Why we need a Recovery Plan for America’s Physicians ​

Physicians will always put the needs of our patients first, even when that means placing ourselves at great risk as was the case during the darkest days of COVID-19. When the nation needed us, we were there. What we ask in return is that our nation reaffirm its commitment to us by embracing the American Medical Association’s Recovery Plan for America’s Physicians, which seeks fundamental changes to create a health system that better supports patients and physicians today and over the long run.

The AMA’s Recovery Plan outlines a five-point strategy to strengthen our physician workforce, recover from the trauma of this pandemic, and improve health care delivery by eliminating some of the most common pain points that threaten to drive physicians from practice. The AMA’s comprehensive approach includes:

• Supporting telehealth to maintain gains in coverage and payment.
• Reforming Medicare payment to promote thriving physician practices and innovation.
• Stopping scope creep that threatens patient safety.
• Fixing prior authorization to reduce the burden on practices and minimize dangerous care delays for patients.
• Reducing physician burnout and addressing the stigma around mental health.

Each of these objectives is within our grasp, and achieving them will streamline health care delivery, improve patient care, and support innovation while simultaneously allowing us to respond more effectively to future public health emergencies. Let’s take a brief look at each component of the overall strategy.

Supporting telehealth expansion

The widespread adoption of telehealth services and technology throughout the pandemic allowed physicians to serve patients’ needs in a comprehensive and cost-effective manner. The AMA is working to build upon that success by permanently eliminating pre-pandemic coverage restrictions, ensuring that physicians have the tools and resources they need to seamlessly integrate telehealth into their practices, and enabling patients to access telehealth services from wherever they are.

Medicare payment reform

Diverting the Medicare physician payment system from its current unsustainable path and steering it instead toward physician practice sustainability will protect patient access to quality, evidence-based care while easing administrative burdens. When inflation in practice costs is considered, Medicare physician payment plunged 20% from 2001 to 2021. Medicare spending on physician services per enrollee retreated by 1% between 2010 and 2020, even as spending per enrollee for other parts of Medicare jumped by 3.6% to 42.1%. The AMA’s Recovery Plan tackles Medicare physician reimbursement by emphasizing simplicity, relevance, alignment and predictability.

Stopping scope of practice creep

Patients rely on physicians to direct the care they receive, and the Recovery Plan presses our AMA’s vigorous opposition to inappropriate scope of practice expansions by nonphysicians. Patients are at the center of everything physicians do, and ensuring their protection and well-being in the modern health care environment continues to drive our emphasis on physician-led teams. Every member of health care teams brings important skills to patient care, and nonphysicians made major contributions during the pandemic. That said, patient safety demands that we lift up physicians for their expertise as leaders of health care teams, and their ability to draw out valuable contributions from each professional on that team.

Fixing prior authorization

Prior authorization programs that insurers often use to deny care and increase their own profits have grown out of control. The AMA Recovery Plan will press the fight against this archaic process that delays necessary medical care and routinely causes patients to abandon treatment entirely, often with disastrous results. We intend to right-size prior authorization through multiple reform initiatives underway at both the state and federal levels while offering physicians the resources and tools needed to slash the burden this process imposes on their practices.

Reducing physician burnout

Physicians struggled with professional burnout long before the pandemic pressed them to the very limits of human endurance. Although each physician may experience burnout differently, the cause is nearly universal: An overly bureaucratic and burdensome work environment that steals time from patient care and finds physicians feeling powerless to change it. The well-known resiliency that physicians routinely display is not without limits – but we know that a sizable percentage do not seek counseling or other help for anxiety, depression or even suicidal ideation for fear of being judged inadequate by colleagues, or having to disclose this action to a state licensing board. The recovery plan includes action at the state and national levels to strip away outdated language on applications for medical licensing, health care sector employment and credentialing that promotes stigmatization of behavioral health care.

The AMA’s Recovery Plan for America’s physicians is ambitious, yet achievable. Prioritizing and meeting the needs physicians will improve patient care and health outcomes. Working closely with all members of the Federation of Medicine, the AMA intends to reach these goals and help fulfill our mission to promote the art and science of medicine, and the betterment of public health.