New AMA leader: Doctors will demand more

Posted June 16, 2010 at 8:16 a.m.

By Bruce Japsen |
The new president-elect of the American Medical Association promises to
lead the nation’s largest doctor group in a more demanding and
confrontational relationship with members of Congress.

“The AMA is going to be more insistent and a little edgier with its
relationships with Congress and the administration in demanding some of
the things we doctors need,” Dr. Peter Carmel, who won a hotly
contested election earlier this week to become the AMA’s
president-elect, said in an interview with the

Carmel, a 73-year-old pediatric neurosurgeon from Newark, N.J., has been on the AMA’s board of trustees for the last eight years and will serve as president-elect until next June. He will then become president, and a year later will serve as the “immediate past president” until June 2013.

In a rare three-doctor race for president-elect, he beat out two members of the 21-member AMA board of trustees that are primary care doctors: a Massachusetts obstetrician and an Indiana family doctor.

Doctors are outraged that Congress failed to avert a 21-percent cut in payments to doctors from the Medicare health insurance program for the elderly that physicians will begin experiencing this week. The cut, which has been delayed many times by Congress in recent years, took effect June 1, meaning doctor checks from claims they submitted for Medicare payment claims will be lower starting this week.

Carmel said members of Congress can expect more hard-hitting attacks from the AMA such as the recent full-page advertisements the doctors group placed in several newspapers that criticized U.S. Senators for leaving Washington for their Memorial Day recess before fixing the payment cut.

“They tell me that (Democratic Senate Majority leader) Harry Reid is infuriated with the ad and I hope so,” Carmel said. “If I had a way of infuriating his Republican counterpart (Senate minority leader) Mitch McConnell, I would do that, too.”

Obama was critical of Republicans in the Senate as well, making the Medicare fee cut a key part of his presidential radio address this past weekend.

In Carmel, the AMA elected a leader with academic and clinical expertise. Carmel is a noted neurosurgeon who maintains an active pediatric neurosurgery practice in Newark, N.J. He is also department chair at the New Jersey Medical School, which has the only neurological surgery residency program in New Jersey.

He comes from a family of physicians that includes his wife, a radiologist, and a son who is a pediatric neurologist. His father was a family practice physician and his daughter-in-law is an internist.

Some AMA observers and doctors at this week’s meeting at the Hyatt Regency Chicago say Carmel won the rare three-doctor race because he was the most critical of the health reform law than the other candidates. In addition, many AMA members feel the health care reform law favors primary-care doctors over specialists and he understands that.

As one example, the Medicaid program for the poor will raise reimbursement rates for primary-care doctors and largely leave specialists’ rates unchanged though they vary from state to state. In addition, specialist doctors who tend to pay higher malpractice premiums were upset that health care reform did not cap malpractice awards.

But AMA board chairman Dr. Ardis Hoven said all three of the candidates for president-elect are collegial and view the health care reform law as a success and a “first step in” reforming the U.S. health system.”

“It’s not primary care versus everybody else, but the need for all physicians to get paid for what they do,” said Hoven, an infectious disease specialist from Lexington, Ky. “There are going to be multiple opportunities going forward to change and modify this law.”

Despite Carmel’s criticism of Congress, he said the AMA and its member doctors are happy the law will expand health benefits to more than 30 million uninsured Americans and eliminate hurdles to coverage such as a health plan’s ability to deny care to patients with pre-existing medical conditions.

 ”Doctors are pretty much pleased with the gains for patients that are in the health-care law,” Carmel added. “There is some great stuff in there. But we didn’t get our doctor issues at all solved.”<>



  1. jack (me) June 16, 2010 at 8:43 a.m.

    I see that you took down the other Chicago Breaking Business News story about the AMA being O.K. with health care reform, except for the reimbursement rates, to which I said it showed where the doctors’ interests really were.
    Their pocketbooks get mentioned again. I wonder how long this article will remain. Probably not more than 30 seconds after someone at the Tribune reads this comment, if anyone does.

  2. Chuck June 16, 2010 at 8:48 a.m.

    Talk about throwing stones at glass houses.
    The AMA should focus on cleaning their internal mess before trying to champion healthcare reform.

  3. hbr June 16, 2010 at 12:23 pm

    Why would congress care about an organization that only has 20% of the physicians in this country belonging to them?

  4. Ella June 16, 2010 at 12:38 pm

    @jack….sure, they only care about their pocketbooks. Whatever. I suppose they don’t get charged rent for office space, and they don’t have to pay staff. Oh, and all thise years of education was FREE. Let’s not forget the super-low malpractice insurance rates because no one EVER sues. Jack, stick to what you know best…which is nothing having to do with physicians. Go empty trash cans.

  5. Jake June 16, 2010 at 12:44 pm

    I don’t think the hippocratic oath read “First, get paid well; then do no harm.” Lets just be clear that all that the Dr’s in the AMA really care about is keeping what they have, good salaries. I agree that medical malpractice should be capped, but the only reason the Dr’s are fighting for this is so that they can keep more money. Do you really think that Dr’s would cut their rates for care if malpractice is capped? When patients go to a doctor, they don’t do comparison shopping, since most have insurance, and/or don’t think it will matter. I’m sure there are some honest doctors out there that are willing to sacrifice for the greater good, but they are few and far between.

  6. Chuck June 16, 2010 at 12:48 pm

    @ Ella – Jack is speaking about something he knows all too well. Please understand the AMA’s position in this whole deal prior to opening your yap!
    Ella, it looks like trash can detail is in order for you not Jack.

  7. MD June 20, 2010 at 12:21 pm

    The comments from jack show how little people know doctors or the business of medicine. As a doctor it took 9 years of training after college to get to this point, while my friends were buying houses, fancy cars I was on call all the time sacrificing nearly every hour taking care of my patients. When I got done with my training I didn’t even know how to bill my patients. The money I make is no where near what CEO of united healthcare, cigna, aetna, etc make. Many of the sales (device, medication, etc) reps who come to my office make more money then me. The rate cuts will ultimately affect everyone not just doctors as physicians in my position will have to cut overhead, see more patients, shorten time spent with patients and this will result in lower quality of care. No health insurance company has gone bankrupt and instead they continue to show record profits, while cutting services, raising premiums and paying less to healthcare providers.