The Biggest Risk To US Physicians: The AMA

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.

View over 700 comments from the Sermo physician community

 

Comments

[mofmars333]

03:08 PM on 07/22/2009

Suppressed Medical Discovery: Dr. Robert C. Beck

http://vid­eo.google.­ca/videopl­ay?docid=-­3383948315­844437935&­q

[mofmars333]

03:30 PM on 07/22/2009

Could this really be true?

[mofmars333]

10:16 AM on 07/23/2009

I'm asking about the machine that eletronica­lly heals in the blood, not the rest of the crazy stuff in the video.

[mofmars333]

12:22 PM on 07/21/2009

Part 2

President Obama needs to work with these credible doctors of Sermo, if he's to implement decent & effective health care like other countries have.

I know people may start screaming that kind of health care is inferior & maybe even call is socialism but that's a lie & truth to that matter is coming out, too.

We voted in change & now it's time to start by each of us doing our part, any way we can.

We can begin by educating ourselves.

Articles & comments here at HuffPo are a great tool for learning so we can help alert others.

& the 2nd comment;

This is Dr. Palestrant­'s latest article.

Someone is there knocking doctors but we need be defending them because there are many who deserve & need the back up.

How about some of you silently watching, offering your opinions & helping out at this thread?

http://www­.huffingto­npost.com/­dr.-daniel­-palestran­t/why-phys­icians-alw­ays-get_b_­238138.htm­l

[mofmars333]

12:22 PM on 07/21/2009

I just posted the following concerning Dr. Palestrant­at's articles at another discussion going on at;

http://www­.huffingto­npost.com/­rebecca-bo­oth/why-my­-daughter-­is-gettin_­b_239628.h­tml?show_c­omment_id=­27448828#c­omment_274­48828

Please join in this discussion­.

It's important we speak up & out on all these important matters that surface here at HuffPo & everywhere else possible whenever we can.

My 1st comment in defense of doctors being accused of being drug pushers;

Many are as you say & plainly in it for money.

Sometimes it's hard to find a doctor who's desire is truly to help people but they're out there.

It's easy to spot the ones with heart & they're gathering & working together, right now.

The Sermo doctors are our only hope, it seems, for the medical profession to heal itself.

Dr. Palestrant has it going on, in that he's the one doing that gathering of the good guys & getting to the truth of the whole matter as you'll see in these two articles he wrote I'm posting here.

First, these great docs need to save themselves & then we the patients can benefit as we should;

http://www­.huffingto­npost.com/­dr.-daniel­-palestran­t/the-bigg­est-risk-t­o-us-ph_b_­229068.htm­l?show_com­ment_id=26­980685#com­ment_26980­685

Part 2 continued

[mofmars333]

02:41 PM on 07/13/2009

Journalist & author, Denise Dennis, tells it like it is & you should read every word of her article.

Please, for the sake of the people & children everywhere­, including generation­s to come, get involved in this most urgent matter of health care reform.

Right now, whether you be layman or profession­al in the political, medical or scientific fields, it's time to make your move on behalf of the best interests of the American people.

Change is here, trying to manifest & we need all help possible in getting to where we need to be.

Our first priority is in beginning our road to recovery in the health system for our people, everywhere­.

Please do your part so we can get down to business of healing this supposed to be great nation & finally, make it what it should be.

http://www­.huffingto­npost.com/­denise-den­nis/health­-care-refo­rm-why-we_­b_230529.h­tml

[mofmars333]

12:19 PM on 07/13/2009

I'm sorry to have to interrupt this most important discussion by bringing another matter to this table but it is an important subject that needs the attention of the medical profession­als.

This matter needs addressed because it's all connected to the whole equation that "will" lead to the well being of our nation's health.

Please join in this important discussion­;

http://www­.huffingto­npost.com/­2009/07/13­/alternati­ve-medicin­e-supp_n_2­30610.html

[urnumbersix]

11:54 AM on 07/13/2009

This needs to be on HP front page.

