Harris Extols Public Trust in Physicians, AMA in an Era of Mistrust

In an age of distrust—of government, of politicians, of the media, even of fellow citizens across the political or cultural divide—people still trust their doctor, said psychiatrist and AMA President Patrice Harris, M.D., in her presidential address at the Interim Meeting of the AMA House of Delegates last month in San Diego.

Ted Grudzinski/AMA

“Physicians are routinely ranked among the most trusted professions,” Harris said in a speech titled “Physicians Matching the Moment: Earning Public Trust in an Era of Mistrust.”

“How have we maintained that level of trust when we see it slipping away in other areas of society? Because of the values of our profession and our aspirations to meet the three dimensions of trust—competency, honesty, and compassion.”

Harris, a former member of APA’s Board of Trustees, was elected AMA president at the June 2018 meeting of the House of Delegates and inaugurated this past June. Her presidential year runs through June 2020. She is the first African American woman president of the AMA and has served on the AMA Board of Trustees since 2011. She served as secretary for the 2014-2015 term and as chair of the board for the 2016-2017 term. Harris is also chair of the AMA Task Force to Reduce Opioid Abuse, and in that position she has emphasized the need to reduce opioid prescribing by physicians while also advocating for treatment for substance use disorders and pain management.

Harris used her presidential remarks to remind physicians of a long list of AMA activities encompassing competency, honesty, and compassion that she said will continue to merit the trust of the public and of individual patients.

Harris said the AMA’s commitment to competency is embodied in the following activities:

• Adherence to science and evidence-based medicine. “Our patients trust their physicians and the AMA because we fight for science, calling out quackery and snake oil when we see it. Consider the anti-vaccine movement, now spreading fear and false information on social media. The AMA is fighting back by making sure vaccines are widely available and that exemptions in vaccine regulations are solely for medical reasons.”

• Commitment to health equity. “Evidence tells us our country’s history of discriminatory policies has led to health disparities that persist today for women, low-income families, and communities of color,” Harris said. She said that the AMA’s Center for Health Equity is working “to ensure that health equity is imbedded into the DNA of our organization and is foundational to all our work.”

• Fighting insurance discrimination. “The evidence tells us that prior authorization delays access to necessary care and may lead to life-threatening emergencies. That’s why the AMA has activated a grassroots campaign and is advocating for prior authorization reforms in Congress through the regulatory process and in legislatures across the U.S. If insurance companies believe they’re more qualified than physicians to decide what patients need, let us be very clear, … that’s a fight we are willing to have, and we will not back down.”

Honesty is embodied in these AMA activities and policies:

• Opposition to the Trump administration’s immigration policies. “The AMA opposes the administration’s child separation policy at the southern border, knowing those traumatic experiences will likely lead to adverse health effects over a lifetime. That’s why we support humane treatment for all immigrants … and why we called for oversight of detention facilities and access to basic health services, including vaccines. Children are not supposed to be in cages no matter who, what, why, or how.”

• Advocating for the LGBTQ community. “We oppose the Pentagon’s ban on transgender persons in the military. Gender identity does not and should not disqualify someone from serving our nation. And that’s why we continue to fight proposals that would eliminate the Affordable Care Act’s nondiscrimination protections for women and LGBTQ people.”

• Protecting physician freedom of speech. “We fought back when the administration imposed a ‘gag rule’ on physicians under Title X, preventing us from having evidence-based conversations with our patients and recommending appropriate referrals for care,” Harris said. “The patient-physician relationship is the cornerstone of health care, and trust in this relationship depends on open and honest conversations about all of our patients’ health care options.”

Compassion, the third critical component of the public’s trust in physicians, is demonstrated by the AMA’s commitment to these principles:

• Treating the whole person. “Patients rely on us to not only understand the nuances of diagnosis and treatment, but also how family dynamics may affect a patient’s ability to follow a course of care. Our patients rely on us to understand that the head is connected to the rest of the body and appreciate the connection between mental health and overall health.”

• Upholding medical ethics. “Patients rely on us to advocate to change those laws and policies that are contrary to the interests of our patients. Our code of ethics demands it.”

Harris said these policies and principles are driven by the AMA’s purpose, embodied in its mission “to promote the art and science of medicine and the betterment of public health.”

“We give life to our mission when we promote solutions to surprise billing that keep patients out of the middle of conflict and hold insurers accountable; when we fight for common-sense gun laws to keep our communities and neighborhoods safe; when we pull back the curtain on the dangers of e-cigarettes and vaping; when we fight for user friendly, interoperable electronic health records, eliminating one of the major contributors to physician burnout; and when we fight to remove the obstacles of documentation burden that interfere with patient care.

“These ongoing efforts shape our organization’s purpose.” ■