First oncologist to serve as AMA president

On June 13, 2017, the delegates of the American Medical Association (AMA) voted for Barbara McAneny, MD, FASCO, MACP, as the organization’s president-elect, making her the first oncologist elected to serve in this leadership position. Her 1-year term as AMA president will begin in June 2018.

“On behalf of ASCO, I offer my congratulations to my friend and colleague Dr. McAneny,” said 2017-2018 ASCO President Bruce E. Johnson, MD, FASCO. “I am delighted that she has been elected to represent the entire physician community and certain that her broad expertise and insight on today’s challenging health care environment will greatly benefit the practice of medicine and our patients.”

Dr. McAneny, a medical oncologist and hematologist, is the CEO of New Mexico Cancer Center and New Mexico Oncology Hematology Consultants, LTD. She has been a member of the ASCO Board of Directors, president of the New Mexico Medical Society, president of the Greater Albuquerque Medical Association, and president of the New Mexico Chapter of the American College of Physicians. An ASCO member since 1985, Dr. McAneny previously served as chair of ASCO’s Professional Development Committee, editor of Journal of Oncology Practice, and as ASCO’s delegate to the AMA House of Delegates.

A nationally recognized leader in promoting high-quality, high-value cancer care, Dr. McAneny received a $19.8 million award from the Centers for Medicare & Medicaid Innovation (CMMI) to implement and test the COME HOME project, an oncology medical home model to help oncology practices provide higher quality cancer care at a lower cost.

She is a committed and experienced advocate for oncologists and oncology practices, testifying before the U.S. Congress on issues ranging from the impact of insurance company mergers, Medicare changes, and repeal of the Sustainable Growth Rate (SGR). She has also represented the AMA in negotiations with health plans to reduce administrative burdens on physicians.

In the following interview, Dr. McAneny discusses the issues on which she hopes to have an impact as AMA president.

Why did you run for AMA president?

BM: The health care system is neither working well for patients, nor for doctors. We clearly are in the process of trying to restructure health care on the national level. The health care changes in our system are going to affect every single specialty and every single doctor in every single practice setting. Therefore, taking it to the AMA, which represents every specialty society in every state, is a way to make sure we do not leave any patients or doctors behind.

What will it mean to have an oncologist as president of the AMA?

BM: Whenever a politician wants to cite an example of someone wronged by the insurance system, frequently they choose someone whose cancer could not be treated. Whenever people want to debate the high cost of pharmaceutical agents, they point at cancer. Whenever people are looking at the quantity of the health care resources spent, the debate becomes should we pay for cancer care or vaccinate children? Either we can have an oncologist who actually works in that setting, someone who lives it and breathes it, or we can have people who do not understand what we do using our specialty as examples. It is important to have the oncology voice speaking for our specialty and our patients.

You have described the American health care system as doing “a very good job of dividing doctors and keeping us relatively powerless as we fight over pieces of a decreasing pie.” Is that still true?

BM: Yes. As we move into more alternative payment methodologies, the payment that an oncologist receives for treating patients with cancer is going to be bundled—at least in terms of quality measurement and cost—with every other specialty: pathologists, surgeons, primary care doctors, radiologists, etc. We absolutely have to work together to make sure that every specialty can survive financially and does their job clinically. We have to make sure resources are distributed fairly among all the specialties. This is a huge job, and any specialty that is not at the table will likely be significantly left behind.

What are some of the issues you hope to address as AMA president?

BM: I want to help put physicians in the driver’s seat as we structure health care systems. We do not need health care systems that make hospitals or health plans richer. We need health care systems structured to take care of patients and appropriately reward the people who take care of patients. I see early-career physicians coming out of training with a dream that they think they cannot chase because they are saddled with huge amounts of debt. They were told they had to take a more lucrative specialty to pay that debt or are afraid to branch out and create an independent practice because of economic insecurity. I want any physician considering where they wish to practice to do it based on their interests and their personal preferences, not economic coercion. I want to help the AMA work toward creating a medical education system that prepares our students to work in team-based systems for the 21st century. We have to figure out a better way to pay for graduate medical education and research. The people working in the lab are unable to get the multiyear grants they need to make a difference.

How will your past advocacy experience serve you in your new role?

BM: Advocacy is taking care of patients not just one at a time, but trying to get to the root cause of the problem. I learned early on that when doctors stand together for the greater good of the patient, we are an impressive force. The tobacco industry has lost huge amounts of ground because doctors were willing to stand up and spend their time going to city councils, state legislatures, and various governmental entities to make their voices heard. We have a responsibility as physicians to look at the systems that are making people sick and see if we can rearrange those systems in a way that helps us keep those patients healthier.

How do you define a successful health care system?

BM: The canary in the coal mine for a health care system that either works or fails people is poor patients with cancer. A system that works properly will take poor people who have an urgent need for care, get them into a system, and get them what they need. I do not believe that any American should have to decide whether they are going to buy food for their kids or whether they are going to pay an insurance premium in fear that they will be thrown off their plan and never insured again. Patients with cancer, because their need is so acute, are the litmus test for whether or not a health care system can really deliver what it promises.

Interview conducted by Jack Lambert, staff writer; adapted and reprinted with permission from 2017 ASCO Daily News.