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The 988 Suicide & Crisis Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week, across the United States. Call or text 988 or text TALK to 741741.
Claim CME and access the transcript for this episode: https://bit.ly/43JSDDn
Explore the Preventing Physician Suicide toolkit: https://bit.ly/4bYQpBP
Explore the After a Physician Suicide toolkit: https://bit.ly/3yEstFz
Explore the Collective Trauma toolkit: https://bit.ly/4c3e9Ff
Follow STEPS Forward on LinkedIn: https://bit.ly/steps-forward-linkedin
When three colleagues died by suicide within a year, Geisinger didn't just grieve, they built a system. In this AMA STEPS Forward Podcast®, host Kevin Hopkins, MD speaks with Halle Ellison MD, MAS PSHQ, FACS, Director of Physician and APP Well-being, and Stephanie Andreacci, LCSW, Peer Support Program Manager, about the creation and evolution of Geisinger's Personnel Crisis Response Team (PCRT).
What started as an effort to coordinate a fragmented, siloed response has grown into a comprehensive, proactive framework with 160 activations in just three years. Dr. Ellison and Stephanie share how they tackled stigma, changed language around suicide, built cross-departmental collaboration, and created a culture where asking for help is not just accepted, but expected.
🩺 The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most — patients. We will meet this challenge together. Join us: https://ama-assn.co/JoinRenew
🥼 Go to https://ama-assn.co/FightingForDocs to learn more about our AMA advocacy priorities, including:
▹ Reforming Medicare payment
▹ Fighting scope creep
▹ Fixing prior authorization
▹ Reducing physician burnout
▹ Making technology work for physicians
📺 Subscribe to @americanmedicalassociation on YouTube: https://ama-assn.co/youTube
📧 Sign up for #MorningRounds and free daily newsletters from the AMA: https://ama-assn.co/Newsletters
🎧 Listen to our latest medical podcasts: https://ama-assn.co/Podcasts
💬 Follow #AMA on social media: https://ama-assn.co/Social
📓 Access the Journal of the American Medical Association #JAMA login: https://ama-assn.co/JAMA
Disclaimer
The AMA STEPS Forward® Podcast is for informational purposes only. The content is believed to be accurate as of the date of publication. Mention of a third-party organization, product, or service in the Podcast does not imply and is not intended as a promotion or endorsement by the American Medical Association (AMA). This content is not intended as medical, legal, or consulting advice, or as a substitute for the advice of a physician, attorney, or other professional. The views, opinions, and positions expressed by the speakers are theirs alone, and do not necessarily reflect the views, opinions, or positions of the AMA, the individual’s employer, or any affiliated organization. The AMA makes no warranty regarding the accuracy or completeness of any information provided in this Podcast. The materials and information contained herein are provided as-is. No part of this Podcast may be reproduced, stored, transmitted, or distributed in any form or by any means, without the prior written permission of the AMA.
Listen to the first two episodes in this series:
Register for the October 6th webinar with all three guests from this series: https://bit.ly/4hfoR0C
Explore the Stress First Aid Toolkit: https://bit.ly/4zwhd9o
Explore the Wellness Centered Leadership Playbook: https://bit.ly/3P6Xlab
Explore Katherine Meese’s research:
Explore recent AMA research on moral injury:
Follow STEPS Forward on LinkedIn: https://bit.ly/steps-forward-linkedin
In this final episode of a three-part series on moral injury, host Heather Farley, MD, MHCDS sits down with Katherine Meese, PhD, to discuss the differences in how moral injury is experienced by frontline teams and leadership, and how the trust gap between the two can be bridged. Dr. Meese expands on the “middle management trust gap,” how leaders can unintentionally erode trust by blaming decisions on those above them, and offers practical ways to communicate hard decisions, rebuild trust through apology and forgiveness, and share ownership of a healthier culture.
