New WADA President: “It is such an honor to be a doctor”
South Carolina practicing family doctor becomes 176e president of the American Medical Association.
The new president of the American Medical Association says physicians have a key role to play in the lives of their patients.
Gerald Harmon, MD, is a practicing family physician based in South Carolina. He has been a member of the WADA Board of Directors since 2013 and served as Chairman of the Board from 2017 to 2018. Prior to his election to the WADA Board of Directors, Harmon served on the WADA Board on Service medical.
Harmon was inaugurated as the 176e AMA president in June, succeeding Susan Bailey, MD. He recently spoke to HealthLeaders on a range of health care topics, including the pandemic, health equity and physician burnout. The following is a slightly edited transcript of that conversation.
HealthLeaders: At this point in the coronavirus pandemic, what is the main pandemic challenge facing doctors?
Gerald Harmon: Physicians have always been shown to be one of the most trusted sources of information for patients. Patients receive direct advice and recommendations from their doctors. Now, doctors need to build confidence in vaccines and encourage better access to vaccines.
Vaccine administration has slowed down because it is not quite a priority for many people. So now it is essential for doctors to have the vaccines available to immunize their patients. We know that doctors are eager to vaccinate patients, and we always try to make sure doctors’ offices across the country have a stock of the vaccine.
It is therefore important that physicians serve as a source of information about vaccines and encourage their patients to receive the vaccine, but it is also important that vaccine suppliers get vaccines to doctors’ offices and surgeries so that they can receive the vaccine. administering these vaccines to patients and the spread of COVID.
HL: What can doctors say to their patients to increase confidence in vaccines?
Harmony: There is misinformation in the media and social networks. I try to offer my patients that there are appropriate vaccination protocols. I’m saying that these vaccines were developed quickly, but without going past scientific hurdles.
The messenger RNA and adenovirus technology has been withdrawn from the market. We didn’t have to go through funding circles because the federal government requested the funding up front. The absolute rigor of the scientific process has been observed, and these vaccines are among the safest and most effective ever developed. Patients need to be sure that these vaccines are safe.
HL: How can physicians help advance health equity?
Harmony: One of the things that I become is the spokesperson for WADA’s Health Equity Accelerator. Part of our mission statement is to advance the art and science of medicine and improve public health. It is difficult to do this without advancing health equity and addressing health disparities. Thus, health equity is essential to our mission statement.
We published a plan in May with various actions on health equity. We want to promote fairness and racial justice in WADA itself. We want to expand the capacity to understand and implement anti-racism and equity strategies. We want to build alliances with other stakeholders. We want to look upstream at the social determinants of health and the root causes of inequalities. We want to ensure that there are equitable structures to provide health care, such as the expansion of broadband in underserved and rural communities. Finally, we want to foster some pathways to truth, education, reconciliation and transformation of WADA’s past racial inequalities.
It’s a big deal. We have had policies established by the WADA House of Delegates establishing that race is a social determinant of health.
HL: Assess the impact of the coronavirus pandemic on physician burnout.
The burnout of physicians has worsened. Doctors and others have absolutely stepped up their efforts during the pandemic. They had taken an oath to take care of people. They risked their lives and even the lives of their families while caring for COVID patients.
One factor that has limited burnout during the pandemic is a renewed sense of purpose. We conducted surveys at WADA during the pandemic which found that up to 48% of doctors felt a renewed sense of purpose. They realized that the practice of medicine was a calling. We had some psychological, emotional and physical exhaustion, but we found meaning in our purpose.
Now that the adrenaline is receding and we are entering a post-pandemic state of balance where we do not have the overwhelming burden of COVID disease, we still have hurdles to physician satisfaction.
We have the barrier of electronic records that do not speak to each other. We have statistics that doctors spend many hours a year waiting to connect to an electronic record. We also know that for every hour of direct patient care, physicians spend up to two hours documenting what they’ve done — so it’s a very inefficient system. Then there is the obstacle of prior authorization, whether it is a prescription drug, a referral to a specialist, or an imaging procedure. We know that the average doctor has almost 40 pre-clears to treat each week. We consider prior authorizations as barriers to care. We have a lot of disincentives to keep the morale of physicians high.
HL: What are the main solutions for physician burnout?
The AMA has prescriptions for physician burnout. If you have a dynamic and engaged physician workforce who are resilient, this is essential to achieving national health goals. We also know that burnout isn’t just a medical workforce issue: a healthcare organization itself needs to become resilient.
For example, if I work for a large healthcare system, I want the organization to develop a policy of resilience. The healthcare system can’t just say that physicians need to be more resilient and work harder. Healthcare organizations can take a more systems approach. They can focus on staffing and planning. They can focus on providing doctors with the right tools. They can focus on better vendor support for electronic records. They can work with physicians to reduce the burden of accreditation. These irritants can be reduced without reducing the quality of care.
HL: What advice would you give to new doctors who are just starting to practice medicine?
Harmony: Don’t forget your chance to be a doctor. If you are a new doctor now, you have received a gift. You can treat your neighbor with a level of confidence that you have never had before.
To become a medical practitioner today, you have climbed a steep hill. You trained within twelve years, then qualified for a college degree, then qualified for medical school. You’ve met all kinds of successful standards – you can take data, analyze it, and come up with meaningful application for the benefit of mankind. You are an extraordinarily gifted person if you are a young doctor. Take it to heart without having an artificial sense of self-importance. Apply your giveaway.
Whether it’s me as a family physician, emergency physician, researcher, pathologist, and all kinds of practicing physicians, it’s a great honor to be a physician. I recommend that every doctor take advantage of this honor and be proud to be a doctor.
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Christopher Cheney is the editor of clinical care at HealthLeaders.