AMA Names Madara CEO

James L. Madara, MD, was introduced Thursday as the next executive vice president/CEO of the American Medical Association. He vowed to "refocus" the nation's largest, oldest physicians' organization on its "core mission" of promoting medicine and the public health.

Madara, 60, a pathologist and the former CEO of the University of Chicago Medical Center, takes over an organization that has struggled with declining and fractious membership over the past several years, especially after the AMA's controversial decision last year to support healthcare reform.

In addition, the AMA has failed to secure a permanent fix for its top priority -- the nettlesome annual Sustainable Growth Rate fight, and that has left physicians staring at a potential 29.5% Medicare reimbursement cut in 2012. That has left many questioning the AMA's lobbying skills in Washington, DC.  

Speaking with a handful of reporters during a Thursday teleconference, Madara offered few details on how he will address those and other pressing issues when he takes over the AMA's top administrative job on July 1.

When asked, for example, how he hopes to increase AMA membership, Madara spoke at length but offered no specifics. "What keeps physicians bound to a group is largely the reason why they entered the field to begin with, and that is to provide care for those that are ill and keep those that are healthy, healthy," he said. "This is an enduring feature of the field. With the current uncertainty, addressing this uncertainty with physicians' passions is important and it lines up exactly with the mission statement to promote the art and science of medicine and the betterment of public health. That mission statement and activities that align physicians' voices so they reflect the altruistic reasons for which they entered medicine will be the binding agent that keeps the group together and attracts people to the AMA."

When pressed on specific plans to boost AMA membership, such as advertising campaigns or membership drives, Madara said: "We are going to work on the substantive questions that are the big issues for physicians in general. For example when one looks at the plan for 2011 on our Web site, the issues of quality, the issues of access, the issues of creating a situation where physicians have sustainable practices are first and foremost on our minds."
 

Madara called the division in the ranks at AMA over the healthcare reform law "healthy debate."

"Among any group that is passionate about what it does and passionate about the practice of healthcare in America, there is going to be disagreement," he said. "We see disagreement on all sides. The AMA is a democratic organization where we move policy and the House of Delegates decides policy based on democratic principles that will never be 100% agreement. I think we see this in any organization that touches healthcare at this present time. What I detect in my early entry is nothing more than a very healthy debate looking at different views concerning something of fundamental importance to our nation and the health of our nation."

As for any perceived miscommunications between the AMA's Chicago headquarters and its lobbyists in Washington, D.C., Madara deferred to Ardis Dee Hoven, MD, chair of the AMA board. She rejected any suggestions of a disconnect between the two offices. "We work hand in hand, with our DC folks. They are part of us," Hoven told reporters on the conference call.
 
Madara was asked about his controversial leadership during his 2002-2009 tenure as CEO at the University of Chicago Medical Center, especially his role in creating the Urban Health Initiative. The program sparked controversy when it redirected patients with less-severe injuries or illnesses at UCMC crowded emergency department into community hospitals and clinics. He said any criticism of the initiative has to be placed in context of the time and place.

"At its core was an effort to improve health and access to care for the communities of indigent and underserved patients," he said. "Recall the context on the Southside was the collapse of several hospitals including famous hospitals like Michael Reese. We had to find new ways of providing care."

"In many ways the effort we deployed was ahead of its time," he said. "It focused on wellness and prevention and connecting patients to the care they needed in an appropriate setting. It looked to improve the coordination of care, the continuity of care, to ensure that patients had a medical home. There were challenging issues in this but I have to say it was not pushing out, it was reaching out. Our physicians and students went to clinics, went to community hospitals, opened new beds, and created new resources. My experience with this program and the lessons learned in it will serve me well in this new role with the AMA."

In addition to his time at UCMC, Madara served as Timmie Professor and Chair of Pathology and Laboratory Medicine at the Emory University School of Medicine before assuming the Thompson Distinguished Service Professorship and deanship at the University of Chicago Pritzker School of Medicine.

After resigning from the University of Chicago Medical Center in August 2009, Madara joined Leavitt Partners, a healthcare consulting firm created by former Health and Human Services Secretary Mike Leavitt.