🩺 The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most — patients. We will meet this challenge together. Join us: https://ama-assn.co/JoinRenew
🥼 Go to https://ama-assn.co/FightingForDocs to learn more about our AMA advocacy priorities, including:
▹ Reforming Medicare payment
▹ Fighting scope creep
▹ Fixing prior authorization
▹ Reducing physician burnout
▹ Making technology work for physicians
📺 Subscribe to @americanmedicalassociation on YouTube: https://ama-assn.co/youTube
📧 Sign up for #MorningRounds and free daily newsletters from the AMA: https://ama-assn.co/Newsletters
🎧 Listen to our latest medical podcasts: https://ama-assn.co/Podcasts
💬 Follow #AMA on social media: https://ama-assn.co/Social
📓 Access the Journal of the American Medical Association #JAMA login: https://ama-assn.co/JAMA
Disclaimer
The AMA STEPS Forward® Podcast is for informational purposes only. The content is believed to be accurate as of the date of publication. Mention of a third-party organization, product, or service in the Podcast does not imply and is not intended as a promotion or endorsement by the American Medical Association (AMA). This content is not intended as medical, legal, or consulting advice, or as a substitute for the advice of a physician, attorney, or other professional. The views, opinions, and positions expressed by the speakers are theirs alone, and do not necessarily reflect the views, opinions, or positions of the AMA, the individual’s employer, or any affiliated organization. The AMA makes no warranty regarding the accuracy or completeness of any information provided in this Podcast. The materials and information contained herein are provided as-is. No part of this Podcast may be reproduced, stored, transmitted, or distributed in any form or by any means, without the prior written permission of the AMA.
Listen to the first episode in this series, Moral Injury in Medicine: The Frontline with Wendy Dean, MD:
Register for the October 6th webinar with all three guests from this series: https://bit.ly/4hfoR0C
Explore the Stress First Aid Toolkit: https://bit.ly/4zwhd9o
Explore the Wellness Centered Leadership Playbook: https://bit.ly/3P6Xlab
Explore Jason Lesandrini’s research on moral injury:
Explore recent AMA research on moral injury:
Follow STEPS Forward on LinkedIn: https://bit.ly/steps-forward-linkedin
In this second episode of a three-part series on moral injury, host Heather Farley, MD, MHCDS sits down with Jason Lesandrini PhD, FACHE, LPEC, HEC-C, Assistant Vice President for Ethics, Advance Care Planning and Spiritual Health at Wellstar Health System in Georgia, to talk about how moral injury uniquely affects health care leaders who are often caught between organizational demands and their teams and are expected to execute decisions they privately question. Lesandrini distinguishes between decisions leaders merely disagree with and those that truly violate their values while sharing practical ways leaders can name moral distress early, build ethical workplace cultures, and avoid losing themselves in the process.
🩺 The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most — patients. We will meet this challenge together. Join us: https://ama-assn.co/JoinRenew
🥼 Go to https://ama-assn.co/FightingForDocs to learn more about our AMA advocacy priorities, including:
▹ Reforming Medicare payment
▹ Fighting scope creep
▹ Fixing prior authorization
▹ Reducing physician burnout
▹ Making technology work for physicians
📺 Subscribe to @americanmedicalassociation on YouTube: https://ama-assn.co/youTube
📧 Sign up for #MorningRounds and free daily newsletters from the AMA: https://ama-assn.co/Newsletters
🎧 Listen to our latest medical podcasts: https://ama-assn.co/Podcasts
💬 Follow #AMA on social media: https://ama-assn.co/Social
📓 Access the Journal of the American Medical Association #JAMA login: https://ama-assn.co/JAMA
Disclaimer
The AMA STEPS Forward® Podcast is for informational purposes only. The content is believed to be accurate as of the date of publication. Mention of a third-party organization, product, or service in the Podcast does not imply and is not intended as a promotion or endorsement by the American Medical Association (AMA). This content is not intended as medical, legal, or consulting advice, or as a substitute for the advice of a physician, attorney, or other professional. The views, opinions, and positions expressed by the speakers are theirs alone, and do not necessarily reflect the views, opinions, or positions of the AMA, the individual’s employer, or any affiliated organization. The AMA makes no warranty regarding the accuracy or completeness of any information provided in this Podcast. The materials and information contained herein are provided as-is. No part of this Podcast may be reproduced, stored, transmitted, or distributed in any form or by any means, without the prior written permission of the AMA.
