Cecil B. Wilson, MD, an internist and president of the staffs at both Winter Park Memorial Hospital and Florida Hospital, has got his work cut out for him as the newly inducted president of The American Medical Association. Entering office amid a health reform battle that continues to rage four months after the legislation passed, Wilson faces flagging membership as well as pressure to change the dwindling group's stance on the landmark legislation.

Several influential delegations at the AMA annual policymaking meeting said they would like the group to to push for eliminating a 21 percent cut in Medicare payments, raise doctor pay from state Medicaid programs and advocate for sweeping liability reform, reports the Chicago Tribune.

"It's been a devastating year for organized medicine," Dr. John Ostuni, a Freeport, N.Y., endocrinologist, told AMA leadership Sunday at the Hyatt Regency Chicago, adding that AMA leaders should not use the group's "prestige and good name to move legislation forward that may well have adverse consequences."

Thus, on Tuesday, the last day of the meeting, the AMA voted to adopt a number of new scientific policies, according to a press release. In one measure intended to address the "Medicare meltdown" caused by a 21 percent Medicare physician payment cut, the AMA voted to immediately formulate legislation for a new Medicare payment option. It would allow patients and physicians to freely contract for payments that differ from the Medicare schedule, while allowing patients to use their Medicare benefits.

"Seniors deserve a Medicare benefit that allows them access to and choice of physicians," said David O. Barbe, MD, AMA trustee. "Low Medicare payments, continued payment uncertainty, and a steep 21 percent payment cut have put access and choice in jeopardy. A new patient-centered category of Medicare payment will allow seniors to use their Medicare benefit fully for the healthcare they need."

Wilson, inducted in a Chicago ceremony June 15, came out in support of the SGR-avoiding healthcare reform bill earlier this year as the AMA president-elect, echoing President Barack Obama's sentiment that the bill "wasn't perfect" but important for extending coverage to the uninsured, according to the Orlando Sentinel.

According to Winter Park mayor Ken Bradley, who has worked as an administrator with Wilson at Winter Park Memorial Hospital, Wilson's strength as a leader is seeing both sides of an issue to bring disparate groups together.

"He's been a patient advocate as well as a physician advocate," said Bradley.

Despite the optimism surrounding the new leadership, the group concedes it's losing members. The AMA attributes the decline to its stance on health reform, as well as the ongoing recession. According to the Tribune, the AMA is projecting a 5 to 7 percent decline in membership this year from a 2009 year-end total of 228,150 dues-paying physicians.

In addition, MedPage Today reports that the AMA is actively reevaluating its definition of membership. One consideration may be to automatically consider physicians who access a certain number of AMA digital tools, such as CME, electronic journals and practice management programs to be members, says Rebecca Patchin, MD, an anesthesiologist and pain management specialist from Loma Linda, Calif., who is chair of the AMA board of trustees.

To learn more:
- read this story in the Chicago Tribune
- see this piece on MedPage Today
- check out this article in the Orlando Sentinel
- see this AMA press release

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