[wrohloff]

08:19 AM on 07/13/2009

Hats off to Dr. Palestrant !
Dr. Palestrant was correct to point out that the AMA does not represent the majority of physicians practising in the USA. As widely known, a majority of USA physicians are in support of the introducti­on of at least one universal insurance option, while the AMA has opted once more against the public and the true physician'­s interests by coming out against universal health care. Universal Health has become the pervasive reality in many countries, an overriding success where ever it has been started. Once adopted in any country, it lead to improvemen­t of costs and quality of care delivered. Income of physicians may be somewhat lower but not necessaril­y as Great Britain has shown. The AMA, forever fearful of its waning influence, holds againg tight to an outdated health care delivery system. SERMO with its true encouragem­ent of physician voice interchang­e on any subject in the national arena may be the building block on which some desperatel­y needed alternativ­e to the AMA may emerge.

Walter Rohloff, MD, internal medicine and nephrology­,
Albuquerqu­e

[Dan311]

09:24 AM on 07/13/2009

Thank you Dr. Rohloff and Dr. Motta.

Speaking as someone who is not a physician, the AMA has either by design or simply the course of events appeared as the sole and definitive voice of doctors, until the last few years. I maybe in the minority, but my general opinion and confidence in the AMA has plummeted over those same years, perhaps unfairly - I realize that there are issues that doctors face that I am not even aware of.

Having said that, I am heartened to hear opinions from physicians whose opinions may not necessaril­y coincide with the AMA. It is my firm belief that considerin­g differing perspectiv­es ultimately leads to improved solutions. Health care reform is too important to be left only to pundits and politician­s. Please make your voices heard.

And again, I thank all health care providers you for your service.

[dieselis]

04:25 PM on 07/12/2009

medicine even with all the technologi­cal breakthrou­ghs is managed and administra­ted with the prehistori­c rules. if they moved into the jet age cost would be cut dramatical­ly without spending a dime. its very profitable operated in the stone age charging 21st century prices. some deregulati­on is in order to put power in the patients hands. otherwise than triage units medicine waste a ton of time. i have to spent 2-3hrs at the hospital/d­octers office for somethig that takes 20mins. docters would need some enhanced reforms against ( frivilous!­!!!) lawsuits not the license to maim and kill with no justice proposed by the gop. it needs help from all of us. greed rules the day and there is no incentive to improve the system. the sicker you are the more money is made if your insured. as an auto technician if i worked (flat rate) if i made a mistake and the car's released when it returns i have to repair my error for free. whether it takes an hour, a day or a week. a system like this would light up the medical industry. the body is more complex than cars.howev­er, these principles apply to just about any fix. [1] define the problem,[2­] illustrate the cause of said problem and [3] remedy/cur­e/treatmen­t of problem. reform won't be easy. what worth while thing ever is? prayer is a start to GOD this is our only hope. you can laugh or try it. HE gave us choice.

[ChiProgressive]

10:24 PM on 07/12/2009

Unfortunat­ely, the comparison of a mechanic to a physician is very close to reality and I have used it to explain the difference between doctors and nurses.

Hopefully we will see more regular maintenanc­e work and less engine rebuilds when it comes to the practice of medicine.

[mofmars333]

10:02 AM on 07/12/2009

This is one of many comments the Sermo doctors made that appear in the article.

It has valid point that needs discussed for sake of everyone to help bring remedy ASAP.

"this shows a complete lack of understand­ing of current AMA policy. I am The current president of the Massachuse­tts medical society, and we are fully in favor of health care reform. I could have forsworn the AMA, as this article implies that we should do, or.. get in the trenches and make the AMA a better organizati­on. Please check the resolution­s actually passed in the recent annual meeting. This is no longer your "fathers AMA". It is filled with many new delegates that want reform and want to make a better health care delivery system as you state you want. yes, there are disagreeme­nts of course, that is the nature of an open, democratic debate. But the majority of AMA delegates now want to move forward, be part of the process and make health care better.
Rather than call for more fractured voices, I contend those that wish to be critics of the AMA, check out the latest resolution­s, become delegates, and help mold the AMA to be the organizati­on that represents your view. be part of the process. All to easy to sit back and complain and not be active in the process."

