Breaking down barriers that are disrupting the physician-patient relationship is a top priority for Susan Bailey, MD.
With the worst pandemic in a century punctuating her recent inauguration as president of the American Medical Association, Susan Bailey, MD, is bracing for a momentous one-year term.
On June 7, Bailey became the 175th president of the country's leading physician organization. She is the third consecutive woman to hold the post, succeeding Patrice Harris, MD.
Bailey has been a practicing allergist/immunologist in Benbrook, Texas, for more than three decades. She was first elected to the AMA Board of Trustees in 2011. Before becoming an AMA officer, Bailey served as president of the Texas Medical Association and Tarrant County Medical Society.
Bailey earned her medical degree at Texas A&M University College of Medicine. She completed her residency and fellowship training at the Mayo Graduate School of Medicine.
In a recent interview with HealthLeaders, Bailey shared her perspectives on the top issues facing physicians and her plans as AMA president. The following is a lightly edited transcript of that conversation.
HealthLeaders: What is it like to become the leader of the AMA in the middle of a deadly pandemic?
Bailey: To become president of the AMA in the middle of a pandemic is a bit surreal. Usually, an AMA president is inaugurated at our annual meeting and there is lots of fanfare, but I gave my inauguration speech in front of a camera in a quiet studio. Then I just started doing the job.
The responsibility is so incredible. We will get through this pandemic, but the only way that we can do it is by working together, and it is difficult to work together when we can't have meetings and can't see each other.
It is incumbent on the AMA and me to make sure that we fully utilize all of the technology that we have at hand to be able to reach out to our colleagues, our patients, regulators, and legislators to get our message across.
HL: You have made the removal of barriers between physicians and their patients such as burnout a priority. How do you plan to achieve this goal?
Bailey: I am very passionate about protecting the physician-patient relationship. There are many entities that are interfering with that relationship, and each must be dealt with in turn.
Attacking the dysfunction in healthcare will require working in Washington as well as at the state level to minimize the burdens that are interfering with patient care. The concerns include prior authorization from payers, payment policies, and burnout. All of these concerns are going to have to be approached differently. Fortunately, we have the power of the AMA to help us do that.
There is growing awareness that burnout is a health system problem—it is not an individual problem. Burnout is not a moral failing or weakness. Burnout is the response to not being able to take care of your patients in the way you have been taught.
The AMA is looking at ways to prevent burnout, primarily by attacking the dysfunction in healthcare. We think burnout begins in medical school, and we support reasonable duty hours as well as residency and fellowship programs to address burnout and provide mental health resources.
Our strategic initiative to improve health outcomes, to remove the dysfunction in healthcare, and to design the medical education system of the future are all working to provide burnout solutions at the individual level, the practice level, and the health system level.
HL: Give an example of a payer issue that is creating barriers between physicians and their patients.
Bailey: Prior authorization is what jumps to mind immediately. I am an allergist in private practice. I have been in the same small, single-specialty practice for more than 30 years. A big part of my practice is prescribing medications. There are incredible and often ridiculous requirements to get my patients the medications that they need. It is completely out of control.
By some estimates, doctors and their staff spend up to two days a week trying to deal with prior authorizations. The AMA has worked with a group of payers in the past and set some goals; but, unfortunately, the problem just continues to get worse and worse.
It is going to be important to go back to the drawing board with the payers, investigate legislative solutions, and not rest until we get this problem fixed. It will be interesting to see whether we can get the prior authorization rollbacks that have happened during the coronavirus pandemic to persist.
HL: For physicians, what tops the agenda in addressing the coronavirus pandemic?
Bailey: The coronavirus pandemic has predominated all of our thoughts and work over the past few months. The bottom line is that we must be able to safely and effectively treat coronavirus patients. To do that, we must have plenty of personal protective equipment and other supplies to protect our patients as well as protect healthcare workers and their families.
Another area is the non-coronavirus care that is currently being delayed because of the pandemic. We need to encourage patients to continue to receive their chronic care—for their diabetes, their hypertension, and other conditions. Children need to be getting their immunizations—surviving a coronavirus pandemic will not do us much good if we end up with a measles epidemic because children have not been able to get their immunizations.
HL: Do you think the pandemic is going to spur permanent changes for physicians?
Bailey: Remote care and telehealth have been front and center during the pandemic. At my practice, telehealth has enabled us to continue to take care of our patients.
We are very grateful that the Trump administration has reduced many of the barriers that have inhibited physicians from using telemedicine in the past—the payment policies and the privacy requirements. A lot of these new policies have implications for patients that are not limited to the pandemic. The AMA believes these new policies should be permitted to continue after the coronavirus public health emergency ends.
The AMA recently delivered a letter to Centers for Medicare & Medicaid Services Administrator Seema Verma that provided examples of telehealth policies that should continue under Medicare after the coronavirus public health emergency. We must be able to continue to serve patients in their homes. We must facilitate the use of telehealth services in different ways outside of the home and make sure physicians can supervise patient services using telecommunications technology.
Fortunately, the telehealth genie is out of the bottle, and I am looking forward to continuing to serve my patients with telehealth. Most specialties are going to devise recommendations on what should be done through telehealth and what needs to be done face-to-face. However, if we are not able to pay for telehealth services in the future, those recommendations are not going to be very helpful.
Christopher Cheney is the senior clinical care editor at HealthLeaders.
Photo credit: Chris Dorney
New AMA President Susan Bailey, MD, says impediments to the physician-patient relationship include prior authorization from payers, payment policies, and burnout.
Bailey hopes the expansion of telehealth during the coronavirus pandemic is a permanent change in healthcare.
During the pandemic, she says the primary priorities for physicians are the safe and effective treatment of coronavirus patients as well as continuing non-coronavirus care such as chronic disease management.