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In his farewell address, Jesse M. Ehrenfeld, MD, MPH, outgoing president of the American Medical Association (AMA), described his fight for a more equitable, stable healthcare system, and a medical society that's grown more inclusive over the past quarter-century.

Looking back on why he had taken on a role that required so much time away from home -- he and his husband have a 5-year-old and a 17-month-old -- Ehrenfeld concluded that, in a world where the risks to patients and the burdens on physicians are ever growing, and the tide of misinformation and mistrust is unrelenting, the challenges to healthcare were too much for him to look away.

"This is my fight," he said.

During his speech at the AMA's annual House of Delegates meeting on Friday, he talked about the AMA's work to improve health disparities.

He recalled how he and his husband, Judd Taback, donated blood for the first time last fall. The FDA had lifted a ban on gay men donating blood that May -- a change that the AMA had advocated for years, he said.

He also described a meeting with the Old North State Medical Society -- one of the oldest medical societies for Black physicians in the country -- which had weighed on him when he first agreed to it, because of the AMA's long history of discrimination. Yet, Ehrenfeld found he was proud to share the association has done to tackle health disparities, diversify the physician workforce, and to "right past wrongs," he said.

In addition, he pointed to improvements to mental health parity, including the AMA's contributions to a proposed rule that ended "a 16-year battle with insurance companies" that, for years, evaded a 2008 parity law.

"A new rule will finally put some teeth into this law, and make it much easier for patients to access the mental health care they need and for physicians to be appropriately compensated for the care they provide," he said.

Ehrenfeld also spoke about the AMA's efforts to address the nation's drug overdose epidemic through policy changes, and highlighted the first decline in overdose deaths in 5 years as "a welcome sign of progress in this long and deadly battle."

Since beginning his presidency, Ehrenfeld said he has taken pains to educate others about how the AMA has changed since 2001, when he first joined.

"We've become a more inclusive organization, a courageous ally to many -- including myself -- who had faced prejudice or discrimination simply because of who they are, where they were born, or what they believe in," he said. "Although the pace of change can be frustratingly slow, I want to assure you tonight that we are making meaningful progress and we are being recognized for lending our powerful voice to the cause of equity and justice."

Ehrenfeld also underscored the AMA's top priority, Medicare payment reform, which he said threatens the sustainability of physician practices, patient access to care, and the pipeline for future physicians.

"Thanks to our AMA's comprehensive , multiple hearings, media visibility, grassroots outreach, and extremely persistent lobbying efforts, there is now broad acceptance that the current Medicare payment models do not work. And there is growing support in Congress for Medicare reforms aligned with our models that seek to put physicians on equal footing as everybody else in healthcare," he noted.

He further highlighted perennial concerns, such as scope-of-practice expansion challenges and prior authorization, citing positive advances on both fronts.

Despite the onslaught of legislation from optometrists who want to perform eye surgeries and naturopaths lobbying to prescribe medication, the AMA helped eliminate 100 such bills last year and dozens more in 2024, Ehrenfeld said.

As for prior authorization, he saw sunlight in this area as well, with the news that UnitedHealthcare and Cigna both shrunk their volume of prior authorization requirements by 20%, and the release of a final rule from CMS that will reduce decision times for all government-regulated health plans.

"These changes will save physician practices and our healthcare system an estimated $15 billion over the next 10 years -- never mind the countless hours and incalculable frustration of physicians and our patients," he said. "None of this would have happened without AMA advocacy."

In closing, Ehrenfeld pointed out that some of the largest for-profit healthcare systems in the world have failed to make a primary care model that's sustainable.

"That's a challenge I'm going to continue to prioritize as I leave the presidency," he said.

"How can we ensure access to care? How can we continue to recruit and support the best and brightest into medicine?" he posed. "This is why we fight ... And we're going to keep fighting until this work is done."

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