CHICAGO — The first openly gay man to lead the American Medical Association takes the reins at a frightening time for American healthcare.
Transgender patients and those seeking abortion care face restrictions in many places. Physicians’ medical judgment is being overridden by state laws. Misinformation is rampant. And the nation isn’t finished with COVID-19.
In the two decades since Dr. Jesse Ehrenfeld first joined the AMA as a young medical resident, the nation’s largest physicians’ group has tried to shed its image as a conservative self-interested trade union . While physician pocketbook issues remain a major focus, the AMA is also a powerful lobbying force for a range of public health issues.
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Two years ago, the AMA won widespread acclaim for announcing plans to eliminate structural racism within its ranks and the American medical establishment. It has adopted policies that emphasize health equity and inclusivity—moves that have led critics to accuse it of “awareness.”
At 44, Ehrenfeld will be one of the youngest presidents of the AMA when he begins his one-year term on June 13. An anesthesiologist, Navy combat veteran and father of two young children, he recently spoke with The Associated Press about his background and new job.
The conversation has been edited for clarity and length.
Q. Why is it a big deal for you to be part of the LGBTQ community and how will it inform your role as AMA president?
A: I didn’t run as a gay man. It is not my platform, but it is a part of my identity. And people know this.
Representation and visibility is very important. I can’t tell you how many emails, letters, phone calls, text messages I received when I was selected in this role from people all over the world who saw this as an important moment, an important recognition of what should be inclusivity and equality To help advance health equity for everyone.
Q: How will your experience as part of the LGBTQ community inform and influence your new role?
A: I have experienced the health care system as a gay person, as a gay parent, in many ways as wonderful positive experiences and in other ways, some deeply hurtful experiences. And I know we can do better as a nation. We can do better as a system that elevates health. And I look forward to opportunities during my year as president to shine a light on that.
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Question: What are examples of those experiences?
A: There are times when our healthcare system does not accommodate people who are not the majority. As a gay parent and a gay dad, I can’t tell you how many forms I’ve filled out where there’s room for mom and there’s room for dad. It’s a small thing. But it is a sign that we are different and perhaps we are not welcome or accepted.
When you have those small, subtle irritations that add up day by day, whether you’re an LGBT person or from a minority group, that causes stress. These friction points … are apparent to so many people who are in underserved communities, so many in the LGBT community, and especially transgender individuals. And I know we can do better.
I have been fortunate enough to be able to bring two beautiful boys into this world with the support of an incredible group of physicians. But there were definitely a lot of moments along the way where it was clear we were a little different from everyone else which didn’t need to be.
Q: This seems an unprecedented time for political interference in medicine.
A: I am very concerned about government interference in decision making for patients. The Supreme Court ruling regarding abortion has had profound implications for reproductive rights. And fundamentally, patients have a right to access evidence-based health services. This includes comprehensive reproductive health care. This includes care for transgender people.
States that ban abortion, that ban healthcare for transgender youth, are fixing the government in the patient-doctor relationship. And we know it leads to devastating health consequences and can be life-threatening. The AMA continues to speak out against these types of actions.
Why: What power does the AMA really have to protect those rights?
A: I don’t think we are powerless at all. The AMA was deeply involved in providing guidance to the Biden administration to help physicians and patients understand that you are not required to disclose private medical information to third parties. And we will continue to call for things like unrestricted access to mifepristone (the abortion drug).
Why: Are you discouraged by the number of states that seem to be jumping on this bandwagon?
A: I’m an optimist. There are specific political divisions that are still different. The attack on science, the attack on following the evidence to care, is new. Globally, this has accelerated during the pandemic, but rampant misinformation, misinformation – all of these challenges are things that I know we can overcome. For this AMA needs to raise our voice and not give up.
Why: Will addressing the nation’s mental health crisis be part of your role?
A: We need Congress to act. It’s been 15 years since healthcare companies repeatedly failed to comply with a landmark law in 2008 around mental health parity and substance use disorder.
That law passed by Congress was never implemented. Those violations remain more severe than they were a decade ago.
It affects patients with autism. It affects patients with eating disorders, substance use disorders. It delays care. Patients are being harmed by this.
And we are potentially causing deaths that are avoidable. We know there are federal actions that can be taken to help, including enabling patients to recover damages associated with the denial of improper care.
The other aspect around mental health access that is really important is the sustainable expansion of access to telehealth.
Q: Critics have long said that the AMA is primarily a self-interested trade group. What kind of fallacy is this?
A: We have a very simple message, and that is to advance the art and science of medicine for the betterment of human health. And that’s why we care about things like climate change and health equity.
We have to ensure that there is joy in the practice of medicine. We must ensure that our health care systems reward and support and allow practices to flourish.
And you see boneheaded decisions like the fact that physicians got a 2% pay cut from Medicare last January as opposed to an inflation update. Those are the things that matter. They are financial.
But without advocacy in those areas the practices will stop. Medicare patients will not have a doctor to see. And we simply cannot allow this to happen.