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Dr. Madara: Pandemic demands nimble response and AMA is delivering

The COVID-19 pandemic has tested physicians and the health care system, and its full impact on society may not be known for some time. But is has also provided validation, even if painful, that the AMA’s strategic plan has put the organization on the right path, said James L. Madara, MD, the AMA’s executive vice president and CEO. 

In a virtual address to the AMA House of Delegates at the November 2020 AMA Special Meeting, Dr. Madara described how the AMA strives to continue steady progress each day through advocacy efforts in the halls of Congress, state regulatory bodies and through the courts.

“The work of the AMA is long-term and policy-driven,” he said. But then an unanticipated crisis arrives and, rather than steady progress, an immediate, nimble and flexible response is required, which the AMA has provided during the COVID-19 pandemic.

The AMA was prepared for this challenge because of a strategic approach that focuses on three big ideas aligned with the changing needs of patients and physicians:

  • Removing obstacles that interfere with patient care.
  • Driving the future of medicine by reimagining medical education.
  • Confronting chronic disease and other public health crises.

This focus—amplified and accelerated by advocacy, health equity and innovation—had the AMA well positioned to facilitate the explosion in telehealth tools that occurred early in the pandemic.

The AMA’s successful advocacy led the Centers for Medicare & Medicaid Services to remove restrictive regulatory barriers and ensured proper payment for telehealth services, Dr. Madara said. At the same time, the AMA—as part of its ongoing Digital Health Implementation Playbook series—launched an online Telehealth Implementation Playbook to walk physicians through a 12-step process for adopting real-time audio and visual visits between patients and physicians.

“More than 90% of physicians connected remotely with at least some patients in 2020, that’s an inflection point that promises to shape delivery far into the future,” Dr. Madara said.

He added that the AMA continues to analyze how best to integrate the technology into practice workflow while ensuring patient privacy and meeting the challenge of smoothly incorporating telehealth efficacy, efficiency and equity into practice operations.

“As with all digital health, we must also make sure that every community and demographic benefits,” Dr. Madara said.

The severity of COVID-19—particularly among Black, Latinx and Indigenous populations—often depends on a patient’s underlying conditions, such as hypertension.

“The reasons for this alarming imbalance are complex, but relate to and underscore the persistent inequities throughout both our health system and broader society,” Dr. Madara said. “Inequities that place historically marginalized groups on unequal footing, severely limiting their ability to access the care they need.”

He noted that the AMA Center for Health Equity was an early advocate for collecting comprehensive race and ethnicity data to help structure appropriate responses to the pandemic.

AMA responses included a reference guide for physicians and care teams to train patients to perform self-measured blood-pressure monitoring. More recently, the AMA partnered with the American Heart Association and Essence magazine on a national campaign advocating for improved heart health for Black women and their families.

Underneath these initiatives were advocacy efforts that secured $175 billion dollars in federal financial support to practices that, according to AMA research, have experienced an average 32% drop in revenue due to COVID-19.

In addition, there was the fast-track development of updates to the Current Procedural Terminology (CPT®) code set to assist the public health response to COVID-19, most recently for codes relating to vaccines.

Tools and content have also been created to assist practices in taking actionable steps to reduce stress and anxiety while promoting staff well-being.

“The urgency and the challenges of this pandemic tell us that AMA’s strategy is exactly on the right path,” Dr. Madara said. “It validates all that we are working to achieve. And it brings new meaning to our mission to promote the art and science of medicine and the betterment of public health.