The largest group in organized medicine, the American Medical Association, has routinely criticized the SGR formula. Recently, the AMA asked Congress to stop the cut for a year. The AMA favors a repeal of the SGR to be replaced by a system that more closely tracks the Medicare economic index.
But the Physician Foundation's report notes that the AMA endorsed healthcare reform "though many physicians at the grassroots level were not in favor of the law." As a result, the report stated, there has been a "disconnect" between those physicians and the AMA, which has been essentially a disappointment in engaging physicians in the wake of healthcare reform, in Ray's view.
"It's so sad the AMA sold us out and how this legislation was rammed down our throats against the will of the majority," says one of the 1,200 physician comments submitted to the Physician Foundation for its report.
Others also criticized the AMA, but the organization was not the only target. "The state of medicine is in need of significant improvements but a rushed, sloppy policy that does not include the input of physicians is akin to malpractice," says another.
"No one," says yet another, "in the policy making world understands the problems physicians face. I wish they could follow me through my practice for one full week."
Physicians need to be heard, Ray says, not only to discuss the issues but also to influence others to be doctors, and physicians to stay on in their profession.
"By golly, I want people to be motivated to go into the medical profession," Ray says. "I'm 70 years old and I'll be needing a doctor myself."