Explore the Stress First Aid Toolkit: https://bit.ly/4zwhd9o
Explore the Wellness Centered Leadership Playbook: https://bit.ly/3P6Xlab
Explore Dr. Wendy Dean’s research on moral injury:
Explore recent AMA research on moral injury:
Follow STEPS Forward on LinkedIn: https://bit.ly/steps-forward-linkedin
In this first episode of a three-part series, host Heather Farley, MD, MHCDS sits down with Wendy Dean MD, a moral injury expert, to unpack how the language around moral injury matters, and what happens with health care systems ask clinicians to practice in ways that violate their professional identity and values.
From prior authorization battles to restrictive referral policies, they explore the real-world forces driving moral injury and what health systems can do to start to heal the trust gap between clinicians and leadership.
🩺 The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most — patients. We will meet this challenge together. Join us: https://ama-assn.co/JoinRenew
🥼 Go to https://ama-assn.co/FightingForDocs to learn more about our AMA advocacy priorities, including:
▹ Reforming Medicare payment
▹ Fighting scope creep
▹ Fixing prior authorization
▹ Reducing physician burnout
▹ Making technology work for physicians
📺 Subscribe to @americanmedicalassociation on YouTube: https://ama-assn.co/youTube
📧 Sign up for #MorningRounds and free daily newsletters from the AMA: https://ama-assn.co/Newsletters
🎧 Listen to our latest medical podcasts: https://ama-assn.co/Podcasts
💬 Follow #AMA on social media: https://ama-assn.co/Social
📓 Access the Journal of the American Medical Association #JAMA login: https://ama-assn.co/JAMA
Disclaimer
The AMA STEPS Forward® Podcast is for informational purposes only. The content is believed to be accurate as of the date of publication. Mention of a third-party organization, product, or service in the Podcast does not imply and is not intended as a promotion or endorsement by the American Medical Association (AMA). This content is not intended as medical, legal, or consulting advice, or as a substitute for the advice of a physician, attorney, or other professional. The views, opinions, and positions expressed by the speakers are theirs alone, and do not necessarily reflect the views, opinions, or positions of the AMA, the individual’s employer, or any affiliated organization. The AMA makes no warranty regarding the accuracy or completeness of any information provided in this Podcast. The materials and information contained herein are provided as-is. No part of this Podcast may be reproduced, stored, transmitted, or distributed in any form or by any means, without the prior written permission of the AMA.
Access the transcript of this episode and claim CME here: https://bit.ly/3Hi0LTO
Explore Lifeline for Moms: https://bit.ly/4buiWQI
Explore MCPAP for Moms: https://bit.ly/4hbmA3f
Explore the Behavioral Health Screening as a Part of Ongoing Care Webinar with Dr. Moore Simas: https://bit.ly/4iuIgbw
Follow us on LinkedIn: https://bit.ly/steps-forward-linkedin
Dr. Tiffany Moore Simas, Medical Director for Lifeline for Moms, and Obstetric Engagement Liaison for the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms, explores the opportunities and challenges of maternal behavioral health-focused care models while emphasizing the importance of integrating behavioral health as a core component of perinatal health services. She also discusses programs designed to help physicians provide comprehensive, whole-person care to their patients, addressing both physical and mental health needs throughout their perinatal journey.
🩺 The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most — patients. We will meet this challenge together. Join us: https://ama-assn.co/JoinRenew
🥼 Go to https://ama-assn.co/FightingForDocs to learn more about our AMA advocacy priorities, including:
▹ Reforming Medicare payment
▹ Fighting scope creep
▹ Fixing prior authorization
▹ Reducing physician burnout
▹ Making technology work for physicians
📺 Subscribe to @americanmedicalassociation on YouTube: https://ama-assn.co/youTube
📧 Sign up for #MorningRounds and free daily newsletters from the AMA: https://ama-assn.co/Newsletters
🎧 Listen to our latest medical podcasts: https://ama-assn.co/Podcasts
💬 Follow #AMA on social media: https://ama-assn.co/Social
📓 Access the Journal of the American Medical Association #JAMA login: https://ama-assn.co/JAMA
Disclaimer
The AMA STEPS Forward® Podcast is for informational purposes only. The content is believed to be accurate as of the date of publication. Mention of a third-party organization, product, or service in the Podcast does not imply and is not intended as a promotion or endorsement by the American Medical Association (AMA). This content is not intended as medical, legal, or consulting advice, or as a substitute for the advice of a physician, attorney, or other professional. The views, opinions, and positions expressed by the speakers are theirs alone, and do not necessarily reflect the views, opinions, or positions of the AMA, the individual’s employer, or any affiliated organization. The AMA makes no warranty regarding the accuracy or completeness of any information provided in this Podcast. The materials and information contained herein are provided as-is. No part of this Podcast may be reproduced, stored, transmitted, or distributed in any form or by any means, without the prior written permission of the AMA.
