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The first openly gay leader of the American Medical Association has taken over at a turbulent time for American healthcare.
Transgender patients and patients seeking abortion care face restrictions in many places. State law overrides a physician’s medical judgment. Disinformation is rampant. And the country is not over COVID-19.
In the two decades since Dr. Jesse Ehrenfeld first joined the AMA as a young resident, America’s largest physician body has been trying to shed its image as a conservative, self-interested trade association. While doctors’ pocketbooks remain a big focus, the AMA is also a powerful lobbying force on a range of public health issues.
Two years ago, the AMA won widespread praise for announcing a plan to eliminate structural racism within its ranks and within the U.S. healthcare establishment. It has adopted policies that emphasize health equity and inclusion — moves that have inspired critics to accuse it of being “unsane.”
Ehrenfeld, 44, will become one of the youngest AMA presidents when he begins his one-year term on June 13. An anesthesiologist, Navy veteran and father of two young children, he recently spoke to The Associated Press about his background and new job.
Dialogue has been edited for clarity and length.
Q: Why is it a big deal for you to be part of the LGBTQ community at this time, and how does that affect your role as AMA chair?
A: I am not running as a gay man. That’s not my platform, but it’s part of my identity. People know this.
Representation and visibility are very important. I can’t tell you the number of emails, letters, phone calls, text messages that I got when I was elected into this role from people around the world that saw this as an important moment, an important recognition of what inclusivity and equality can is to help promote health equity for everyone.
Q: How will your experiences as a member of the LGBTQ community inform your new role?
A: As a gay man, as a gay parent, I’ve experienced the health care system, in many ways wonderful positive experiences, in other ways, some very damaging experiences. I know we can do better as a country. As a system that promotes health, we can do better. I hope to have the opportunity to make that clear during my presidency.
Ask: What are examples of these experiences?
A: Many times, our health care system cannot accommodate people who are not in the majority. As a gay parent and a gay dad, I can’t tell you how many forms I’ve filled out with mom’s place and dad’s place. It’s a small thing. But it’s a signal that we’re different, maybe we’re not welcome or accepted.
When you have those small, subtle irritants that add up day in and day out, whether you’re LGBT or from a minority group, it creates stress. These points of friction … are so obvious to many people in underserved communities, many people in the LGBT community, especially trans people. I know we can do better.
I have been blessed to have brought two beautiful boys into this world with the support of an incredible team of doctors. But there are definitely moments along the way where it’s clear we’re a little bit different from everyone else, and it’s not necessary.
Q: This seems like an unprecedented time for political interference in medicine.
A: I am very concerned about government interference in patient decision-making. The Supreme Court’s ruling on abortion has had a profound impact on reproductive rights. Fundamentally, patients have the right to receive evidence-based healthcare. This includes comprehensive reproductive health care. It includes care for transgender people.
States that ban abortion and ban health care for transgender youth are putting the government in the doctor-patient relationship. We know this can have devastating health consequences and can be life-threatening. The AMA continues to speak out against such actions.
Q: What powers does the AMA really have to protect these rights?
A: I don’t think we are powerless at all. The AMA was deeply involved in helping the Biden Administration issue guidance to help doctors and patients understand that you do not have to disclose private medical information to third parties. We will continue to call for unrestricted access to (the abortion pill) mifepristone.
Q: Are you frustrated by the number of states that seem to be jumping on the bandwagon?
A: I am an optimist. Now there are different specific political divisions. Attacks on science, on evidence-based care delivery, are new. Globally, it accelerated during the pandemic, but rampant misinformation, disinformation — all these challenges are challenges that I know we can overcome. It takes the AMA to make our voices heard and not give up.
Q: Will addressing the nation’s mental health crisis be part of your mandate?
A: We need Congress to act. For 15 years, health care companies have repeatedly failed to comply with landmark 2008 laws on mental health equity and substance use disorders.
That law passed by Congress was never enforced. These violations are still more serious than they were a decade ago.
It affects people with autism. It affects patients with eating disorders, substance use disorders. It delays care. This is harming the patient.
We are likely to cause avoidable deaths. We know there are some federal actions that can be taken to help address this issue, including enabling patients to recover damages associated with wrongful denial of care.
Another really important aspect around mental health access is permanently expanding access to telehealth.
Q: Critics have long said that the AMA is primarily a self-interested trade group. How could it be an illusion?
A: We have a very simple message, which is to advance the art and science of medicine to improve human health. That’s why we care about issues like climate change and health equity.
We have to make sure that the practice of medicine is fun. We must ensure our healthcare system rewards and supports and allows practice to flourish.
You look at stupid decisions like doctors taking a 2% pay cut from Medicare this January instead of an inflation update. These are important things. They are financial.
But without advocacy in these areas, the practice will end. Medicare patients will not need to see a doctor. We just can’t let that happen.
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