New president-elect imparts AMA aspirations

Kentucky-based internal medicine and infectious disease specialist Ardis Dee Hoven, MD, has been elected president-elect of the American Medical Association (AMA). Her election was announced June 18 by the physician’s organization during its annual meeting in Chicago.

Hoven, who has been on AMA’s board of trustees since 2005, will assume the president’s office in June 2013. She is the medical director of the Bluegrass Care Clinic, an infectious disease and HIV/AIDS practice based in Lexington, Ky., that is affiliated with the University of Kentucky College of Medicine.

As the AMA and its members discuss the organization’s future goals during the annual conference, Hoven took some time to share the organization’s goals and her own as future AMA president with Stephanie Bouchard, managing editor of Healthcare Finance News, a sister publication of PhysBizTech.

Q: What goals are you setting for yourself as the new leader of the AMA?

A: One of my challenges all along my career in medicine and particularly at the AMA has been being out there and listening and paying attention. I am deliberately going to continue to have that message. I do believe the American Medical Association, and me as a representative, plus the physicians of this country, need to continue to have a dialogue – a meaningful dialogue –where we listen to one another, we learn from one another and we get to a place that’s best for patients and physicians whom we serve.

I find that going about the country talking with doctors, talking with other thought leaders, a team approach almost, if you will, is a very good thing to do and this is going to be one of the goals that I’m going to continue to carry forward because I do think it’s going to be very important.

The other thing that I’m very excited about doing is, in fact, what we’re doing right now in some of our things, new targets, new key directions. One of those we’ve got to do is improving patient outcomes. I think when we talk about patient satisfaction, we talk about improving health outcomes. The AMA is going to be very much involved in that...A lot of folks around here call this a moonshot because this is a big move. This is something the AMA can and must do.

The next key direction is going to be in the whole area of medical education. Having said that, I think for many years those folks who teach medical students and doctors and those of us who are doctors and were taught, have recognized that the world out there has changed – the environment of delivering healthcare has changed. Probably it’s past due time (but) the medical education of physicians of the future has got to change to reflect what’s going on globally around us and nationally as well.

The third one has got to do with what I like to call physician satisfaction. This has got to do with making sure the delivery models of care are appropriate to the physician, locality, the types of patients they serve, the preferences, but at the same time, it’s meaningful, it can be done well. It’s done to make the physician happy, their practice satisfactory. They love taking care of patients and they want to be able to do it in an environment that is conducive to that. I think so much as what has gone on out there right now has made practice for doctors difficult. The regulatory burdens that are born every day just in simple things like pre-authorizations or when patients come in and say ‘they changed my pharmacy again’...this constantly moving target of regulatory change and expectations from so many sources, many of which are conflicting.

Q: What do you think your toughest challenges as the organization’s new leader will be?

A: I think part of it goes to what I just talked about. I think the physicians of this country have different needs and it’s driven by where they practice – rural, inner city; the type of practice. Is it a large, multispecialty, integrated practice? Are they part of a system? Are they hospital-based? Are they still in a two- or three-person small practice in rural Missouri? So the challenges we are going to have and our job is going to make sure that that practice can thrive and grow and do exactly what the patients need and what the physicians want to be able to do for them. That’s going to be a challenge.

The other challenge, I think, as we move forward, is a continual challenge, which is patient access to healthcare. Despite what happens to the ACA, what happens with health reform law, we in this country must address that there are no 100 percent guarantees of anything. We must be diligent in making sure patients, every American, has healthcare – good, high-quality healthcare. ... If we lose sight of that, we have lost sight of what we are on this earth to do. I feel very strongly about that.

Q: What are some of the ethical challenges you think the healthcare industry faces right now in this time of turbulence in the industry?

A: Again, I think access to care is still going to be an issue. (Many challenges) are financially driven. If you look at Medicaid populations, underserved populations, the uninsured – trying to make sure they’re getting what they need – because we don’t want to do healthcare on the back end, which is what, unfortunately, we do in this country. We don’t concentrate enough on the prevention and wellness and front end of care. All of our healthcare dollars, all of our time, is spent on the back end when patients are sick and that’s not good for them, that’s not good for the costs, it’s not good for anybody. That to me is always a challenge.

The other thing is cost. The American Medical Association, and I think, every physician in this country, recognizes that if the cost of care goes up, that is not a good thing because what we’ve got to do is provide what is best for the patient. More care, or more expensive care, isn’t necessarily better care. You want the right care, at the right time, at the right place, by the individual, by the right physician, so we must continually look at that as we are beginning to and have been doing for some time.

The other part of this is the role of the patient in all of this. The patient in the examining room or the patient’s family in the examining room with the physician looking at their responsibility in making this a partnership as we decide what is in their best interest and having the information available for them. So I think these are the challenges we’ll continue to face. I think we’ve made great strides but we have a long way to go.

Q: What encouragement – if any – would you give doctors in their roles as both caregivers and business leaders?

A: Being a doctor is probably the best job in the world. It really is. All of us went into medical school with passion, the fire in our belly, the desire to make a difference in people’s lives and being a physician is probably the best place to be do that. It is a very, very privileged place. I encourage my colleagues out there to remember that because that is what’s so wonderful about them and the people they take care of. That very sacred place between the doctor and the patient is one of the most important things we must take care of. That’s our job.

The other encouragement for them is one the AMA is doing right now in looking at the business of medicine, if you will, and it goes back to one our directions I mentioned earlier, which has got to do with how we’re going to address delivery change and payment change...So I think for physicians, this is very encouraging because at the end of the day they’re going to end up with something that’s going to make them much more satisfied and happy in their roles as physicians, be they in a hospital system, be they in a small or an academic medial center or wherever they want to be to do the work that they love. I find it’s a bright day. I think we have great opportunity, health system reform, health delivery changes are already under way. Despite what happens with ACA, we’re in a better place and we will continue to move forward.


Image courtesy of the American Medical Association.

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