AMA Prez Says “Welcome Linchpins!” by Pat Conrad MD

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Finally, some leadership at the AMA!  Too often, I’ve been forced to criticize the AMA for its subservience to big government, and its heavy-handed, tone-deaf way of dealing with average physicians.  Too much regulation?  We’ll sell more ICD/CPT codebooks.  Not getting paid enough?  We’ll write another strongly worded letter to Congress, asking if we could please have a committee consider whether or not to review the options on somehow possibly reforming our approach to revising the SGR, that is if it’s okay with you.

I’m pleased to see that in her first major op-ed as the president of the AMA, Ardis Dee Hoven, MD, has grabbed back the reins of power for her profession ad constituency.  Her column in the American Medical News is titled: “IMG’s:  Linchpin to the future of U..S. Health Care.”  She goes big guns out of the gate, stating that 25% of practicing U.S. docs, and 27% of residents are international medical graduates, who overwhelmingly provide care in underserved rural areas, with high percentages of elderly and minorities.  Wow.

Pres. Hoven bemoans that in four years, the U.S. is projected to be short 60,000 physicians, and that to fight this, the AMA is shooting for an additional 15,000 primary care and surgical residents, if Congress will okay them.  She pokes a sharp stick in the protectionist balloon of higher individual state requirements for IMG’s, and states outright that there should be more international representation in leadership positions on state and specialty boards, in order to start reforming those absurd licensing policies.  The IMG section is also “lobbying to alleviate visa complications and delays.”

Hoven calls for the permanent J-1 visa waiver program; increasing the J-1 cap from 30 to 50 per state; and exempt docs-in-training from specialty foreigner caps.  She touts recent Judiciary Committee testimony, and upcoming immigration legislation to further ease the way for foreign, sorry, international docs to bolster our sagging health force.

The strategy is brilliant, and the time for initiative is now.  For decades the AMA unwisely engaged in protectionism on behalf of U.S. doctors, and what did that get them?  A workforce of spoiled, entitled docs too busy complaining about declining revenues and bitching about mandated EHR’s to drive out into the country and care for the underserved.  This will be a walk in the park for providers who’ve already mastered a second language and third world driving reflexes.

How dare U.S. docs disdain taking more Medicaid patients, when the AMA has been actively trying to increase those rolls?  Knowing that it won’t make U.S. physicians more financially stable, the AMA will instead, brilliantly, alter their perspective by infusing them with IMG’s.

Upset at filling out an ICD-10 superbill?  It beats riding to work with a crate of chickens on the roof.

Are you mad that the latest 2% Medicare cut will make little Johnny’s private school unaffordable? Your new surgeon earned $50 a month in Nigeria and thinks you’ve got a great deal. Want to cry about not being able to take the family on a cruise this year?  That pediatrician rode a refugee boat from Vietnam to get here, without the VIP cabin.

Despite a $60 million PR blitz in 2005, ungrateful physicians largely stayed away from AMA membership.  What better way to lead them back to the fold than with an international flare in these shortage times?

For decades, the AMA has been an active participant in the policies, laws, and pressures that have made medicine a progressively unattractive pursuit.  Now that we have a looming shortage of doctors to service those policies, Dr. Hoven will improve the lie by welcoming more of those tired of being pursued.  “Linchpin” indeed:  as the U.S. continues to decline toward the Third World, Dr. Hoven’s AMA will help lead the way.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  6 comments for “AMA Prez Says “Welcome Linchpins!” by Pat Conrad MD

  1. cgknoxmd
    August 27, 2013 at 10:21 am

    Perhaps we could also utilize foreign nurse practitioners and PA’s, too!

  2. Gomez Thenewf
    August 22, 2013 at 9:23 am

    Why not admit more U.S. citizens to medical school?

  3. Mark O'Brien
    August 21, 2013 at 12:33 pm

    While the help is welcome, what about assisting us solo private practice docs burdened by increasing paperwork, ” Mother may I ” approval ( from people who need to justify their assistance, and proven not to save money), and increasingly experiencing “compassion fatigue” ie burnout. I’m fighting the the fight against hospitals “helping” physicians through ACO, gatekeeper, capitation, or the current buzzword. Their survival is worth sacrificing a few docs along the way. Hope the AMA can help the IMG. Might consider joining if they are truly entering the fight.

  4. Bill Ameen, MD
    August 21, 2013 at 10:49 am

    Welcome back, Dr. Doug! Should the AMA be renamed A.I.M.A (American International Medical Association)? While I’m at it, even not considering myself a xenophobe, I’m wondering why hospitalists are overwhelmingly international graduates? Do hospitals get a tax exemption granting those so-called J-1 visas (which I’ve never really understood)? Or are US graduates finding better jobs and FMGs take the crappier jobs like hospitalists? (Speaking of which, if most of the 5000 hospitals in the US have more than 4-5 hospitalists at an average of $175,000/year/doc what’s that doing to the cost of healthcare in the US? Although certainly I for one am glad not to have to hike through the hospital at the end of a long working day!)

  5. Jerry Brown MD
    August 21, 2013 at 10:26 am

    A friend from Kurdish region of Iraq (family came to US in 1996) is sending his kid to Erbil in Kurdish region of Iraq for medical school. It will be free and I assume she will be heading back to US as IMG. From my own time in Iraq (ending early 2012), the medical system seems to be about 20 years behind the West and that amounts to a severe handicap for its current medical students. However, they can only go up in quality from where they are now.

  6. Doug Farrago
    August 20, 2013 at 7:11 am

    Brilliant, Pat.

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