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Physicians may not have signed up for political fights and combating medical disinformation, but they will enter the fray when their patients' lives are at stake, according to the president of the American Medical Association (AMA).

The AMA is willing to work with all political leaders when it comes to improving patients' health, said Jack Resneck Jr., MD, at the AMA Interim Meeting of the House of Delegates, held virtually and in Hawaii.

"But make no mistake, when politicians insert themselves in our exam rooms to interfere with the patient-physician relationship, when they politicize deeply personal health decisions, or criminalize evidence-based care, we will not back down," Resneck said to booming applause.

Resneck said he was angered by the hostility and threats physicians faced, and by laws that restrict evidence-based care, such as abortion services and gender-affirming treatment. "Enough is enough. We cannot allow physicians or our patients to become pawns in these lies," he said.

In June, the AMA House of Delegates reaffirmed the importance of reproductive health services, including abortion and contraception, Resneck said. Following the Dobbs decision, several states began trying to criminalize abortion.

Physicians have shared stories of patients with ectopic pregnancies, sepsis, or incomplete miscarriages who were forced to travel many miles to access basic medical care. In some cases, colleagues felt compelled to call hospital attorneys before performing urgent abortions; in others, unstable patients were "shipped across state lines" because physicians were torn between the law and their code of ethics, he said.

In states where abortion bans have exceptions if the life of the mother is deemed at risk, physicians may still feel like their hands are tied. "I never imagined colleagues would find themselves tracking down hospital attorneys before performing urgent abortions, when minutes count ... asking if a 30% chance of maternal death, or impending renal failure, meet the criteria for the state's exemptions ... or whether they must wait a while longer, until their pregnant patient gets even sicker," Resneck said.

And "drivers of disinformation ... are falsely claiming that we have exaggerated or even fabricated stories about the real consequences of those laws," he noted.

Resneck reported that the AMA has filed amicus briefs in about a dozen state and federal courts, and spoken with the Biden administration plus Congress, to advocate to protect patients and physicians in a post-Dobbs world.

"But I can't sugarcoat just how dangerous it is for physicians to know that governors, legislators, state attorneys general and law enforcement are all perched right on their shoulders in exam rooms, waiting to judge decisions we make in partnership with our patients," he said.

Disinformation about gender-affirming care -- such as claims of "genital mutilation surgeries" or treating children without parental knowledge -- are another battle physicians face. The AMA has called on the Department of Justice to investigate threats of violence against physicians and children's hospital who provide gender-affirming care. In turn, those "drivers of disinformation" have cried censorship. Such actions are part of a larger movement that aims to criminalize gender-affirming care, Resneck stressed, but what opponents fail to realize is that gender-affirming care helps mitigate stigma and discrimination, along with cutting depression and the risk of suicide among transgender and non-binary adolescents.

Health Equity, Medicare Cuts

Resneck noted that the medical community also must lead the charge against things like a Wall Street Journal editorial "erroneously" claiming medical schools were admitting "unqualified Black and Hispanic students," or a neo-Nazi group protesting outside of a Boston hospital, claiming that health equity has lead to the "killing [of] white patients."

"You know and I know that we did not pick these fights ... the AMA is fiercely nonpartisan," he said. "We are influential individually as physicians, and collectively as the AMA, because we are the grown-ups in the room ... we will always stand up for our policies for physicians and for our patients."

He called on all physicians to be "ambassadors of truth" against the "unprecedented attacks on our profession."

Resneck also went after proposed "reckless Medicare cuts," noting that "as practice costs have surged in the face of substantial inflation, and physicians struggle to retain staff, I can't think of a worse time for Medicare to threaten almost 8.5% across the board payment cuts. How demoralizing."

While the AMA and organized medicine in general are working to block those cuts, such barriers to practice, coupled with the frustration of prior authorizations, and "unsafe" scope of practice proposals, are driving more and more physicians from the field. Burnout increased from 38% to 63% in 2021, and one in five physicians plan to leave practice in the next 2 years, he stated.

"We haven't lost the will to do our jobs; we're just frustrated that our healthcare system is putting too many obstacles in our way," Resneck said.

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