Every year or so, we hear that some big Medicare pay cuts for doctors are on the way, and almost every time Congress swoops in at the last minute to block the cuts, according to this post in the Wall Street Journal Health Blog. But now leaders of the AMA and other big doctor groups have been in Congress lately asking for a change to the underlying system that keeps creating these near misses. At issue is the "Sustainable Growth Rate," a formula Congress created in 1997 to try to keep payments from spiraling out of control.