Just by striding onto the stage at the AMA's House of Delegates meeting
last month in Chicago, President Obama may have won some hearts—a few
anyway—in a corner where support may not come naturally.
After all, it had been 25 years since President Reagan visited the AMA. And
this was a Democratic president who has made no secret of his admiration for
the way a single-payer health system works in some countries or of his
preference for a "public option" for health insurance in this one
(see AMA Opposes Single Payer, but Is Open to Public Option).
And as a Democrat, Obama is—in the eyes of many in the AMA—on
the wrong side of the malpractice issue: he does not favor caps on malpractice
But while the president did not avoid those difficult issues, or others
such as the possibility of "bundling" payments to hospitals and
physicians for care of a patient—another subject about which there is
some anxiety within the AMA—he mostly came to the AMA with his hand out,
asking for help.
President Barack Obama paid a historic visit to the AMA House of
Delegates to ask doctors' help in reforming America's health care
Photo by Ted Grudzinski / courtesy of AMA
"I need your help, doctors, because to most Americans, you are the
health care system," the president said. "The fact is
Americans—and I include myself and Michelle and our kids in
this—we just do what you tell us to do. That's what we do. We listen to
you; we trust you. And that's why I will listen to you and work with you to
pursue reform that works for
AMA leaders and delegates expressed heartfelt appreciation for that."
We are grateful for your efforts to make the path toward health system
reform as open and inclusive as possible and, in particular, that we have been
included in those efforts," said AMA immediate past President Nancy
Nielsen, M.D., in remarks introducing Obama.
Section Council on Psychiatry Chair John McIntyre, M.D., said he thought
the speech could be a great recruiting tool for the AMA. "I think it's
impossible to listen to that speech and say that the AMA is irrelevant, which
is unfortunately what some doctors say when they don't join," McIntyre
said. "It's very clear both by being there, and by the content of his
message, that the president recognizes the role the AMA has played thus far
and will play going forward."
Past APA President Carolyn Robinowitz, M.D., who has been active in the AMA
since 1978, agreed. "If you have never joined the AMA, this is the time
to do it, because people are paying attention to us."
The vice chair of the section council, David Fassler, M.D., said,"
The president gave an impressive address that was received with
considerable enthusiasm. He touched on many of the issues troubling physicians
and interfering with the practice of medicine.... Overall, I heard lots of
common ground with respect to the major goals and objectives. I also think
that by his appearance, the president extended a hand to the medical
community. In doing so, he furthered the likelihood of actually achieving
Those interviewed by Psychiatric News agreed that the president
showed a remarkable facility with the difficult core issues related to health
care reform and an understanding of physicians' concerns: he emphasized, more
than once, that patients who like their health insurance and their doctor will
not be required to switch; acknowledged that doctors do not want a replica of
the Medicare system, with its broken payment system; recognized the problem of
medical-student debt; and said he was in favor of tort reform.
"I think what is remarkable is his ability to capture the essence of
the issues in so many venues," said APA President-elect Carol Bernstein,
M.D. "He was able to really articulate the issues facing physicians with
regard to health care."
McIntyre said, "President Obama was clearly aware of many of the most
important issues identified by physicians, and his references to what we would
call the 'patient-doctor relationship' resonated with the House of
Robinowitz added that it was also a testament to the work that Nielsen and
other AMA leaders have done to forge a relationship with the
Though some media reports cited booing—there were scattered boos, of
an almost lighthearted nature when the president acknowledged that he did not
favor malpractice caps—the response of delegates throughout was largely
very positive, with the president stopping many times for applause and for
"People not only applauded, but it was genuine and warm," said
Bernstein said, "I think it is critical that our members know that
despite what was reported in some of the popular press, almost everything he
said in the House of Delegates was met with great enthusiasm."
There were two topics that the president did not mention in his
speech—mental illness and parity—and it did not go unnoticed by
section council members. "I was sorry about that," said Bernstein."
But it shows that we need to be very proactive and to work with our
medical colleagues to make clear to everyone that there is no health without
Robinowitz observed that Obama had come to the AMA meeting to talk about
health care reform from a broad perspective. "I have no doubts that he
supports parity, so it didn't worry me that he didn't directly address that.
It does point out to me—and there should be no doubt in anyone's
mind—that we have to join with all of medicine and work with all
practicing physicians." ▪