response from traditional professionals concerned about change and evolution. Because of the unique perspective of hospitalists and hospital medicine, SHM needs to be at the table. And we need to have thoughtful suggestions as we help to shape the future as well as send articulate responsible hospitalists to participate in these deliberations.

Public Policy Committee Leads the Way

The SHM Public Policy Committee (under the chairmanship of Eric Siegal and Laura Allendorf on SHM’s Washington D.C.-based staff) is taking the initial steps to be a player in healthcare advocacy. SHM has commissioned Health Policy Alternatives, a major Washington D.C. advisor on health policy, legislation, regulations, and policy making process, to develop a White Paper to better define the unique aspects of hospital medicine in a form that is understandable and meaningful to legislators and regulators, including the Centers for Medicare and Medicaid Services (CMS).

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