AMA President comes home to MUSC for Alumni Weekend

March 22, 2022
Two young men and a young woman pose with an older gentleman in a conference room
Dr. Gerald Harmon, second from left, poses with MUSC medical students Weston McDonald, Lee Cagle and Maggie Stroud. Photo by Cindy Abole

The MUSC College of Medicine welcomed home an especially distinguished graduate for Alumni Reunion Weekend this year – Gerald E. Harmon, M.D., family medicine doctor, retired major general and president of the American Medical Association, the nation’s leading medical organization.

Harmon, a native South Carolinian, graduated from MUSC in 1977. Since then, he’s served as chief physician for the National Guard Bureau and assistant surgeon general for the U.S. Air Force; in leadership positions in the South Carolina Medical Association; as medical supervisor for his local school district; and as a clinical faculty member guiding residents and medical students for the Tidelands Health MUSC Family Medicine Residency Program – all while seeing patients from the same location in Pawleys Island that he’s worked out of since 1983.

A lot has changed since his days in training, but the core of medicine remains the doctor-patient relationship, something that he takes very seriously, he said.

That relationship came up multiple times during his talk, which ranged from combating COVID-19 misinformation to expanding the number of residency positions.

Harmon said that even more far-reaching than the coronavirus pandemic is the “pandemic of distrust” that has been building in the U.S. for years, even before 2020, adding that there has been an erosion of trust in subject matter experts, but society needs government and public health. He is working to regain trust, and said he learned in the military that the way to overcome distrust is to “continually demonstrate overwhelming competence.”

He also noted that he doesn’t believe in getting between doctors and their patients. Harmon is a strong supporter of vaccines, and emphasized that the COVID-19 vaccine is extremely effective at preventing severe COVID and death. If a doctor believes a specific patient should not take the COVID-19 vaccine, then he supports that doctor’s guidance because the doctor knows the patient and his or her history.

If, however, a doctor becomes a public voice against vaccination or in favor of unproven treatments – then, he said, “I’m going to take issue with that.” That doctor is no longer working within the doctor-patient relationship but has instead become a purveyor of misinformation, he said – and someone who could be putting people at risk.

Medicine must be based on science, which requires meticulous clinical trials, he said, mentioning a current clinical trial of ivermectin that MUSC is participating in. Anything else, he said, is “medicine by anecdote.”

Harmon also talked about the need for more residency spots – a particularly timely discussion, given that his talk occurred the day after Match Day, the national program that matches graduating medical students to residency programs. Once people complete medical school, they must go through an additional training period called residency, in which they practice in a specific field of medicine with increasing levels of independence. Some residencies can be as long as seven years but at a minimum, in order to receive a state medical license, a doctor must complete at least a year-long internship.

However, there are more medical students than there are residency positions. According to the National Resident Matching Program, there were 36,277 resident positions available this year and 42,549 active applicants for those positions.

“We need more medical students, but what we really need is more doctors,” Harmon said. Medical school enrollments have been increasing by about 3% annually, but residency positions haven’t.

He noted that Congress recently provided funding to expand residency positions, but said the provisos that have been added hamper the practical benefit of the funding.

Medical debt is another related issue because it means that graduating doctors are less likely to choose lower-paying specialties like family medicine.

In talking about the AMA’s advocacy role, Harmon spoke about working to get rid of prior authorization and to make permanent the more flexible rules that were implemented for telemedicine during the pandemic.

“Prior authorization is a dirty word to me,” he said.

He’s seen the effects not only in his practice but with his own mother. When her benefits plan was updated, suddenly the medicines that have kept her stable for eight years required prior authorization, he said.

“Putting a 91-year-old at risk because of an administrative hassle is a crime,” he said.

As far as telemedicine, Harmon said it makes a big difference for people in rural and underserved areas – and telemedicine doesn’t have to be a video conference. It can be a phone call, he said. He thinks that some money coming from the federal government to South Carolina will be able to expand broadband access in places like Yauhannah, in Georgetown County.

“Those patients in those communities are underserved. They don’t get access to the same quality of health care as the people do in downtown Charleston,” Harmon said. “They’re taxpayers, too. They’re American citizens, too. They're our patients, and we need to make sure they get an opportunity for health care.”

Harmon also spoke passionately about the need to diversify the physician workforce so it looks like America.

“If our physicians are representative of patients, we have better interactions,” he said.

It comes down to lived experience and communication, he explained. For example, if he’s in a room with other pilots, he can use pilot lingo and shorthand that would take a lot of explaining to non-pilots. The same can be said for cultural experiences.

Harmon gave a nod to MUSC’s efforts to diversify not just the physician workforce but all health care pipelines.

The MUSC College of Medicine is a recognized leader in diversifying the medical student body, he said.