Dr. Jesse Ehrenfeld — the first openly gay person to lead the American Medical Association, the Chicago-headquartered organization that’s the nation’s largest physicians lobby group — will be taking that high-profile post at a fractious time for U.S. health care.
Transgender patients and those seeking abortion care face restrictions in many places. The medical judgment of physicians is being overridden by state laws. Disinformation is rampant. And the nation isn’t finished with COVID-19.
In the two decades since Ehrenfeld first got involved with the AMA as young medical resident, the AMA has tried to shed its image as a conservative, self-interested trade association. While doctors’ pocketbook issues remain a big focus, the AMA also is a powerful lobbying force for a range of public health issues.
Two years ago, the group won praise for announcing a plan to dismantle structural racism within its ranks and the U.S. medical establishment.
It has adopted policies that stress health equity and inclusiveness — moves that inspired critics to accuse it of “wokeness.”
At 44, Ehrenfeld will be among the AMA’s youngest presidents when he begins his one-year term on June 13.
An anesthesiologist in Milwaukee, Navy combat veteran and father of two young children, he spoke in an interview about his background and new job. The interview has been edited for clarity and length.
Question: Why is your being part of the LGBTQ+ community a big deal — and how will it inform your role as AMA president?
Answer: I didn’t run as a gay man. That’s not my platform — but it’s a part of my identity. And people know that.
Representation and visibility is so 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 be to help advance health equity for everyone.
Q: How will your experience as part of the LGBTQ+ community inform and influence your new role?
A: I’ve experienced the health care system as a gay person, as a gay parent, as in many ways wonderful positive experiences and other ways, some deeply harmful experiences. And I know that we can do better as a nation. We can do better as a system that can lift up health. And I expect that there’ll be opportunities to shine a light on that during my year as president.
Q: What are examples of those experiences?
A: There’s so many times where our health care system just does not accommodate people who aren’t in the majority. As a gay parent and a gay dad, I can’t tell you how many forms I filled out where there’s a place for the mom and a place for the dad. It’s a small thing. But it’s a signal that we’re different and maybe we’re not welcome or accepted.
When you have those small, subtle irritations that add up day after day after day, whether you’re an LGBT person or from a minority group, that causes stress. These friction points … are so pronounced for so many who are in underserved communities, so many in the LGBT community and particularly for transgender individuals.
I’ve been fortunate to have two beautiful boys brought into this world with the support of an incredible group of physicians. But there were definitely lots of moments . . . where it was clear that we were a little bit different than everybody else in a way that didn’t need to be.
Q: This seems like an unprecedented time for political interference in medicine.
A: I’m deeply concerned about government intrusion into decision-making for patients. The Supreme Court ruling around abortion has had profound implications for reproductive rights. Fundamentally, patients have a right to access evidence-based health care services. That includes comprehensive reproductive health care. It includes care for transgender people.
States that ban abortion, that ban health care for transgender youth are placing the government right into the patient-physician relationship. And we know that this leads to devastating health consequences and can jeopardize lives.
Q: What power does the AMA really have to protect those rights?
A: I don’t think we’re powerless at all. The AMA was deeply involved in helping the Biden administration put out guidance to help physicians and patients understand that you don’t have to disclose private medical information to third parties. And we’ll continue to call for things like unrestricted access to [the abortion drug] mifepristone.
Q: Will addressing the nation’s mental health crisis be part of your role?
A: We need Congress to take action. There have been 15 years now of repeated failures by health care companies to comply with what was a landmark law in 2008 around mental health parity and substance-use disorder.
That law passed by Congress has never been enforced. Those violations continue to be more serious than they were a decade ago.
It affects patients with autism. It affects patients with eating disorders, substance-use disorders. It delays care. It’s harming patients.
And we are likely causing deaths to happen that are avoidable. We know there are federal actions that could be taken to help with this, including enabling patients to recover losses associated with an improper denial of care.
The other aspect around mental health access that is really important is permanently expanding access to telehealth.
Q: Critics have long said the AMA is primarily a self-interested trade group. How is that a misconception?
A: We have a pretty simple message, and it’s to elevate the art and science of medicine for the betterment of human health. And that’s why we care about things like climate change and things like health equity.
We have to make sure that there is joy in the practice of medicine. We have to make sure that our health care systems reward and support and allow practices to thrive.
And you look at boneheaded decisions like the fact that physicians got a 2% pay cut from Medicare this past January as opposed to an inflation update. Those are things that are important. They’re financial.
But, without advocacy in those realms, practices will close. Medicare patients won’t have a doctor to see. And we just we can’t allow that to happen.
