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CHICAGO -- Jack Resneck Jr., MD, conveyed a message of hope, progress, and unity in his final speech as American Medical Association (AMA) president, but without ignoring "very real" threats to the profession.

During the AMA House of Delegates (HOD) meeting Friday, he quipped "You got to hear from 'angry Jack' back in November," referring to his speech on the AMA confronting bullying politicians at an interim meeting. This time, he pledged not to spend the whole of his speech "dwelling on the very real, very dangerous external attacks engulfing our profession."

Nonetheless, Resneck said he still has serious concerns about the country's divisiveness and the future of the profession. "Only 57% of doctors today would choose medicine again, if they were just starting their careers," he stated, noting that this is more than just "daydreaming" of another job -- roughly two in five physicians wish they'd never chosen the profession at all.

Resneck blamed the increasing level of burnout on disinformation, payment cuts, administrative burdens, and state courts interfering with the patient-physician relationship. He also expressed disappointment in the lack of momentum to address gun violence: "Preventable and needless homicides and suicides continue and the political inaction is atrocious."

On a more hopeful note, he referred to his inaugural speech, and the story of a "casual runner" from Cleveland who mistakenly ran the Cleveland marathon instead of the 10k race she registered for. That is the "perfect metaphor" for physicians called to a healing profession, but experiencing a completely different reality, he said. Resneck added that physicians are "darn good" at persevering no matter the odds, whether it's continuing to have the quit conversation with a chronic smoker or addressing a vaccinate-hesitant parent.

He said that same "tenacity" extends into physician advocacy work, such as tackling medical misinformation, attempting to fix a "broken Medicare system," or pushing back against "obnoxious prior auth[orization] abuses" when insurers delay and deny needed care. Also, fighting the threats of lawmakers who want to dictate treatments and medications.

He called out political leaders for "fueling fear and sowing division" while also vilifying public health officials, transgender adolescents, and physicians who support anti-racism work and abortion rights.

"It's not about science," he said. "Interfering with the sacred patient-doctor relationship is about control."

In the marathon of medicine, physicians may find themselves out of breath, their stamina flagging, Resneck noted. He encouraged physicians to envision the race as a relay, perhaps even the Olympic torch relay, where a flame passes from person to person "protecting something far bigger than any one individual or any one leg of the course."

"Even when there are temporary setbacks, our common cause is to speak out for and to advance our flame, our ethical values and our common purpose," he said.

On the progress front, Resneck noted that the top pillar of the AMA Recovery Plan is to to ensure the sustainability of the profession. The association took an "important step" forward with the reintroduction of a bipartisan bill linking physician payment updates in Medicare to inflation, he said.

Also, AMA advocacy at state and federal levels helped preserve Medicare telehealth expansions, stopped state by state, and helped rein in prior authorization abuses.

At the FDA, the AMA helped make Naloxone available over-the-counter (OTC), and is continuing to push for OTC oral contraceptives. It also supported and lobbied for changes the FDA made to outdated restrictions around blood donations for men who have sex with men.

The association was "instrumental" in the development of and the elimination of questions about "past impairment" from licensing and credentialing forms, he pointed out.

As for the AMA litigation center, it has been "very, very busy," on multiple fronts, Resneck added: Suing Cigna for of physicians, advancing a menthol cigarette ban, and halting court-mandated "substandard care," such as when the Wisconsin Supreme Court tried to force physicians to for COVID-19.

He thanked the Texas Medical Association for its help eliminating parts of the "No Surprises Act," which he said unduly favored insurance companies. And Resneck credited AMA advocacy, in part, for a federal appellate court ordering an on a lower-court ruling that would have stripped patients' rights to access some preventive care services with no out-of-pocket costs.

Finally, he lauded the Supreme Court for blocking -- at least for now -- "attempts by a single district judge with no scientific or medical training" to take mifepristone off the market.

Resneck closed by addressing the medical students and young physicians in the room who might be questioning their career choice -- "Please do not ever lose your passion for humanity and healing" -- and reminding all of the delegates of the privileges and responsibilities of the profession.

"There is no time to waste," he said. "Our patients are depending on us to continue this fight. We will not let them down."

New Leadership

an otolaryngologist and president of Kentuckiana Ear, Nose & Throat in Louisville, Kentucky, was voted AMA president-elect by acclamation (there were no other candidates) at the close of the Friday session. Scott is the current AMA HOD speaker.

Ob/gyn of Paragon Women's Care in Dayton, Ohio was voted HOD speaker-elect by acclamation. She is the current HOD vice speaker.

The four candidates for HOD vice speaker are:

• , of the University of South Florida Morsani College of Medicine in Tampa
• , of Henry Ford Health in Detroit
• , an anesthesiologist in Chicago
• , of Mass General Brigham in Boston

Elections will take place on Tuesday.

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