Peter Carmel, MD, Elected to the AMA Board of Trustees
The June 18 election of AANS member Peter Carmel, MD, to a four-year term on the American Medical Association Board of Trustees occurred at a felicitous moment for neurosurgery.
The professional liability insurance crisis is intensifying-particularly for specialties-while at the same time Medicare reimbursement is declining, combining in what some have termed medicine’s “perfect storm.” Dr. Carmel’s election amplifies neurosurgery’s concerns within the voice of medicine and adds considerable ballast to neurosurgery’s endeavor to right the ship and reverse the trend of declining patient access to specialty care.
“The liability crisis is our number one priority,” he stressed. “We need to get that message out. We need to tell the public that their medical system has been corrupted…If patients see that the liability crisis affects them, then they will be willing to be our allies.”
Dr. Carmel cited the turnaround of HMO proliferation in the 1990s, fueled by public opinion and the negative experiences of many individuals, as an example of how “the public is always medicine’s best ally.” On a related note, he acknowledged the role of the media in the process. “The media can be our friend if we give them the right message,” he said.
His election concludes his 17 years of advocacy in the AMA’s House of Delegates and heralds a new day at the AMA.
“I believe the AMA will evolve in the next five years into an organization of organizations,” said Dr. Carmel. “If that happens, the AMA will start to represent a majority of America’s doctors.”
As a delegate Dr. Carmel worked within the AMA to give specialties like neurosurgery an equal voice. “Neurosurgeons in general have had a jaundiced view of the AMA, perceiving it as a captive of medical types,” he explained. His work to modify the AMA’s structure, particularly on the Specialty and Service Society and as chair of the Council on Long Range Planning and Development, helped “create parity in representation for specialty societies and states” and “set the stage for change in the AMA.”
He credited the facts that a neurosurgeon was elected to the board and that he is the eighth surgeon and the eleventh proceduralist of 19 board members as further evidence of a changing AMA.
Dr. Carmel’s election also celebrates the spirit of advocacy awakened in neurosurgeons. In an open letter thanking organized neurosurgery and individual neurosurgeons for their support in achieving his election, he said:
The CNS and the AANS provided the bulk of the financial resources and this was generously supplemented by the CSNS. The Senior Society members were extremely effective with their phone calls to delegates, as well as calls made by members of the CSNS and other neurosurgeons around the country. This sort of direct local contact was a unique experience for most of the delegates.
Dr. Carmel praised the leadership of the AANS through the Washington Committee as being increasingly effective in lobbying and forming coalitions for neurosurgery in Washington, D.C.
“Neurosurgery has become more politically sophisticated and more proactive over the last 25 years,” he said. “We really have come light years through the Washington Committee, brought along by the leadership provided by AANS.”
The first neurosurgeon in more than 20 years to serve on the AMA Board of Trustees, Dr. Carmel brings a perspective as a practicing pediatric neurosurgeon to the table. He is professor and chair of neurological surgery at New Jersey Medical School.
“Neurosurgery has so much to give medicine,” Dr. Carmel summarized. “The AMA must have a different attitude toward policy and what it speaks out on; neurosurgeons have to look at the AMA as a vehicle to carry forth neurosurgery’s concerns.”
Manda J. Seaver is staff editor of the Bulletin.