What factors from the outside environment do you think will be important to AMDA’s future success?  Movement to evidence-based medicine  Emerging models of practice in long term care  Use of non-physician providers (scope of practice issues)  Physician staffing models  Volunteer commitment, performance and ability to work with staff  Movement to community-based care, non- institutional care  Patient-centered care focus of culture change movement  Baby boomer consumers  Growing number of old/old (85+)  Culture change movement  Other

Here are the four goals the board proposed. Do you agree, disagree or want to add to the list? 1. Clarify and strengthen AMDA’s place in the health care environment 2. Advance the performance and practice of medical directors, attending physicians, and others who provide patient care 3. Stabilize and strengthen membership and state chapters 4. Optimize AMDA governance and operations, to foster maximum stability and strength for the future

Review the following common themes and strategies that were identified. What do you think? Do they cover all your ideas?  Leverage what we have  Change long term care provider approach to clinical matters to evidence-based model with standards of practice and care  Focus on implementation and dissemination of clinical and educational models  Communication/expectations/accountability for volunteers and staff  Increase communications, deliver external messages repeatedly and build collaborations to deliver message to broader LTC community  Increase recognition of long term care as physician leader with other disciplines  Think about what will attract physicians to long term care practice in all areas of our activity  Reach physicians early in their training and help plan LTC career with education and practice models  Other

Here are the topic priorities. How do they fit with your ideas, team goals?  Medical Director F-Tag 501  Hospice and palliative care  Pay for performance/value-based purchasing  Assisted living  Professional liability (medical director and attending physician)  Medication errors  Pain management  Electronic medical records/health information  Reimbursement  Scope of practice (i.e., physician versus non-physician practice issues)  Advance planning/directives  Home health  Prescription drug benefit  State survey enforcement  Emergency preparedness/disaster management  State survey process  Subacute care

Rank areas of AMDA activity for the future with 1 being the highest priority.  Advocacy  Education  Training  Information dissemination  Professional development, curricula  Other

Which other areas to you feel AMDA should become active?  National public relations campaigns  Affecting curriculum for medical education research  Educating other long term care professions about medical direction  CPG on-site implementation leadership  Establish standards for long term care practice based on CPGs and other tools  other

What tools do members want?  Information I can share with consumers  Model medical director report  Inservice programs to use with attendings, nursing  Practice guidelines for medical directors  Pocket guides on various topics for medical director  Face-to-face meetings  Online CME  Attending physician certificate program  PDA-based CPGs and other protocols  Model forms  Practice models for all long term care settings  Credentialling models to use with physician staff  Information on survey, relevant F-Tags  Other

Let’s consider each statement that follows. Do you agree or disagree?  AMDA should raise expectations for physician performance in long term care.  AMDA should protect the current physician scope of practice.  AMDA should encourage use of nurse practitioner models.  AMDA should require state chapter members to belong to national AMDA.  AMDA should focus more on post acute / short stay patient care.

Let’s consider each statement that follows. Do you agree or disagree?  AMDA should have national public relations campaign to promote positive image of long term care.  AMDA should hold volunteers accountable as staff.  AMDA should have a policy in favor of closed staffs in nursing homes.  AMDA should not support pay for performance / should develop its own metrics.  AMDA should develop a SNFist model.

Let’s consider each statement that follows. Do you agree or disagree?  AMDA should remain primarily a physician organization.  AMDA should allow associate members to be delegates to the House of Delegates.  AMDA should reduce the amount of pharmaceutical support overall.  AMDA should limit pharmaceutical funding to certain areas like exhibits.  AMDA leadership reflects the average long term care physician/medical director.

Let’s consider each statement that follows. Do you agree or disagree?  AMDA should encourage more research into long term care topics, controversies.  AMDA should develop policy on standards of care for LTC hospitals.  AMDA should address issues for consumers, e.g., treatment decisions.  AMDA should change its name to reflect more than medical director and nursing home setting.  Other?