The Biggest Risk To US Physicians: The AMA

The sad fact is that the AMA membership has now shrunk to the point where the organization should no longer claim that it represents physicians in this country.
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On June 15th, 2009, President Barack Obama traveled to Chicago to deliver a speech to share his vision for reinventing health care. It was an impressive oration and an important step in the journey towards comprehensive health care reform. Too bad the US physician community was a no show, for although he received several rounds of applause and a standing ovation, his audience, the American Medical Association (AMA) has long since lost it's role as the voice of US physicians.

We stand on the verge of a trillion dollar health care reform effort - the largest in our country's history - and yet input from practicing physicians has been scarce if not entirely absent. The importance of dedicated, practicing physicians having a voice in this debate is critical to the future of our nation's health care. Seeing the increasing divergence between the perception that the AMA seeks to perpetuate among the general public and an increasingly angered physician population, Sermo polled the 100,000 US physicians in our community as to what they thought of the AMA. Within five days, over 4,100 US physicians voted on the poll and discussed it in over 700 comments. The results were nothing short of stunning - 89% of those physicians say, "the AMA does not speak for me" (See full survey results).

The following is a posting I presented along with the poll to the Sermo physician community on July 1st, 2009. This will be the first of a series of blog posts representing the Sermo physician community's view points on key issues facing healthcare and the reform process currently under way in our country.

First posted to the Sermo physician community on July 01, 2009:

From the Founder: The Biggest Risk to US Physicians: The AMA

As physicians, our first step in the health care debate needs to be clearing the air about who speaks for us on what topics. Today, I am joining the increasing waves of physicians who believe that the AMA no longer speaks for us. As the founder and CEO of Sermo, this is a considerable change of heart, given the high hopes that I had when we first partnered with the AMA over two years ago. The sad fact is that the AMA membership has now shrunk to the point where the organization should no longer claim that it represents physicians in this country.

The AMA has drawn its power from the support of the physician community. The waning membership reflects our objection as the AMA has failed us consistently for over 50 years. Make no mistake, the debate within the AMA about how to stop their membership decline is not new. What is new is the lengths to which the AMA appears willing to go to deceive the public on this topic. The AMA routinely claims that their membership is 250,000 practicing physicians. At best, this is 25-40% of practicing US physicians and even that claim is based on some stretching of the truth. The 250,000 total includes a number of non-practicing constituencies, including medical students, residents, and subscribers of the AMA's journals. Paying membership is generally accepted to be far lower. How much lower? Actual numbers are remarkably difficult to come by.

At this critical moment in history, we cannot watch the AMA fail physicians so completely yet again. Nor can we stand by and let false perceptions about who speaks for physicians persist. At the very least, all parties should understand the intrinsic conflicts of interest that are in play, and the AMA should be held accountable to these truths. Better yet, physicians should call for sweeping changes within the AMA. In the best-case scenario, the AMA will shed its relationships with insurers and abandon tactics that take advantage of physicians to generate millions of dollars in revenue. It is an inherent conflict of interest to claim advocacy for physicians while profiting from a reimbursement system that makes it increasingly difficult for physicians to practice medicine.

The flight from the AMA signals that physicians don't believe the AMA is willing to make these changes. The longer that the public and our lawmakers cling to the perception that the AMA represents the voice of US physicians (and the AMA succeeds in perpetuating this), the more imperiled the medical profession will be and with it the broader US healthcare system. It's time to turn to entities like Sermo where physicians are establishing a new voice to collectively discuss the future of our profession.

There can be no healthcare reforms that have any chance of succeeding without buy-in from physicians. As a country, we cannot risk another failed reform effort. As physicians, we cannot risk letting the AMA represent our interests. This is our time to educate the public about which voices truly represent us and our commitment to our patients.

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