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Doctors need to remember their "why" to give themselves a sense of purpose during the COVID-19 pandemic, said Gerald Harmon, MD, the 176th president of the American Medical Association (AMA), in his inaugural address to the AMA's House of Delegates during the association's annual meeting.

"During these times of struggle and heartbreak, it is important for us as physicians to 'remember our why,'" said Harmon, a family physician in Georgetown, South Carolina, and an Air Force veteran. "Why did we enter medicine? Why do we struggle against overwhelming regulatory and administrative burdens? Why are we risking our health and our families during this global pandemic?"

"I would submit that the education, the training, the years of experience and sacrifice we have gone through has prepared us for 'such a time as this,'" he added, invoking the words of Mordecai in the Biblical book of Esther. "This past year -- and the year forward -- is why we -- America's physicians and the AMA -- are here. As Viktor Frankl -- who was a Holocaust survivor -- wrote, 'those who have a why to live, can bear with almost any how.'"

The inauguration ceremony, held remotely due to the pandemic, began with remarks by outgoing AMA president Susan Bailey, MD, who was followed by an invocation given by Rev. Carl Anderson Jr. of St. Stephen AME Church in Georgetown, South Carolina. Bailey then gave a few additional remarks before introducing the evening's entertainment, singer/actor Major Attaway and composer and pianist Jim Hodges, along with some other instrumentalists; together they performed "America the Beautiful," "Nobody Knows the Trouble I've Seen," and "You'll Never Walk Alone."

AMA board of trustees chair Russ Kridel, MD, then took the stage to deliver a brief biography of Harmon before starting the swearing-in ceremony. Harmon -- who was in a separate location -- was accompanied during the swearing-in by his wife, Linda.

During his speech, Harmon said that the pandemic has given Americans a new appreciation for the role of physicians. "Americans recognize how much they rely on their own personal doctors and other healthcare workers on the front lines -- how much they depend on the researchers and scientists to develop treatments and vaccines, the medical educators and teachers who mentor and train the vital physician workforce to take care of us, and the other physicians in non-clinical jobs who deliver crucial healthcare resources in an emergency like the pandemic."

Indeed, he continued, "the AMA's own surveys find that nearly 50% of doctors have experienced a 'renewal of purpose' among the tribulations of pandemic response. In a year defined by so much suffering and headache, this is welcome news." But he also alluded to the difficulties that the pandemic posed for physicians, as well as everyone else.

"Like you, I have seen the terrible outcomes of this devastating virus and have experienced the loneliness of being unable to gather with friends and colleagues -- even for crucial events in life, like weddings or funerals," he said. "Adding to the suffering, the COVID pandemic has revealed enormous gaps in how we care for people and communities in America and demonstrated the disproportionate impact of this pandemic on communities of color -- and the weaknesses of our under-funded and under-resourced public health infrastructure."

Harmon said little about the agenda he planned to pursue as AMA president, although he did mention one issue. "We're going to embed the principles of equity and racial justice within the AMA and throughout our health system," he noted. "Just a few weeks ago, the AMA released a comprehensive strategic plan to guide us in our work to advance health equity and justice; and to improve the quality of care for people who have too long been marginalized. Meaningful progress won't happen until we, as doctors, recognize how profoundly systemic racism influences the health of our patients, and until we commit to taking action within our own spheres of influence."

He gave an example of this from his own experience. "A couple months back, when rounding with our physician inpatient team, I was advised that the patient on the third floor was a 70-year-old man with pneumonia who really did not say much and was described as 'difficult to communicate with,'" he said. "I went in to see him and found an older Black gentleman with a last name that was clearly local. As noted, he gave only one-word responses."

"Rather than continuing to quiz him about his illness and his symptoms, I sat down," Harmon continued. "I told him I had met and treated several folks with his surname. I asked where he lived and what he did for a living." After discovering that the patient was a jet engine mechanic, "I told him I had some experience with jet engines, and so he opened up a bit. Turns out he had obtained a degree in aerospace and worked on jet propulsion engines for NASA at Langley Air Force Base, and I had been assigned there for 3 years. He was, quite literally, a rocket scientist."

"From there, we established a bond, and I was able to understand him, and address his health needs with a more meaningful conversation," Harmon said. "We provide better care when we treat the patient and not just the disease, and when we endeavor to overcome racial stereotypes in our interactions."

Harmon concluded, "Today, I ask you, wherever you may find yourselves in this field: caring for patients; doing the work of advocacy, of education, of research; or being a supportive family member to the physician you care about, remember your 'why' and pledge with me ... to act worthy of ourselves and our calling."

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