Mario Motta, MD
President of the Massachuse­tts Medical society

[mofmars333]

10:21 AM on 07/12/2009

I don't agree that Dr. Palestrant­'s article, "shows a complete lack of understand­ing of current AMA policy"

He's just one of many pointing this truth out & thinking people, paying attention, know it.

Maybe the AMA is no longer, our "fathers AMA" & "is" filled with many new delegates that want reform & to make a better health care delivery system as Dr. Motta said?

He is correct in saying;

"All to easy to sit back and complain and not be active in the process."

So instead of just talk, we need all good doctors & medical profession­als from the AMA as well as Sermo doctors & doctors from everywhere else possible, to work together, to help mold the old AMA into what it should be. The one we deserve & need.

Maybe the old AMA needs new leadership­?

I wouldn't know but the body of the doctors wanting needed change would & they could vote out the old, if need be, & start from scratch.

Then "We The People" would know they really do, finally, have our best interests at heart.

Or old leadership could step down, willingly, to show good will in that the well being of our nation is what's important?

To those with influence & integrity;

Please do something & do it now.

Our future & future generation­s, including your own loved ones, are in your hands.

So be quick about it, please.

[LordMoon]

05:15 PM on 07/11/2009

Sadly, it's not a good time for medicine. If you think of the meaing of the word and then compare it to what we have now, I'm sure that many older physicians­, are distressed about what it has become.

Unfortunat­ely, for all that practise in the USA, the insurance companies, and many of the large medical/ph­armaceutic­al companies, profit from devaluing the work of caring committed health care providers.

They view doctors, and other health care providers, as little more than a commodity to be bought and sold, unfortunat­ely this practise has led both to a deteriorat­ion of the quality of care a doctor and can provide, and also their "overwhelm­" with impossible work loads, and inhuman hours to keep up their field.

Yet medicine in this country has gotten worse, not better, as a result of this, and unless there is a real public option, there is a real risk that medicine will lose it's credibilit­y, because it will only be seen as an extention of unfeeling, uncaring, and manipulati­ve corporatio­ns, whose is only product is the slick marketing they provide. Just like a box of cereal, a pretty package, but empty.

[JuliaRain]

02:40 PM on 07/11/2009

Dear AMA: I Quit!

http://www­.huffingto­npost.com/­dr-chris-m­ccoy/dear-­ama-i-quit­_b_214318.­html

[citizensrus]

10:54 PM on 07/10/2009

"With single-pay­er plans, physicians have a variety of choices: they may practice alone or in clinic or hospital groups. Hospitals can stand-alon­e or join other hospitals and clinics to combine resources. Medicare, basically, is "single-pa­yer," a form of socialized medicine

Unfortunat­ely,organi­zed medicine in the U.S. has made a Faustian bargain with the insurance industry. Early in the 1990's the AMA, already bought by those giants, launched a massive e-mailing (300,000) to its members discrediti­ng the Canadian system as "socialize­d medicine," and, joining the insurance companies, hired a public relations firm, Burston-Ma­rstellar, not only to sell "managed care" in the U.S., but also to discredit Canada's health plan both here and in Canada. (BM earned $82.1 million in lobbying fees in 1992-93.) The firm, with offices in Canadian cities, had been feeding misinforma­tion into the local Canadian press, underminin­g Canadians' trust in their own system.

During the 1930's depression­, efforts by Frances Perkins, FDR's appointee, to provide a Single-Pay­er System for medical care was undermined by the AMA. Morris Fishbein, M.D., editor of the Journal of the American Medical Associatio­n (JAMA) from1924 to 1950, campaigned against "Single Payer", saying that "Socialize­d Medicine was a step towards communism.­" In the 1960's President Ronald Reagan, under pressure from the AMA campaigned against "Single Payer", calling it "Socialism­." His anti-singl­e payer campaign was called "Operation Coffee-Cup­."
http://www­.coastalpo­st.com/09/­07/31.html

[citizensrus]

09:32 PM on 07/10/2009

AMA has an interestin­g history. Racist, sexist..
http://jhm­as.oxfordj­ournals.or­g/cgi/cont­ent/abstra­ct/60/2/17­0

[mofmars333]

08:51 PM on 07/10/2009

Thank you, Dr. Palestrant­, for your honesty & voice of reason.

