Trusted Leader - June 2009
Tex Med. 2009;105(6):47-50.
By Larry BeSaw
When Jim Rohack, MD, is sworn in as the American Medical Association's president in Chicago later this month, it will mark the second time he's taken a presidential oath for the medical profession. He's already served as the Texas Medical Association president during 2000-01.
He'll face challenges on numerous issues as the AMA leader - health system reform, Medicare fees, national liability reform, the push to improve quality, and the future of the AMA itself. But he's not ducking them and has no second thoughts about raising his right hand to take the oath of office.
"I think it clearly shows that sometimes when you're in challenging times it's good to have someone who's had a lot of experience in a leadership role," he said.
Experience indeed. You might say he grew up in organized medicine, starting as a medical student. (See " An Impressive Record .")
Texas Medicine interviewed Dr. Rohack as he prepared to become the AMA's newest president.
Texas Medicine: What will be your priorities as AMA president?
Dr. Rohack : Clearly, we've got to get Congress and the administration aligned. We recognized that a few years ago when we had a president who was for national tort reform, we had a House of Representatives that was for national tort reform, but we had a Senate that kept blocking it.
Texas Medicine : Do you have some specific issues in mind?
Dr. Rohack : I'll be focusing on four things. They are care for the uninsured, the unreality of the Medicare Sustainable Growth Rate (SGR) formula for physicians, improving the value we get for what we spend in health care dollars, and prevention and wellness.
Texas Medicine : What do you mean by value?
Dr. Rohack : Value is the equation where you can look at quality plus safety, divided by cost. If you just focus on reducing cost and you don't look at the quality equation, you may not get what you need.
On the other hand, we recognize that we're going to have to do something on cost as a profession. We can do that by creating and following evidence-based guidelines. We've signaled to the White House that usually the Democratic Party is not pro-tort reform, but here's a situation that if we don't have some liability protection so that if we follow the guidelines and don't order a particular test, that we're not going to be sued later because we didn't do it. Then doctors won't stop practicing defensive medicine, and there won't be significant cost savings.
Texas Medicine : Is there any reason for optimism that Congress will finally replace the SGR with a Medicare payment system that's fair to physicians?
Dr. Rohack: Luckily we've been talking about it long enough that the president put in his budget $333 billion specifically to fill the hole that the SGR has created. No other president has done that, so now the ball is back in Congress' court. It needs to fill the hole if we're going to move forward on Medicare.
Texas Medicine : Are you optimistic as well about the outcome of the health care reform debate?
Dr. Rohack : For the first time in a long time, you have people who are willing to listen to try to find solutions. Unfortunately, our political process is such that we have folks in the Senate and House of Representatives who have been working on this for a long time but nothing has happened. Now we have a president who has come in and made health care reform part of the economic recovery.
From a physician standpoint, the big difference is we have had access to the highest levels of the administration to help provide input and they appear to be listening, as opposed to the last attempt at health care reform back in the '90s where it was a closed shop of policy wonk people. I'm optimistic because you have economic people also indicating health care and coverage for all, at least for basic benefits, as being important for the economic viability of America.
Texas Medicine : You mentioned prevention and wellness. What do you plan to do in that area?
Dr. Rohack : Part of that is to highlight the real problem we have with the ethnic and racial disparities. I'll be the first AMA president from UTEP, and the incoming president of the National Medical Association, Dr. Willarda Edwards, also is a UTEP graduate. If you remember your history, in 1966 UTEP was known as Texas Western and was the first school to win the national basketball championship with five black starters.
Understanding that UTEP helped break down racial barriers, we both decided that the synchronicity of us being presidents at the same time would allow us to highlight the issue of ethnic and racial disparities. It's important and needs to be solved. We'll look for opportunities to address that. In the first week of September, Dr. Edwards and I will go back to El Paso to talk about the importance of education so that we have a diverse workforce and keep kids in school, and give them the opportunity to advance, especially the underrepresented minorities.
Texas Medicine : The AMA membership in Texas is not where AMA would like it to be. One of the problems is that many physicians rely on their specialty society to speak for them nationally. Is there anything you can do to encourage more Texas physicians to join AMA?
Dr. Rohack : When Texas physicians look at their membership dues, they ask if they are getting value for those dues. My response is that $420 is an investment to make sure AMA, as well as TMA, is strong so that when we go to Congress we have the numbers behind us. We will battle for the profession but we're up against the unified hospital front, a unified insurance front, and certainly the government.
If you're loyal to your specialty and let your specialty be your national voice, that is the same problem Babylon had with many tongues. Each specialty has its own unique desires and when Congress hears that cacophony of voices, it just says, 'Medicine doesn't know want it wants' and ignores it all. TMA has been very powerful in Austin but as TMA goes to Washington, when we look at our votes, we only have two senators and we don't have the largest number of representatives, so we still have to work with coalitions. The strength of our medical profession is to have a national voice that speaks for all doctors. I still firmly believe that the stronger the AMA is, the better the care for our patients will be because we'll be speaking with one voice.
Larry BeSaw can be reached by telephone at (800) 880-1300, ext. 1383, or (512) 370-1383; by fax at (512) 370-1629; or by e-mail at Larry BeSaw .
An Impressive Record
Temple cardiologist Jim Rohack, MD, brings a long history of involvement in organized medicine to the American Medical Association presidency.
He started as a member of the TMA Medical Student Section, then progressed to membership in the resident and young physician sections, chair of the TMA Council on Medical Education, a member of the Board of Trustees, and, finally, its president.
His AMA involvement is equally impressive. He was a TMA delegate to AMA, member of the AMA Council on Medical Education, and the AMA representative to the Liaison Committee on Medical Education, the Accreditation Council on Continuing Medical Education, the Liaison Committee for Specialty Boards, and the steering committee of the Federation of State Medical Boards Convened Summits on Assessment of Physician Competency. He has been a member and thenchair of the AMA Board of Trustees and chaired both the AMA board's Executive Committee and the Organization and Operations Committee.
Finally, he has served as treasurer of the board of commissioners of the Joint Commission, chaired the National Advisory Council to the Agency for Healthcare Research and Quality, and is one of the principals of the Hospital Quality Alliance.
A senior staff cardiologist and board-certified cardiologist at Scott & White Clinic in Temple , Dr. Rohack is actively involved in patient care as the director of the Center for Healthcare Policy and the medical director for system improvement of Scott & White Healthcare. He's also professor in both the medicine and humanities departments at Texas A&M Health Science Center College of Medicine.
Dr. Rohack, who is a fellow of the American College of Cardiology and the American College of Physicians, has also served on the Bush School of Government & Public Service Advisory Board, The University of Texas M.D. Anderson Cancer Center Executive Advisory Panel, the Texas A&M University System Health Science Center School of Rural Public Health External Advisory Committee, and on the board of directors of the American College of Cardiology, Texas Chapter.
Born in Rochester, NY, Dr. Rohack received his BS degree with highest honors from The University of Texas at El Paso (UTEP) and his medical degree with honors from The University of Texas Medical Branch (UTMB) at Galveston. He received the Ashbel Smith Distinguished Alumnus award from UTMB in 2000, the distinguished Alumnus Golden Nugget Award from the UTEP College of Liberal Arts in 2002, and the Distinguished UTEP Alumnus Award in 2008.
Dr. Rohack lives on a small ranch near Bryan that also serves as a wildlife rescue, rehabilitation, and release facility directed by his wife, Charlotte. They have one daughter.
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