Episode Transcript
Alan Helgeson (announcer):
“Reimagining Rural Health,” a podcast series brought to you by Sanford Health. In this series, we explore the challenges facing health care systems across the country from improving access to equitable care, building a sustainable workforce, and discovering innovative ways to deliver high-quality, low-cost services in rural and underserved populations. Each episode examines how Sanford Health and other health systems are advancing care for the unique communities they serve.
In this episode, host Courtney Collen with Sanford Health News talks with Dr. Bruce Scott, president of the American Medical Association. Dr. Scott is a speaker at the 2024 Summit of the Future of Rural Health Care.
Courtney Collen (host):
I have Dr. Bruce Scott, the president of the American Medical Association, joining us here in Sioux Falls for the third annual Summit on the Future of Rural Health Care and the “Reimagining Rural Health” podcast. Dr. Scott, welcome. Thanks for your time.
Dr. Bruce Scott (guest):
Well, thank you. It’s great to be here with you.
Courtney Collen:
You joined us for a panel talking about policy, politics and advocacy in a dynamic health care environment. I’d love to hear about the AMA’s legislative efforts to improve quality of patient care during this time of rapid disruption.
Dr. Bruce Scott:
Well, you’ve heard all morning the key of access to patient care is the foundation. And unfortunately, there’s a shortage looming of health care physicians in the United States — estimated as high as 86,000 physician shortage in the next 10 years.
But for rural health care, that’s already upon us. And a major reason for that is the broken Medicare payment system.
Right now, believe it or not, in 2024, physicians are paid 29% less when adjusted for inflation by Medicare than they were paid in 2001. And for the last four years, and potentially pending this next year, physicians have actually received a cut in what we’re paid, despite the fact that physicians’ expenses, just like all the other expenses at the grocery store or the gas station, have increased. And at the end of the day, it’s not sustainable.
So, physicians are making difficult choices and in some cases they’re limiting the number of Medicare patients that they’ll see. They have stopped taking new Medicare patients, or in some cases have dropped Medicare altogether, but perhaps most concerning – one in five physicians in a recent poll say they hope to quit medicine, retire, or pursue other interests in the next two years. We can’t afford to lose even one more physician.
Courtney Collen:
What is your most surprising or hottest take from today’s Summit?
Dr. Bruce Scott:
What is so impressive to me is the commitment, the passion of the leaders who are here to try to fix this access problem that exists for rural health care already in the United States, and the innovative ideas that Sanford Health has to try to improve access.
And then finally, the physician heroes that we heard about this morning. Those individuals who are figuring out ways to provide needed care to their patients. And, you know, all across America, there are physician heroes like this that are taking care of patients, and that’s what’s really special about our profession.
Courtney Collen:
And we’re so grateful for all of our caregivers across the country. What innovation or action, Dr. Scott, do you think will move the needle the most in the next one to two years?
Dr. Bruce Scott:
Well, the innovation or action we need right now from Congress is to fix this broken Medicare payment system. And there’s a bill pending, HR-2474, strengthening Medicare for patients and physicians. This is not some radical idea. It simply would link physician payment to the inflation rate, the same inflation rate adjustment that other components of Medicare financing already get. And this would simply put physicians on level ground and potentially adjust for the fact that it’s costing us more money every year to take care of patients.
Courtney Collen:
What do you think is the biggest misperception about rural America?
Dr. Bruce Scott:
You know, we’re in a political season, and I hear the phrase “flyover country.” I practice in Kentucky, a somewhat rural state. And it drives me crazy when you think about the fact that there are 45 million Americans, 20% of our population, live in rural areas. If you put it all together, that’s more Americans than live in the 25 largest cities in the United States. Can you imagine if the politicians, the legislators ignored the 25 biggest cities in the United States and what the population there needed? And yet, rural Americans live sicker and die younger because of things that are correctable, like access to care.
Courtney Collen:
Dr. Scott, how do we strengthen trust in health care during a time of rapid disruption?
Dr. Bruce Scott:
One of the ill effects of the COVID-19 pandemic that no one anticipated was this loss of trust in science. I will say that study after study shows that patients still trust their physician. You know, the AMA was formed back in 1847 to combat charlatans and snake oil salesmen.
But the difference is today’s snake oil salesmen use the social media to spread their message so rapidly. It’s interesting. We were able to trace back most all of the anti-vaccine comments to 12 individuals that spread the information across the internet. And the impact we’re seeing that now is parents are questioning whether their child should get a measles vaccine. Something that’s been around since I was a child and has been proven to be safe and reduce the risk of measles. I think that the key to restoring trust is for individual physicians to talk to their individual patients and provide true medical, scientifically proven information.
Courtney Collen:
AI and health care. Is it overhyped? Is it real? Where do you stand?
Dr. Bruce Scott:
Well, AI is absolutely real. I will tell you that we prefer the phrase augmented intelligence rather than artificial intelligence to emphasize the fact that AI, no matter what you call it, will never replace physicians. It is a tool that physicians will use, and it’s an exciting tool that will potentially be able to extend what a physician’s able to do.
High percentages of physicians, more than 70%, in a survey, believe that it will help them in terms of documentation and administrative challenges, that it will help them in terms of diagnostic accuracy. About 90% are excited about the potential, but concerned about the transparency, the lack of transparency of many of the innovations that are out there.
We believe that the most important thing is that whatever happens with AI, that it remains patient-centered, that health care needs to be focused on the patient.
Courtney Collen:
Yeah. Thank you for that. I’d love to know what book you’re reading right now, or what book has had the biggest impact on your career, or maybe what’s in your queue?
Dr. Bruce Scott:
That’s an interesting question to ask a physician. I mean, the books that have had the impact on my career have been medical books, otolaryngology textbooks. And what I’m reading right now is a lot of political information, a lot of information regarding health care and the challenges of health care. The book that’s probably on the top of my hopefully to read is Dan Sullivan’s book on continual life improvement. But I don’t know if I’m going to get time to read that or not, maybe on an airplane. I tend to take the advantage of the opportunity to sleep.
Courtney Collen:
That’s not the worst choice to make. Dr. Scott, what do you love most about what you do? Are you still practicing medicine?
Dr. Bruce Scott:
I’m still a practicing ear, nose and throat physician or otolaryngologist. And that’s what I love most, is the opportunity to be able to interact with the individual patient. That said, as I travel around the nation and I meet physicians and I talk to physicians, I’d love to hear their stories and the stories of the physician heroes and how they’re responding to all those challenges that we’ve spoken about during this interview.
Courtney Collen:
Thank you so much for all that you do with the AMA for patients around the country and here with us and your time. Appreciate you.
Dr. Bruce Scott:
Thank you so much for having us. Thank you.
Alan Helgeson (announcer):
You’ve been listening to “Reimagining Rural Health,” a podcast series brought to you by Sanford Health. Hear more episodes in this series or other Sanford Health Series on Apple, Spotify, and news.sanfordhealth.org.
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Posted In Leadership in Health Care, News, Rural Health, Virtual Care
