CHICAGO — The first openly gay person to lead the American Medical Association at the helm of the American healthcare industry at a difficult time.
Transgender patients and those seeking abortion care face restrictions in many places. Medical judgments by doctors are being overridden by state law. Misinformation is rampant. And the country is still not over with COVID-19.
In the two decades since Dr. Jesse Ehrenfeld first joined the AMA as a young resident, the nation’s largest group of doctors has tried to shed its image as a self-interested trade association. conservative. While physician pocket issues remain a major focus, the AMA is also a powerful lobbying force for a wide range of public health issues.
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Two years ago, the AMA won critical acclaim when it announced plans to eliminate structural racism within its ranks and the US medical establishment. It has adopted policies emphasizing equity and inclusive health – moves that have inspired critics to accuse it of “waking up”.
At age 44, Ehrenfeld will be one of the AMA’s youngest presidents when he begins his one-year term on June 13. An anesthesiologist, Navy veteran and father of two young children. , he recently spoke to the Associated Press about his resume and new job.
The conversation has been edited for clarity and length.
Q. Why is being part of the LGBTQ community such a big deal at this point and how will that affect your role as AMA president?
A: I am not running as a gay man. It’s not my background, but it’s part of my identity. And everyone knows that.
Representation and visibility are very important. I cannot tell you the number of emails, letters, phone calls, text messages I received when I was elected to this role from people around the world who saw this as a pivotal moment. , an important recognition of what inclusiveness and equality can be to help promote equity in health for all.
Q: How will your experience as part of the LGBTQ community inform and influence your new role?
ONE: I have experienced the health care system as a gay person, as a gay parent, in many ways wonderfully positive experiences and in other ways some deeply harmful. And I know that we can do better as a nation. We can do better as a system that can promote health. And I hope that there will be an opportunity to shed light on that during my year as president.
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Q: What are examples of those experiences?
ONE: There have been many times when our health care system has failed to meet the needs of the non-majority. As a gay parent and gay father, I can’t tell you how many forms I’ve filled out, including one for mom and one for dad. That’s a small thing. But it is a signal that we are different and that we may not be welcomed or accepted.
When you have small, subtle frustrations that build up day in and day out, whether you’re LGBT or a minority, it causes stress. These points of friction… are clear to so many people in the underserved community, so many in the LGBT community, and especially to transgender people. And I know we can do better.
I have been fortunate to have two beautiful boys born into this world with the support of an incredible team of doctors. But there were definitely a lot of moments along the way where it was obvious that we were a little bit different from everyone else in a way that wasn’t necessary.
Q: This seems to be an unprecedented time for political intervention in medicine.
ONE: I am deeply concerned about government interference in patient decision-making. The Supreme Court’s decision on abortion has profound implications for reproductive rights. And fundamentally, patients have access to evidence-based healthcare services. That includes comprehensive reproductive health care. It includes care for transgender people.
Countries that ban abortion and healthcare for transgender youth are placing governments in the relationship between patients and doctors. And we know that this leads to serious health consequences and can be life-threatening. The AMA continues to speak out against such actions.
Ask: What power does the AMA really have to protect those rights?
ONE: I don’t think we’re helpless at all. The AMA has been deeply involved in helping the Biden Administration come up with guidance to help doctors and patients understand that you do not have to disclose personal health information to third parties. And we will continue to call for things like unrestricted access to (the abortion pill) mifepristone.
Ask: Are you frustrated with the number of countries that seem to be jumping into this group?
ONE: I am an optimist. There are different specific political divisions right now. The attack on science, the attack on tracking evidence to provide care is new. Globally, it’s picked up pace during the pandemic, but misinformation, misinformation is rampant – all of those challenges are ones I know we can overcome. It requires the AMA to speak up and not give up.
Ask: Is addressing the nation’s mental health crisis part of your role?
ONE: We need Congress to act. Fifteen years on, healthcare companies have consistently failed to comply with the landmark 2008 law on mental health and substance use disorders.
That law passed by Congress was never implemented. Those violations continue to be more severe than they were a decade ago.
It affects patients with autism. It affects patients with eating disorders, stimulant use disorders. It delays care. It is harming the patient.
And we have the ability to cause avoidable deaths. We know that federal action can be taken to address this, including allowing patients to recover for losses related to improper denial of care.
Another aspect around mental health access that is really important is the permanent expansion of telehealth access.
Q: Critics have long said that the AMA is primarily a self-interested commercial group. How is that a misconception?
ONE: We have a pretty simple message, which is to advance the art and science of medicine to improve people’s health. And that’s why we care about things like climate change and things like health equity.
We must ensure that there is joy in the practice of medicine. We must ensure that our healthcare systems reward, support and enable practices to flourish.
And you consider silly decisions like Medicare taking a 2% pay cut this past January instead of an inflation update. Those are the important things. They are financial.
But without support in those areas, the practice closes down. Medicare patients will not have a doctor to see. And we’re just that we can’t allow that to happen.
