Dear friends and colleagues
I was honored by the AMA House of Delegates in June of 2,018 when I was elected to be a trustee of the AMA, and now have completed my term of office. I have honored that vote by diligently keeping abreast of any and all developments that affect the practice of medicine and the health care system our patients depend on. I take very seriously the issues that affect the lives of all physicians across the country and our patients. The past few years have been very difficult for public health and the practice of medicine, straining many practices and in fact leading some to close. As of now over 1,000,000 patients in the USA alone have died from Covid-19, a horrendous loss of life. Many families are grieving for their loss, and many physicians are traumatized from the daily stress of caring for these patients. We need to aid and nurture these physicians and practices under both financial and emotional strain. In addition, many of our longstanding problems still need to be addressed. Physicians are still having a difficult time dealing with insurance companies and especially prior authorization, deal with high pharmaceutical costs for their patients, government dysfunction, and ever-increasing care issues. Political interference in the patient-physician relationship must be vigorously resisted: a women’s health care decisions must be between the patient and her physician. It is No wonder 50% of physicians feel burned out. I will remain actively engaged on these important issues that affect physician practices and the health care of our patients. Preserving health care delivery and the practice environment are challenging in the current times. We need to work together to make our health care perform to the best of its ability for the sake of our patients and lessen the huge strain on our health care professionals.
Mario Motta has been on the Board of Trustees of the AMA from 2018 to 2022. He has been active in organized medicine and the AMA since medical school at Tufts University in Boston. A member of the AMA House of Delegates since 2003, Mario served eight years on the AMA Council on Science and Public Health (CSAPH), and was vice chair of the Massachusetts AMA delegation. Dr. Motta was president of the Massachusetts Medical Society (MMS) in 2009-10. He dealt with myriad issues regarding the health care delivery system, health insurance, scope of practice, young physician engagement, and burnout. As chair of the MMS Committee on Legislation, he was intimately involved with Massachusetts health care reform, resulting in the state having the lowest rate of uninsured residents in the United States. His reports on outdoor lighting have led to a revolution in the lighting industry. The AMA continues to receive great praise for this effort, with many cities specifically citing the AMA report in choosing their outdoor lighting as being “AMA compliant.” He is board-certified in cardiology and nuclear cardiology, was director of cardiology research for his practice, and is a clinical professor of medicine at Tufts University.
Mario is well known as an astronomer. Working with the American Association of Variable Star Observers, Harvard–Smithsonian Center for Astrophysics, and MIT, he has numerous observations and publications. In 2013, the International Astronomical Union named an asteroid in his honor. (asteroid 133537mariomotta) In the astronomical community, Dr. Motta is well known for his large and completely homemade telescope and observatory including the optics, a 32-inch f6 telescope.
COVID-19, a health crisis
Covid-19 has led to over 1,000,000 deaths in the USA alone to this point. These were preventable deaths, the COVID vaccines are safe, effective, and lifesaving. It is a national tragedy that so many Americans have lost their lives from this public health crisis. Over 550,000,000 doses have been given, and 214 million fully vaccinated, these people are doing well. Very few have died once vaccinated (mostly those with a history of being immunocompromised). This is now a disease of the unvaccinated, and in my hospital those are the only ones still being admitted with COVID, and unfortunately dying from it. Don’t be a statistic and leave a grieving family, PLEASE get vaccinated. Protect yourself and your loved ones.
We must confront these important issues which affect the practice of medicine:
Insurance, Practice, and Burnout issues
Maintaining a practice in the current environment is a monumental burden on physicians, leading to burnout or worse. Already, it is untenable in many locations for new physicians to set up an independent practice due to over-regulation, abusive insurance contracts, and Medicare rules. Insurance companies exert unjust control over our profession with prior authorization being particularly bothersome. MORE ON INSURANCE
The cost of a medical education is a national embarrassment and a career burden on young physicians. These high costs lead to years of debt on physicians’ income, limiting their ability to set up practices or innovate, or in some cases choosing their preferred specialty. Though 1000 new residency slots now added over the next few years, nearly 2000 graduating students did not match in 2022, more is needed. CME and MIPS a serious problem for physicians MORE ON Medical Education and CME
Our patients cannot afford their medications, which is a leading cause of noncompliance and poor clinical outcomes. Numerous studies have shown that the high price of even generic medications leads some patients to skip doses or discontinue altogether. Big Pharma needs to be held accountable, especially for the indefensible and absurd rising generic drug prices. New patented medications should of course give a healthy rate of return to encourage innovation, but the current trend is not to charge a reasonable rate of return, but rather to charge absurdly high prices straining our health care system. This is all the more outrageous when you consider most of the very expensive newly patented medications basic research was funded with tax dollars. The prohibition on Medicare negotiation is the most urgent priority that needs to be fixed in Washington. MORE ON PRESCRIPTIONS
A PATIENT EXAMPLE OF PBM & PHARMA ABUSE
Outdoor Street Lighting, Glare, and Circadian Rhythm Disturbance: human health and environmental effects.
It is now well established that lighting can effect both human health through circadian rhythm disturbance, and the environment though light pollution. I am happy to say that the AMA has had a beneficial and significant impact by two reports, light pollution: adverse health effects of nighttime lighting (2012), detailing the adverse health effects on human health and the environment, and Human and Environmental effects of Light Emitting Diode (LED) Community Lighting (2016). this last report has led most cities in the US and across the globe to reject 4000K lighting in favor of 3000K lighting, and thus changed and averted major environmental damage. these are available for review and downloading with a number of scientifically published peer reviewed papers.
New: IES (Illuminating engineering society), now has changed its guidelines. Their new new Illuminating Engineering Society roadway and parking lot standards document: RP-8-18 has now come to be more consistent with AMA recommendations, which were published well before the IES changed its recommendations.
NEW: UN report on light pollution issues
Final UN report on light pollution and human health I was involved with has been submitted to the general assembly, hopefully this will lead to international cooperation, and.. The UN recommendations are consistent with AMA policy !!