Congress is again this week and feverishly engaged on a bipartisan settlement to fund the federal government for the remainder of the 2024 fiscal 12 months. Forward of a possible vote, I spoke with Jesse Ehrenfeld, the president of the American Medical Affiliation, the nation’s largest foyer group for docs, about his group’s priorities in Washington.
Some background: Ehrenfeld is a Wisconsin anesthesiologist, researcher and medical faculty professor who additionally directs a health-care philanthropy in his state. He’s an Afghanistan fight veteran, the primary brazenly homosexual president of the AMA and a nationwide advocate for LGBTQ+ rights.
This transcript has been edited for readability and brevity. You’ll be able to hear the entire interview later at this time on “What the Well being?”
Rovner: Congress is coming again and dealing on a price range, or so we hear. I do know physicians are going through, once more, a reduce in Medicare pay, however that’s not the one AMA precedence right here in Washington in the meanwhile, proper? [Note: A 3.37 percent cut to Medicare physician payments took effect Jan. 1.]
Ehrenfeld: It’s unconscionable. And so we’re optimistic that we will get a repair, hopefully retroactive, because the omnibus consolidation work goes ahead.
Physicians proceed to wrestle. My mother and father misplaced their very own major care doctor due to a problem with their major care physician not having the ability to take Medicare anymore. And what we’re seeing is increasingly docs simply stopping seeing new Medicare sufferers, or opting out of this system completely.
Rovner: Now now we have the Supreme Court docket — none of whom have an M.D., so far as I do know — about to resolve whether or not docs [treating] girls with being pregnant emergencies ought to obey state abortion bans, the federal Emergency Medical Remedy and Lively Labor Act, or their medical ethics, all of which can battle. What’s the AMA doing to assist docs navigate these very uneven and altering authorized waters?
Ehrenfeld: Uneven is an efficient phrase for it. It’s complicated. And for the reason that Dobbs determination, now we have been working with all of our state and federation companions to attempt to assist physicians navigate this. It’s unbelievable that now physicians are having to name their attorneys, the hospital authorized counsel, to determine what they will and may’t do. And, clearly, this isn’t an image that helps girls’s well being. So we’re optimistic that we’d get a constructive ruling with this EMTALA determination on the Supreme Court docket. However, clearly, there’s a good distance that we have to go to make it possible for we will preserve entry for reproductive care.
Rovner: Do you suppose that’s one thing that has dawned on the remainder of the members of the AMA that this isn’t essentially about abortion, that is in regards to the skill to apply drugs?
Ehrenfeld: If you happen to have a look at a few of these socially charged restrictive legal guidelines, whether or not it’s in transgender well being or abortion entry, or different gadgets, we take the identical foundational strategy, which is that physicians and sufferers should be making their health-care selections with out legislative interference.
Rovner: It’s not simply abortion and reproductive well being the place lawmakers are attempting to dictate medical apply, but additionally take care of transgender youngsters and adults and even therapy for covid and different infectious ailments. What are you doing to combat the type of “pushing in opposition to” scientific discourse?
Ehrenfeld: Our basis in 1847 was to do away with quackery and snake-oil salesmen in drugs. And but right here we are attempting to do a few of those self same issues with misinformation, disinformation. And clearly, even for those who have a look at the assault on PrEP, preexposure prophylaxis for HIV prevention — making it mainly zero out-of-pocket value for a lot of Individuals — [not providing PrEP is] simply unconscionable. We’ve therapies. We all know that they work. We should make it possible for sufferers and their physicians can have entry to them.
Rovner: Synthetic intelligence can portend big advances and in addition different points, not all of that are good. How is the AMA making an attempt to push [medicine] extra towards the previous, the nice issues, and fewer towards the latter, the unintended penalties?
Ehrenfeld: We have to make it possible for now we have acceptable regulation. The [Food and Drug Administration] doesn’t have the framework that they want. We simply have to make it possible for these modifications solely let secure and efficient algorithms, AI instruments, AI-powered merchandise come to {the marketplace}.
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