Exasperated AMA President: 'We Will Not Back Down'

Jack Resneck Jr. says physicians will fight for the interests of their profession and their patients.

In an impassioned speech before the Interim Meeting of the American Medical Association House of Delegates, AMA President Jack Resneck Jr., MD, denounced disinformation campaigns and government interference in the patient-physician relationship.

Misinformation and anti-science rhetoric have been common during the coronavirus pandemic. Since the Supreme Court of the United States ended the right to an abortion in Dobbs v. Jackson Women's Health Organization, several states have passed laws banning abortion regardless of whether the life of the mother is threatened.

Addressing the AMA meeting on Saturday, Resneck said the country's physicians are facing unprecedented challenges. "How can a profession that put its lives on the line to lead our nation through this pandemic … that continues to fight an onslaught of medical disinformation amid increasing hostility and threats. How can we at the same time face ominous Medicare cuts as practice costs surge … as giant healthcare mergers concentrate market power … And as an ever-growing list of administrative demands pull us away from what drew us to medicine in the first place—caring for our patients."

The practicing dermatologist said he is having an emotional reaction to the threats facing physicians and their profession.

"I'm angry about how science and medicine have been politicized … about the flood of disinformation that seeks to discredit data and evidence, undermine public health, and misrepresent the wise policy of this House and our AMA's work to implement it. It began with COVID and lies meant to sew confusion and divide our nation. Lies about masking … you don't need them, so don't wear them. Lies about vaccines … they have microchips, or don't work, so don't use them. Lies about public health leaders and even frontline physicians … they're profiteering from the pandemic, so don't trust them. You are ambassadors of truth, doing the difficult work to reject these falsehoods and impart your knowledge to a weary public," he said.

Resneck said critics of physicians are misrepresenting the AMA's health equity efforts, distorting gender-affirming care, and ignoring evidence about what needs to be done to address gun violence. "You know and I know that we did not pick these fights, and that our organization isn't on any political team. The AMA is fiercely non-partisan. We have evidence-based, open debates in this House, and our actions are driven by the policies that you create. And you represent every state, every specialty, employed and independent settings, rural and urban communities. You come from every point across the political spectrum."

Physicians are willing to work with politicians, but clinicians will not be intimidated by them, he said. "We are influential individually as physicians and collectively as the AMA because we are the grown-ups in the room. We follow the evidence. Science is our North Star. And because we work with political leaders, from any party, at any time, when they are willing to help us improve the health of the nation. But make no mistake. When politicians insert themselves in our exam rooms to interfere with the patient-physician relationship … when they politicize deeply personal health decisions or criminalize evidence-based care … we will not back down. We will always stand up for our policies … for physicians … and for our patients."

Enduring the fallout of Dobbs

Resneck said the AMA has taken a stand on access to reproductive healthcare services such as abortion and contraception, adding that position is under assault.

"Since we last gathered in Chicago in June, many states have raced to criminalize abortion in the wake of Dobbs, and the drivers of disinformation have been at it again. Now they are falsely claiming that we have exaggerated or even fabricated stories about the real consequences of those laws. … Stories about patients with ectopic pregnancies, sepsis or bleeding after incomplete miscarriages, or cancers during pregnancy—patients who are suddenly unable to get the standard care that was unremarkable for decades … patients who now must, absurdly, travel hundreds or thousands of miles across the country to exercise their choice and obtain basic medical care. Denying our experience is helping prop up restrictive laws that are creating chaos—and leaving physicians in impossible positions," he said.

Resneck said abortion bans are forcing physicians to make choices between following the new laws or risking the lives of their patients. "I never imagined colleagues would find themselves tracking down hospital attorneys before performing urgent abortions, when minutes count … asking if a 30 percent chance of maternal death, or impending renal failure, meet the criteria for the state's exemptions … or whether they must wait a while longer, until their pregnant patient gets even sicker. In some cases, unstable patients are being packed into ambulances and shipped across state lines for care. To those who are forcing physicians into these ethical dilemmas, your efforts are reckless and dangerous."

 
Medicare reimbursement cuts

Resneck called for pressing forward with the AMA's Recovery Plan for America's Physicians, including advocating for Medicare payment reform.

"As we emerge from the worst of COVID, as practice costs have surged in the face of substantial inflation, and physicians struggle to retain staff, I can't think of a worse time for Medicare to threaten almost eight-and-a-half percent across the board payment cuts. How demoralizing! Our AMA is fighting to stop those cuts, and I'm glad to see all of medicine aligned in this effort.  We must and will keep the pressure on Congress to act before the end of the year. But simply blocking every planned cut, as we've done before, isn't good enough. Physicians deserve financial stability, including automatic, positive, annual updates that account for rising practice costs.  And it's time for reform of unfair budget neutrality rules that penalize doctors for things beyond our control," he said.

'Enough is enough'

Resneck expressed exasperation over misinformation and the drivers of physician burnout.

"Enough is enough. We cannot allow physicians or our patients to become pawns in these lies. All of this is exacerbating the burnout crisis in medicine. Doctors, facing threats and obstacles on so many fronts, are tired. Some are wearing down and leaving the profession they have dedicated their lives to. Telling them to be more resilient, or to do more yoga, and to enjoy a free dinner from the hospital CEO isn't going to heal the burnout. While wellness has its place, to focus solely on resilience is to blame the victim. We need to fix what's broken—and it's not the doctor."