Claim CME and access the transcript for this episode: https://bit.ly/3Su2bAj
Explore the AMA Organizational Biopsy®: https://bit.ly/3WVUuSp
Learn more about the AMA Joy in Medicine™ Health System Recognition Program: https://bit.ly/4hUnJge
Explore Creating the Organizational Foundation for Joy in Medicine™: https://bit.ly/4aMYvhL
Follow STEPS Forward® on LinkedIn: https://bit.ly/steps-forward-linkedin
Dr. Suzanna Fox and Yasemin Moore from Advocate Health, which achieved Joy in Medicine Gold for the Southeast region in 2023, discuss the Best Place to Care Initiative and its use of STEPS Forward® resources and Organizational Biopsy® results to provide well-being care for their physicians and Advanced Practice Providers (APPs).
🩺 The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most — patients. We will meet this challenge together. Join us: https://ama-assn.co/JoinRenew
🥼 Go to https://ama-assn.co/FightingForDocs to learn more about our AMA advocacy priorities, including:
▹ Reforming Medicare payment
▹ Fighting scope creep
▹ Fixing prior authorization
▹ Reducing physician burnout
▹ Making technology work for physicians
📺 Subscribe to @americanmedicalassociation on YouTube: https://ama-assn.co/youTube
📧 Sign up for #MorningRounds and free daily newsletters from the AMA: https://ama-assn.co/Newsletters
🎧 Listen to our latest medical podcasts: https://ama-assn.co/Podcasts
💬 Follow #AMA on social media: https://ama-assn.co/Social
📓 Access the Journal of the American Medical Association #JAMA login: https://ama-assn.co/JAMA
Disclaimer
The AMA STEPS Forward® Podcast is for informational purposes only. The content is believed to be accurate as of the date of publication. Mention of a third-party organization, product, or service in the Podcast does not imply and is not intended as a promotion or endorsement by the American Medical Association (AMA). This content is not intended as medical, legal, or consulting advice, or as a substitute for the advice of a physician, attorney, or other professional. The views, opinions, and positions expressed by the speakers are theirs alone, and do not necessarily reflect the views, opinions, or positions of the AMA, the individual’s employer, or any affiliated organization. The AMA makes no warranty regarding the accuracy or completeness of any information provided in this Podcast. The materials and information contained herein are provided as-is. No part of this Podcast may be reproduced, stored, transmitted, or distributed in any form or by any means, without the prior written permission of the AMA.
Access the transcript for this episode: https://bit.ly/4e7KJsK
Explore Dr. Jessi Gold's episode, One Doctor's Search for Humanity in Medicine: https://bit.ly/46eX7CR
Follow STEPS Forward® on LinkedIn: https://bit.ly/steps-forward-linkedin
In this brief episode, host Dr. Kevin Hopkins shares a quick pearl on combating physician isolation. Drawing on insights from Dr. Jessi Gold's episode, he explores how small, honest moments of vulnerability can quietly signal to colleagues that it's okay to struggle out loud. This simple practice can break down the "push through it" culture in medicine and open the door for others to reach out when they need support the most.
