The necessity of physician leadership: Q&A with AMA's new president-elect

Bobby Mukkamala, MD, an otolaryngologist from Flint, Mich., who was recently named president-elect of the American Medical Association, joined Becker's to discuss the importance of physician leadership and his vision as an AMA leader.  

"I'm excited to have the opportunity to help improve medicine beyond just taking care of the otolaryngology needs of my patients here in Flint, but actually be in a position to be able to help healthcare in general," Dr. Mukkamala told Becker's. "It's an exciting opportunity."

Editor's note: This response was edited lightly for clarity and length. 

Question: What has kept you engaged with the AMA for so long?

Dr. Bobby Mukkamala: The state of healthcare in this country is not as good as what I think it should be in multiple aspects. Everything from the fact that we have to request prior authorization 10 times a day for helping to take care of patients to the rate of perinatal mortality — the fact that we're dragging behind a lot of the developed part of the world is concerning. Also, the fact that we spend so much more than anybody else on the planet for healthcare and yet have to deal with obstacles like the expense of prior authorization. Our poor public health performance means that there's a lot of work to be done. That's kept me engaged — the nature of that work and trying to be part of the solution. I never really enjoyed witnessing somebody who complained but then didn't do anything to improve, and I don't want to be that person. So it's nice to be in a position to try to improve. 

It's an exciting time relative to what we spend on healthcare in this country — which is more than $4 trillion a year — and what we get as far as metrics with our performance relative to the rest of the developed world. There's a big gap. I'm excited for the opportunity to talk about how when we put physicians at the center of those conversations and where those decisions get made, that's how those metrics will get changed. That's how we start to get more for what we pay for healthcare in this country. 

Q: How are you staying optimistic about the practice of medicine? 

BM: There's nothing more gratifying than helping a patient in need. What's interesting is that when I go and I talk about all of my concerns regarding healthcare and physicians, and then I come back to Flint and I see a patient who we've cured of cancer, it is reinforcing that work. My goal is to make sure that we have more stories with happy endings as opposed to delays in diagnosis of cancer due to waiting for things like prior authorization, all of which we've seen.

In Michigan, with the help of the American Medical Association, were able to pass a law to revise how prior authorization is done in the state, the Health Can't Wait initiative. Now, there are stories of success in dealing with these headwinds that I see as motivating to continue that work, because solving it in Michigan means that there's other states that need to emulate that solution. When we solve it in one state, we can use the story of that state to make the case for looking for that same solution in these other states. 

Q: Can you characterize the importance of physicians having leadership roles?

BM: It's critical that we have physicians in leadership roles. We have three area hospitals here in the Flint area, and when I see the decisions that get made in the absence of physician input, I more often than not question the logic behind it and the long-term consequences of it. 

This is my 24th year in practice in Flint. I've seen CEOs of all three hospitals come and go every several years for the past 24 years. That's a lot of CEOs to go through. And yet here we are as the physicians in this community that have been here for more than two decades and taking care of the patients. We shouldn't be disconnected from where those decisions get made because a lot of these decisions that CEOs are making, physicians tried 15 years ago that worked in some respects and didn't work in other respects. That is critical information so we're not constantly reinventing that wheel. In the absence of physician input, that's exactly what happens in the C-suites. That wheel just gets reinvented.

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