Q&A: New AMA president optimistic despite 'health care system in crisis'

Key takeaways:

• The AMA’s new president told Healio about his plans for the position and his priorities for the AMA.
• Among them are efforts to reduce physician burnout.

Jesse M. Ehrenfeld, MD, MPH, FAMIA, FASA, was recently sworn in as president of the AMA.

Ehrenfeld, an anesthesiologist from Wisconsin, was elected to the AMA Board of Trustees in 2014 and chaired the board from 2019 to 2020. He was a member of the governing boards of the American Society of Anesthesiologists Resident Component and the Illinois State Medical Society, as well as a member of the governing councils of the AMA Resident and Fellow Section and the AMA’s Young Physicians Section.

Ehrenfeld is the first openly gay person to serve as AMA president.

Healio spoke with Ehrenfeld to learn more about his priorities as AMA president, what he plans to do about some of the field’s top concerns and more.

Healio: What are your priorities for the AMA? What do you think the organization should be focused on right now?

Ehrenfeld: Leading the AMA’s recovery plan for America’s physicians will be among my main priorities. We know firsthand how physicians have put everything into our national response to COVID, but now it's time for the nation to renew its commitment to physicians and, frankly, the shoring of a health care system in crisis. So, I will help lead the charge to prioritize this effort, which includes reforming Medicare payments to physicians, improved telehealth, reducing the stigma around mental health care and burnout. I also plan, as president, to continue our work pushing for changes that will improve the health of everybody in the U.S., particularly those who have been historically marginalized. Issues of LGBTQ health and health equity are close to my heart, have long been a focus of my work in medicine and will be an important part of my work in the year ahead.

Healio: Aside from being inaugurated as AMA president, what are some other highlights of your career?

Ehrenfeld: I served for 10 years in the U.S. Navy as a reserve officer, where I was able to use my medical training to help service members. I was deployed to Afghanistan in 2014 to 2015 and grateful for that opportunity. There are at least three guys who are home today who wouldn't have survived if I hadn't been there. While I was deployed, I was able to shine a light on the lives of LGBTQ service members, including through photos. I got a White House News Photographers Association award in the process and an Emmy nomination for some film that came out of that.

I continue to see patients. I see patients every week. It's not only the easiest thing I do because I know what to do but it grounds everything they do with the AMA. When I pull on scrubs, walk into the operating room, I hear and experience the pain that insurance companies unleash on their patients, their customers, through prior authorization. I hear about the hoops, the phone calls, the letters that my patients have to go through to get surgery authorized. I hear nurses and my physician colleagues complain about the buttons that have to click, the checkboxes to meet, regulatory requirements that really serve no purpose in improving patient quality. So, my work every week as a physician seeing patients is really important because it grounds everything that I do day-to-day, and I look forward to continuing to do that over the coming year.

Healio: What is the AMA doing to help physicians with regard to some of the field’s top concerns like burnout, transgender health care, etc.?

Ehrenfeld: Reducing physician burnout, addressing the stigma of mental health is really important. Following the passage of the Dr. Lorna Breen Health Care Provider Protection Act, which we strongly supported, we're continuing to push for regulatory, legislative and other solutions to get more funding, more resources to support the mental health needs of physicians. We're also working with our state partners at a state level to identify and reform outdated, stigmatizing language on medical licensing applications that prevent people from getting the care that they need because they're worried that they can't get licensed to practice medicine in that state.

In partnership with the Dr. Lorna Breen Heroes Foundation and a number of medical societies, we're working quickly to try to get rid of these questions about past diagnosis and replace them with questions that only ask about current impairments. We’ve also seen some movement — not every state has a confidential physician wellness program. Every state should have one. When there is a physician who needs coaching, who needs help, who needs other services to address burnout, stress or similar situations, they should have a confidential place to go. We're continuing to certainly push on that.

Unfortunately, a lot of the burnout is driven from the fact that we’ve got a lot of backseat drivers telling us how to practice medicine and, as my husband will tell you, there is nothing more irritating than the backseat driver. We've got insurance companies practicing medicine by denying care. We’ve got legislators practicing medicine by outlawing, banning evidence-based practice. And so, we continue to push back against intrusion into the patient physician relationship. And we see a lot of the work that is happening across many states to ban care for transgender people (or) restrict reproductive health care access simply as government overreach into practice development.

Healio: What are some goals that you hope to achieve in this position?

Ehrenfeld: We want to ensure that our patients get the care that they need. And for me, it's important that that's not just patients who are white or speak English or have the best health care coverage. It’s every patient in America. Patients from underserved communities, patients from rural parts of the nation, patients who identify as LGBTQ, patients who may not have citizenship status. Every patient who had a need ought to have that need met by our health care system. And we do know that that's not our reality today.

Healio: Is there anything else you'd like to add that I didn't get to?

Ehrenfeld: We’ve got a lot of challenges in health care today. We've got a health care system in crisis. I’ve got a lot of colleagues at a breaking point, but I am so optimistic. I am so optimistic about the future, about what lies ahead, about where I know I can help lead American physicians in the AMA.

We can get this right. We can heal our nation. But it's only going to happen if we let physicians practice medicine. Medicine that’s driven by science, by our understanding of the human body and health and disease, and by allowing patients to decide with their doctor what’s in their best interest.