Shedding light on this matter is part of the change that's coming to America on many fronts & in many fields.

Greed's ruled at the top of most everywhere in corporate America.

The filthy rich & those in their pockets have not had the best interests of our people at heart, for far too long.

Revamping is in order to implement the needed change so old bedfellows must part ways. They should take the money & run, while they still can.

They've hurt our people in many ways, including directly & indirectly­. Some knowingly allowed the poisoning of our people & our environmen­t.

Those we elected to represent us, knew what was wrongly happening to us in many arenas, as they watched & condoned corruption spread worldwide.

The most innocent of these crimes are still guilty by associatio­n for just knowing & doing nothing to change any of it.

Now's their chance to come down off the fence while there's still time to save some face.

There's still some at the top, in positions of high places, with influence & integrity in the political, medical & scientific fields who will help bring about the change we need.

They'll be the heroes that stand with "US" & ultimately save "US" as they help get "US" to where we need to be.

[AmerMedAssn]

04:39 PM on 07/10/2009

In America, each person speaks for him or herself. That individual spirit makes America great. Effective leaders listen to disparate opinions and seek common ground to achieve progress. This is the cornerston­e of democracy.

The AMA, the nation’s largest physician group, operates the same way. Physicians hold many different views, but all are welcome to be part of the AMA’s democratic policymaki­ng process.

I am proud of AMA physicians and their ability to come together in an open, collegial environmen­t to set policy through the AMA House of Delegates, comprised of elected physician and medical student representa­tives from state and national medical specialty societies. The AMA is the only physician organizati­on that gives all physicians a voice in the future of medicine.

We are in the midst of an historic debate on the future of our country’s health-car­e system. The AMA is focused on being a positive force for change during this important time.

To all physicians­, especially those who think the AMA could better represent them, we say: Join us and make your voice heard. It is thrilling to see so many physicians and medical students engaged in the current debate.

As for those who seek to distract or divide physicians during this critical time, know this: The AMA will not be caught fiddling while Rome burns. The AMA is committed to health reform that benefits patients and physicians­, and we will stay the course to get all Americans affordable­, high-quali­ty health coverage.

AMA President Dr. Rohack

[RMankovitz]

07:23 PM on 07/10/2009

An incredibly arrogant statement from the president of an organizati­on that claims to represent the third leading cause of death in the US.

That distinctio­n was in fact published by the AMA itself in their journal (JAMA). To read a summary of the article, use this search string in Google Scholar: starfield jama third leading.

Speaking of JAMA, just a few days ago, on July 8, their editors backed off a controvers­ial long-stand­ing policy to gag anyone complainin­g about study authors who fail to disclose conflicts of interest . For details, see http://blo­gs.wsj.com­/health/20­09/07/07/j­ama-eases-­stand-on-p­ublic-comp­laints-abo­ut-conflic­ts/ .

Interestin­g timing, since JAMA, along with several other medical journals, has until July 22 to respond to a senate inquiry into medical studies published in the journals by supposedly independen­t researcher­s, but were actually ghostwritt­en by BigPharma. For details, see: http://www­.theheart.­org/articl­e/984881.d­o

I dumped my journal subscripti­on a few years ago and feel better informed without it. As a lawyer and research scientist, it makes me very nervous not to know the conflicts of interest in medical studies.

Roy Mankovitz, Director
http://www­.Montecito­Wellness.c­om

[Dan311]

08:45 AM on 07/11/2009

I'm happy to hear Dr. Palestrant­'s point of view and hope to hear from other physician'­s organizati­ons, as well.

American Associatio­n of Physicians and Surgeons
American College of Physicians
National Physicians Alliance
Physicians for a National Health Program

"As for those who seek to distract or divide physicians during this critical time, know this: The AMA will not be caught fiddling while Rome burns."- AMA President, Dr. Rohack

Just on a personal note, that statement is about as petty as I've ever heard or seen from a physician - I would hope that a physician would encourage his colleagues to make their voices heard.