🩺 The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most — patients. We will meet this challenge together. Join us: https://ama-assn.co/JoinRenew
🥼 Go to https://ama-assn.co/FightingForDocs to learn more about our AMA advocacy priorities, including:
▹ Reforming Medicare payment
▹ Fighting scope creep
▹ Fixing prior authorization
▹ Reducing physician burnout
▹ Making technology work for physicians
📺 Subscribe to @americanmedicalassociation on YouTube: https://ama-assn.co/youTube
📧 Sign up for #MorningRounds and free daily newsletters from the AMA: https://ama-assn.co/Newsletters
🎧 Listen to our latest medical podcasts: https://ama-assn.co/Podcasts
💬 Follow #AMA on social media: https://ama-assn.co/Social
📓 Access the Journal of the American Medical Association #JAMA login: https://ama-assn.co/JAMA
Disclaimer
The AMA STEPS Forward® Podcast is for informational purposes only. The content is believed to be accurate as of the date of publication. Mention of a third-party organization, product, or service in the Podcast does not imply and is not intended as a promotion or endorsement by the American Medical Association (AMA). This content is not intended as medical, legal, or consulting advice, or as a substitute for the advice of a physician, attorney, or other professional. The views, opinions, and positions expressed by the speakers are theirs alone, and do not necessarily reflect the views, opinions, or positions of the AMA, the individual’s employer, or any affiliated organization. The AMA makes no warranty regarding the accuracy or completeness of any information provided in this Podcast. The materials and information contained herein are provided as-is. No part of this Podcast may be reproduced, stored, transmitted, or distributed in any form or by any means, without the prior written permission of the AMA.
Claim CME and access the transcript of this episode: https://bit.ly/45o9s7a
Explore the Value of Feeling Valued Playbook: https://bit.ly/43BX9Vk
Explore the "Real PTO" for Physicians Toolkit: https://bit.ly/4ifGECW
Explore the Wellness-Centered Leadership Playbook: https://bit.ly/4kKpyP9
Follow STEPS Forward® on LinkedIn: https://bit.ly/steps-forward-linkedin
Dr. Rob Saper, Chair of the Department of Wellness and Preventive Medicine at Cleveland Clinic, explains what it means to fully disconnect from your work as a practicing physician, and discusses practical, actionable steps to do so.
🩺 The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most — patients. We will meet this challenge together. Join us: https://ama-assn.co/JoinRenew
🥼 Go to https://ama-assn.co/FightingForDocs to learn more about our AMA advocacy priorities, including:
▹ Reforming Medicare payment
▹ Fighting scope creep
▹ Fixing prior authorization
▹ Reducing physician burnout
▹ Making technology work for physicians
📺 Subscribe to @americanmedicalassociation on YouTube: https://ama-assn.co/youTube
📧 Sign up for #MorningRounds and free daily newsletters from the AMA: https://ama-assn.co/Newsletters
🎧 Listen to our latest medical podcasts: https://ama-assn.co/Podcasts
💬 Follow #AMA on social media: https://ama-assn.co/Social
📓 Access the Journal of the American Medical Association #JAMA login: https://ama-assn.co/JAMA
Disclaimer
The AMA STEPS Forward® Podcast is for informational purposes only. The content is believed to be accurate as of the date of publication. Mention of a third-party organization, product, or service in the Podcast does not imply and is not intended as a promotion or endorsement by the American Medical Association (AMA). This content is not intended as medical, legal, or consulting advice, or as a substitute for the advice of a physician, attorney, or other professional. The views, opinions, and positions expressed by the speakers are theirs alone, and do not necessarily reflect the views, opinions, or positions of the AMA, the individual’s employer, or any affiliated organization. The AMA makes no warranty regarding the accuracy or completeness of any information provided in this Podcast. The materials and information contained herein are provided as-is. No part of this Podcast may be reproduced, stored, transmitted, or distributed in any form or by any means, without the prior written permission of the AMA.
Claim CME and access the transcript for this episode: https://bit.ly/4dMNa4W
Watch the Human Factors in Health Care webinar: https://bit.ly/3ZBkIKW
Explore the Value of Feeling Valued Playbook: https://bit.ly/4qBbY2x
Follow STEPS Forward® on LinkedIn: https://bit.ly/steps-forward-linkedin
In this AMA STEPS Forward® podcast, Kevin Hopkins, MD, speaks with Amanda Deutsch, MD, FACEP, Director of Well-Being in the Department of Emergency Medicine at Thomas Jefferson University, about the power of appreciation and recognition in health care. They discuss why feeling valued is critical to reducing physician burnout and improving retention, how leaders can embed recognition into organizational culture, and practical strategies that help care teams feel seen and supported. Drawing on research, real-world examples, and Dr. Deutsch’s experience in physician well-being, this episode offers actionable insights for building more human-centered and engaged health care teams.
