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Arguably the nation’s most powerful organized body of physician voices in the political sphere, the American Medical Association (AMA) has recently sets its sights on a new target: Meaningful Use. Specifically, the organization is coming after the Federal government’s Meaningful Use incentive program for the implementation of Electronic Health Records (EHR). Unveiling a new website called Break the Red Tape (, the association urged the Obama administration and the Centers for Medicare and Medicaid Services (CMS) to postpone finalizing Stage 3 of the program in order to “align the policy with other programs under the new Merit-based Incentive Payment System (MIPS).”

Town Hall Outrage

As I noted in the July 2015 edition of Practical Dermatology® (available at, MIPS was designed to centralize various penalty/payment programs (i.e., Meaningful Use, Value-based modifier, and PQRS) into one universal system, potentially making the burdensome tasks of complying with various government regulations easier for physicians. However, in addition to any downsides to the new system, the transition itself is very likely to cause some confusion that would make achieving what will arguably be the most difficult qualifying phase of the Meaningful Use program extremely difficult.

The AMA Break the Red Tape website is peppered with physician perspectives, facts and statistics about about Meaningful Use, as well as videos with various physician experts weighing in on the matter. However, the crux of the initiative is a town hall meeting type of forum in which EHR users share their stories and difficulties regarding the impact of Meaningful Use regulations on their practices and patient care. There have been two meetings so far, both run by AMA President Steven Stack, MD. The events are free and physicians can attend in person or online via live streaming.

A Changing AMA

Following the AMA’s strong support of CMS’s decision to ease of the transition to ICD-10 by not to penalizing for lack of specificity, the AMA’s formal lobby to stall the launch of Stage 3 suggests a new direction for the group. While preventing an onslaught of new regulations for physicians might seem a logical step, the group’s actions in recent years have not been particularly physician-friendly. Over the last 10 years, AMA membership has dipped over the group’s perceived political focus. The group’s curious support of various legislative pieces that do not support the interest of physicians has caused some ire among physicians, particularly given the perception of the AMA as the nation’s strongest physician lobby.

Therefore, the new focus on aiding physicians is a welcome change of course that hopefully signals more positive developments to come. In fact, the populist methods it is using to address ICD-10 and Meaningful Use suggest that the association is actually listening to doctors and is serious about speaking up and forcing compromise.

Much of this change in direction can likely be attributed to its young president, Steven Stack. Based on his actions so far, his mission seems oriented toward rallying physicians to compel the government to loosen its restrictions. In the past, the group has functioned under what can only be described as an absolutist philosophy. It was all or none. But Stack has smartly recognized that the best way to move forward is to chip away and get things moving in the right directions. Moreover, Stack is highly interested in Health Information Technology (HIT), which will be pivotal as ICD-10 and Meaningful Use play an increasingly prominent role in the practice of medicine in coming years. But most importantly, Stack’s actions thus far have indicated that he is trying to be on the side of physicians and will not blindly cave to the wishes of Congress or the White House.

An Audible Voice

As the regulatory burdens continue to stack up for physicians, the importance of binding together as a community becomes clear. If the new site and the forceful way in which the AMA is talking about these issues is any indication, there is reasonable hope that the association could be making significant steps toward becoming an organization that truly represents the voices of physicians. Although dermatologists have not felt the need to join the AMA for a multitude of reasons, there finally seem to be some reasons to consider rejoining. n


Mark Kaufmann, MD is Associate Clinical Professor of Dermatology at Mount Sinai Hospital in New York. He is co-chair of the Dermatology workgroup for CCHIT and is on the Medical Advisory Board of Modernizing Medicine.

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