Inaugural Remarks WMA GA 2018 revised

1
Remarks – WMA, Iceland
Ladies and gentlemen, my dear colleagues,
When I attended the General Assembly for the first time, 9 years ago in New Delhi, I was
overwhelmed by the presence of so many prominent leaders of medicine from all over the world.
Since then, every time I participate in WMA events, I feel deep appreciation and admire your
sapient leadership, vision and commitment to our profession, its goals and values.
Dear distinguished delegates, your activity within WMA and everyone’s participation in his or her
NMA, inspires and enlightens me.
I have had the great privilege of getting to know you over the last years and I hope to meet many
more of you over the next year.
Each one of you is shaping the future of healthcare and is furthering his or her nation’s
wellbeing. We all have great challenges and together we can accomplish a great deal on behalf of
our patients.
It is my great honor to stand before you as the President of the World Medical Association.
Before I continue, I want to acknowledge our outgoing President, Dr. Yoshitake Yokokura, who
contributed greatly to the physicians of the world.
Thank you, Dr. Yoshitake Yokokura for your service to the WMA.
Over the years, I have come to realize that the WMA is one of the most important organizations
for physicians worldwide, with unique strengths to meet the challenges of our medical profession
as well as to help NMAs in need. In addition, the WMA assists in instructing the individual
physician, and guiding him or her in this rapidly changing world.
We live in an extremely challenging period. The changes we witness daily seem incomprehensible
and the pace of these changes is increasing constantly.
2
I believe that it is the time for WMA to take a sophisticated, scientific and innovative look to the
future and to help both physicians and patients become prepared for the huge changes in medicine
over the next decade.
Are we prepared for the future?
We can, and to my mind, we should, embark on a critical venture to predict how medicine will
look in 2030, what will be the role of a physician, physicians’ organizations and what can be done
to spur significant positive changes.
I ask to dedicate my year of presidency to this agenda.
It is our mandate as leaders, since an effective leader is one who creates an inspiring vision of the
future.
Working on this agenda I believe that three kinds of scenarios are to be developed: one that reflects
maximal possible changes, another one for minimal changes and the third- the middle one.
The predictable societal changes, technological changes, changes in the role of a physician, and in
patients’ preferences should be addressed.
The goal will be to develop a report that can help physicians and NMAs become prepared for the
future.
What will be the role of a physician in 2030?
In 1903, more than one hundred years ago, the future for Thomas Edison as he predicted was «The
doctor … (who) will give no medicine, but instruct his patient in the care of the human frame, in
diet and in the cause and prevention of disease»
Today, we can predict that the future world of medicine will be a world of electronic health records,
robots, artificial intelligence and machine learning as well as highly developed communication
means.
3
However, moving to a future of medicine is probably like driving on a country road with its ruts,
convolutions and unexpected turns rather than driving on a highway. Recent problems with the
Watson supercomputer demonstrate that.
«A new study from MIT computer scientists, suggests that human doctors provide a dimension
that, as yet, artificial intelligence does not». They have found that a physician’s «gut feeling» plays
a significant role in the intensive care unit. (Lagasse J.
https://www.healthcarefinancenews.com/news/artificial-intelligence-cant-replace-doctors-gut-
instincts-mit-study-says). As researcher Mohammad Ghassemi said: «there is something about a
doctor’s experience and their years of training and practice, that allows them to know in a more
comprehensive sense, beyond just the list of symptoms, whether you are doing well or you are
not».
We can predict that physicians will provide integrated care as members of multidisciplinary teams
and will perform more complex tasks in an increasingly complex work environment, although the
question remains: who will be the leaders of these teams?
But there is another factor that must be addressed in order to effectively propel medicine into the
next decades.
Today, at the time I am speaking on this highly-respected podium, more than 10 million physicians
all over the world take care of those in need of medical help and nearly half of them have symptoms
of burnout defined as emotional exhaustion, interpersonal disengagement, and a low sense of
personal accomplishment. Besides a physician’s well-being, burnout negatively influences the
quality of care and shortens the life-time a physician is able to practice medicine.
This is a great problem for society suffering from a shortage of physicians, which is common in
most countries of the world.
4
In the future of universal health coverage there is a need for a growing number of burnout-free
physicians.
The pandemic of physician burnout, caused, among other things, by very dynamic and changing
working conditions, is a subject I believe we should address.
The quality and safety of patient care depend on high-functioning physicians. This is particularly
challenging in our extremely rapidly changing world.
The wellbeing of physicians, both mentally and physically, has been on the agenda of some NMAs
for several decades. Some resources have been invested to explore and move things forward on
this issue; however, the real objective of combatting this blow to modern medicine has yet to be
achieved.
«Physicians are dealing with an incredible amount of work stress as they confront growing
administrative burden, rising operating costs, new technology and an increasing patient demand
for frontline care. Physician burnout is a symptom of a larger problem – a healthcare system that
increasingly overworks doctors and undervalues their health needs. » (Teresa Iafolla.
https://blog.evisit.com/prevent-physician-burnout)
That is why according to the new Declaration of Geneva that was adopted by our General
Assembly in Chicago a year ago, a physician pledges to attend to his own health, well-being and
abilities in order to provide care of the highest standard.
While preparing for the future, there is a place to develop recommendations for physicians all over
the world to keep this important part of the pledge. Physicians are an indispensable resource of
every society; burn out of this resource endangers the society.
I believe we must draw from our combined experiences and learn best practices.
5
An additional issue that cannot be separated from planning the future is the role of the physician
in contemporary society.
Physicians have been traditionally conservative. For years the practice of medicine followed long-
standing traditions. «A physician possessed a unique body of knowledge to use in the care of
patients. This kind of the doctor-patient interaction was paramount and served as the foundation
of a personal, caring relationship». (Wartman S.A. http://www.aahcdc.org/Publications-
Resources/Series/Nota-Bene/View/ArticleId/20829/The-Role-of-the-Physician-in-21st-Century-
Healthcare). But the forces changing 21st century society and medicine are transforming this
tradition. Physicians should be prepared both mentally and technologically to meet new demands.
I believe that WMA has a capacity to help individual physicians in this challenging process.
The role of NMAs is also under significant pressure as a result of societal changes. The WMA is
the only body to explore this process and develop recommendations that can help NMAs to evolve
their future strategies.
Notwithstanding any future changes, patients and physicians will continue to exist, and we will
continue to honor our social contract.
«Every day, we are given the great privilege of being invited into our patients’ lives. We are with
patients when they are born and when they die; we provide advice and comfort; we prevent illness
and treat and manage disease. Our patients trust us, and we have always taken our advocacy role
very seriously. It is part of the essence of our professionalism and we will keep our patients at the
center of everything we do.» (Dr. Chris Simpson, inaugural speech, CMA 2014)
The support of WMA is essential and I am sure, will be always provided.
Thank you.