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AMA adopts principles for physician employment

BY STEVE LEVINE, TMA VICE PRESIDENT OF COMMUNICATIONS The 2012 interim meeting of the American Medical Association House of Delegates convened just four days after President Barack Obama won reelection. Perhaps it was coincidence, but for the first time in four years, the house meeting lacked fiery public debate over the president’s health care reform plan. Without the sometimes-bitter partisan and geographic divides of their previous gatherings, delegates calmly passed some important advances in AMA policy. About 75 Texas physicians and medical students representing the Texas Medical Association and various sections and national specialty societies participated in the Nov. 10–13 meeting in Honolulu. The Texas delegation’s top parliamentary priority was advancing a plan to move the interim meeting to a wintertime location in or near the U.S. Capitol.

“A new world” Interventional radiologist Jason Sharp, MD, is an AMA veteran but a medical prac- tice rookie. He spent four years as the resident physician member of the Texas dele- gation and served on the AMA Council on Constitution and Bylaws. After a one-year fellowship at Johns Hopkins in Baltimore, Dr. Sharp returned to Texas six months ago to practice. “When you’re looking for a new job, it’s a new world that you haven’t been taught the rules for,” said Dr. Sharp, who accepted a position with Texas Radiology Associ- ates in Dallas. He said he expects the new AMA Principles for Physician Employment approved at the Honolulu meeting to be very helpful for other young doctors who are coming out of residency or fellowship with no training on the business side of medicine.

“It will help us know what the game is, what the rules are … how do I compare and contrast the offers I get?” AMA Board of Trustees member Joe Annis, MD, an Austin anesthesiologist, said the principles cover such aspects of the employee-employer relationship as conflicts of interest, advocacy, contract- ing, hospital-medical staff relations, peer review and performance evaluations, and payment agreement.

“The Principles for Physician Employ- Joe Annis, MD

Lyle Thorstenson, MD

ment provide a broad framework to help guide physicians and their employers as

they collaborate to provide safe, high- quality, and cost-effective patient care.” Dr. Annis said. “The guidelines reinforce that patients’ welfare must take priority in any situation where the interests of physicians and employers conflict.” Read the principles on the TMA web- site at ment.aspx.

Medicare, Medicaid changes pushed

Delegates completed a multiyear project by adopting a framework to transition Medicare to a defined contribution pro- gram that would allow beneficiaries to either buy coverage of their choice from a wide variety of plans or stay in the tra- ditional Medicare system.

Defined contribution amounts would be set at the value of the government’s contribution under traditional Medicare. Lower income and sicker beneficiaries would receive larger defined contribu- tions to ensure affordability of cover- age for all beneficiaries. Contribution amounts would be adjusted annually based on changes in health care costs and the cost of obtaining health insur- ance so the value of a Medicare defined contribution remains stable over time. Tyler anesthesiologist Asa Lockhart, MD, said change is needed because the current system is not working and not sustainable. “We have coverage without access, which I view to be the most cruel situa- tion of all,” Dr. Lockhart said. “Defined contribution would allow for a multi- tude of options and expand choice, but it would do it under the current federal Medicare funding levels.”

January 2013 TEXAS MEDICINE 11

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