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
Tribune.

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.”

bjapsen@tribune.com<mailto:bjapsen@tribune.com>