🩺 The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most — patients. We will meet this challenge together. Join us: https://ama-assn.co/JoinRenew
🥼 Go to https://ama-assn.co/FightingForDocs to learn more about our AMA advocacy priorities, including:
▹ Reforming Medicare payment
▹ Fighting scope creep
▹ Fixing prior authorization
▹ Reducing physician burnout
▹ Making technology work for physicians
📺 Subscribe to @americanmedicalassociation on YouTube: https://ama-assn.co/youTube
📧 Sign up for #MorningRounds and free daily newsletters from the AMA: https://ama-assn.co/Newsletters
🎧 Listen to our latest medical podcasts: https://ama-assn.co/Podcasts
💬 Follow #AMA on social media: https://ama-assn.co/Social
📓 Access the Journal of the American Medical Association #JAMA login: https://ama-assn.co/JAMA
Disclaimer
The AMA STEPS Forward® Podcast is for informational purposes only. The content is believed to be accurate as of the date of publication. Mention of a third-party organization, product, or service in the Podcast does not imply and is not intended as a promotion or endorsement by the American Medical Association (AMA). This content is not intended as medical, legal, or consulting advice, or as a substitute for the advice of a physician, attorney, or other professional. The views, opinions, and positions expressed by the speakers are theirs alone, and do not necessarily reflect the views, opinions, or positions of the AMA, the individual’s employer, or any affiliated organization. The AMA makes no warranty regarding the accuracy or completeness of any information provided in this Podcast. The materials and information contained herein are provided as-is. No part of this Podcast may be reproduced, stored, transmitted, or distributed in any form or by any means, without the prior written permission of the AMA.
Explore Human-Centered Health CareDesigning Systems for Physician Well-Being: https://bit.ly/3RtC2ku
Follow STEPS Forward on LinkedIn: https://bit.ly/steps-forward-linkedin
In this brief AMA STEPS Forward® episode, host Kevin Hopkins MD explains why fixing physician burnout means redesigning workflows, not just offering coping tools. He unpacks how cutting unnecessary cognitive load frees up clinicians' time and mental bandwidth for patient care and shares a simple exercise for spotting and fixing small friction points to build momentum for bigger change.
🩺 The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most — patients. We will meet this challenge together. Join us: https://ama-assn.co/JoinRenew
🥼 Go to https://ama-assn.co/FightingForDocs to learn more about our AMA advocacy priorities, including:
▹ Reforming Medicare payment
▹ Fighting scope creep
▹ Fixing prior authorization
▹ Reducing physician burnout
▹ Making technology work for physicians
📺 Subscribe to @americanmedicalassociation on YouTube: https://ama-assn.co/youTube
📧 Sign up for #MorningRounds and free daily newsletters from the AMA: https://ama-assn.co/Newsletters
🎧 Listen to our latest medical podcasts: https://ama-assn.co/Podcasts
💬 Follow #AMA on social media: https://ama-assn.co/Social
📓 Access the Journal of the American Medical Association #JAMA login: https://ama-assn.co/JAMA
Disclaimer
The AMA STEPS Forward® Podcast is for informational purposes only. The content is believed to be accurate as of the date of publication. Mention of a third-party organization, product, or service in the Podcast does not imply and is not intended as a promotion or endorsement by the American Medical Association (AMA). This content is not intended as medical, legal, or consulting advice, or as a substitute for the advice of a physician, attorney, or other professional. The views, opinions, and positions expressed by the speakers are theirs alone, and do not necessarily reflect the views, opinions, or positions of the AMA, the individual’s employer, or any affiliated organization. The AMA makes no warranty regarding the accuracy or completeness of any information provided in this Podcast. The materials and information contained herein are provided as-is. No part of this Podcast may be reproduced, stored, transmitted, or distributed in any form or by any means, without the prior written permission of the AMA.
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