Madara called the division in the ranks at AMA over the healthcare reform law "healthy debate."
"Among any group that is passionate about what it does and passionate about the practice of healthcare in America, there is going to be disagreement," he said. "We see disagreement on all sides. The AMA is a democratic organization where we move policy and the House of Delegates decides policy based on democratic principles that will never be 100% agreement. I think we see this in any organization that touches healthcare at this present time. What I detect in my early entry is nothing more than a very healthy debate looking at different views concerning something of fundamental importance to our nation and the health of our nation."
As for any perceived miscommunications between the AMA's Chicago headquarters and its lobbyists in Washington, D.C., Madara deferred to Ardis Dee Hoven, MD, chair of the AMA board. She rejected any suggestions of a disconnect between the two offices. "We work hand in hand, with our DC folks. They are part of us," Hoven told reporters on the conference call.
Madara was asked about his controversial leadership during his 2002-2009 tenure as CEO at the University of Chicago Medical Center, especially his role in creating the Urban Health Initiative. The program sparked controversy when it redirected patients with less-severe injuries or illnesses at UCMC crowded emergency department into community hospitals and clinics. He said any criticism of the initiative has to be placed in context of the time and place.
"At its core was an effort to improve health and access to care for the communities of indigent and underserved patients," he said. "Recall the context on the Southside was the collapse of several hospitals including famous hospitals like Michael Reese. We had to find new ways of providing care."
"In many ways the effort we deployed was ahead of its time," he said. "It focused on wellness and prevention and connecting patients to the care they needed in an appropriate setting. It looked to improve the coordination of care, the continuity of care, to ensure that patients had a medical home. There were challenging issues in this but I have to say it was not pushing out, it was reaching out. Our physicians and students went to clinics, went to community hospitals, opened new beds, and created new resources. My experience with this program and the lessons learned in it will serve me well in this new role with the AMA."
In addition to his time at UCMC, Madara served as Timmie Professor and Chair of Pathology and Laboratory Medicine at the Emory University School of Medicine before assuming the Thompson Distinguished Service Professorship and deanship at the University of Chicago Pritzker School of Medicine.
After resigning from the University of Chicago Medical Center in August 2009, Madara joined Leavitt Partners, a healthcare consulting firm created by former Health and Human Services Secretary Mike Leavitt.