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.
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So you have a 4.1% response rate to your survey and you consider it representative of what MDs think and feel? I imagine you are at least somewhat versed in statistics. I do not think there is any way to know if your survey accurately informs us about the opinion of the majority of MDs regarding the AMA. Maybe only the disgruntled responded?
Did these 700 physicians who were responding to a survey on a physician-only site know their responses where going to posted for the world to see?
I find two sentences in your entire post that mentions what you feel is wrong with the AMA. Maybe I should know already what is wrong but I do not. Your article does little to help. It does not even say what the AMA's stance on healthcare reform is. Maybe I should know already, but I do not.
Sweetheart, you didn't read carefully, and maybe you don't know much about statistics. 4.1 is a pretty good response rate for a national survey. Perhaps you didn't notice, but the article does include a link to a very good, complete physician blog posting as to what is wrong with the AMA and its relationship to physicians. Even if it didn't, you probably know about this thing called a "Google Search." If you're curious, look it up.
Also, if you've been around a physician at all, other than having a malady checked, you would know that the AMA is largely considered a dinosaur at best, a part of the healthcare problem, at worst.
As for the 700 physicians who responded with comments knowing whether their responses would be published, first of all, we don't know, and second, how is that relevant to your point?
Okay, I am not sure who you are or why you think you know anything about surveys but 4.1% is a terrible response rate. Maybe it is still valid in this case but there is no way for me to know.
http://poq.oxfordjournals.org/cgi/content/full/68/1/94
I read this article in the first place to see what was wrong with the AMA. I did not find out. I should not have to do a google search to figure out what a writer is talking about. I learned more from the comments (except yours) than from the article.
It may be hard to conceive and comprehend but my post had multiple points. If a bunch of physicians are discussing things among themselves on a private website they would rightly expect their comments to be private and not be shared with the world. Look at the bottom of the page where it says, "Secure and Confidential."
http://www.sermo.com/
The response to the survey was 4,100 physicians. The 700 number is those who actually wrote a comment. I am a Sermo physician - I responded to the survey; I did not add comments.
And yes, we knew that the plan was to post responses for the world to see. The reason I did not post a response has nothing to do with not wanting people to see my comments, but that many of the comments written at the time I completed the survey already reflected my point of view and I did not see any reason to add mine. I am not disgruntled, but I do not belong to the AMA and I see no benefit to me relative to the cost of the membership dues
Reading is fundamental:
"Within five days, over 4,100 US physicians voted on the poll ...."
There were over 700 comments in addition to the poll answers.
I believe it would prove impossible to stay informed on anything without reading and comprehending what is written.
The biggest risk for physicians is their patients. We are leaving in large numbers, because allopaths continue to ignore the wonderful prevention and cureative properties of Mother Nature. We are sick of prescription drugs that are almost worthless and mostly dangerous. Why do doctors ignore nutrition in their approach? Because science has been bought and paid for by drug companies and their 'ghost writers' filling medical journals with bogus 'evidence based' science.
From the outset, I am a medical student at an allopathic medical school. I also am dealing with horrific sciatica from a disc bulge. I was desperate and searched for hours online for "natural" solutions. I went to a chiropracter, had "non surgical decompression" and tried supplements. The only thing I got from these treatments was a bill. I am sure this stuff works some of the time, but I will stick with my steroid injections and surgical options over this stuff.
As a practicing physician I don't focus on "the wonderful prevention and cureative properties of Mother Nature" because when people come to me they are already sick; they seek my help to get well.
I have no argument with prevention, but I don't consider that to be my job. It's YOUR job, before you are sick. When prevention isn't enough, you have the option of seeking advice from an allopath -or not. If you consider medications we prescribe to be "almost worthless and mostly dangerous," then don't take them - I doubt anyone is shoving them down your throat.
We don't go rounding up patients off the street. When they come to us, we offer advise about their illness - which they can follow or not.
Post like this make assumption about physicians' motives, roles, and responsibilities that are inaccurate. We cannot specialize in everything. To expect us to be in charge of "prevention" is like expecting a lawyer to prevent your legal issues as well as helping you to fix them.
Again, I am in favor of preventing as many illnesses as possible - but that doesn't mean you need an allopath' to assist you. I would be thrilled if all that was expected of me is to do what I am trained to do - and not be expected to do everything else as well.
Good show oklagirl. As a very healthy 56 year old I am who eats right (organic) I acknowledge my role in being and staying healthy. Since I am not allowed to grow opium poppies in my backyard Allopathic is the only legal recourse for treatment of pain syndromes. And since marijuana is illegal allopathic is often the only way to go to get some deeper sedation. Why would a healthy man need sedation? Look at our political,financial and media systems and there you have it.
Yes, the AMA is "in bed" with the insurers-they created the CPT coding system and sell rights for it's use to both the government and commerical insurers.....
I am a proud member of the American College of Physicians, the governing board of internal medicine. Also busying representing pediatricians is the American Association of Pediatrics and the FPs are represented by the American Association of Family Practitioners. You will find each of those bodies has proposed solutions to our healthcare crisis. No one is paying much attention because of the MSM's misguided fascination with the AMA, an agency to which less than 30% of practicing MDs belong to
"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." Well thare's one answer to what may be a big part of the problem. How about seeking out some appropriate input from relevent sources?
Dr Palenstrant,
I had pretty much figured the AMA and insurers were in bed together. Do most people realize how physicians are treated? Having quotas of patients to see each day? That it is the specialists who are making the real money? That PCP's and pediatricians are not?
The physicians I know in my town, across the board, say that they are not members, nor represented in any way by the AMA. They have a conflict of interest as stated in the writing above, in that they are receiving money from insurers, in order to survive as an organization, which "representing" the physicians whose lives and practices are being destroyed by the insurance companies they are in bed with. On the Hill, they'd call that a conflict of interest....and there's a lot of that kind of thing on the Hill anyway. Although I practice Chiropractic, it has been clear for the last 15 years at least, that the true enemy of any healthcare provider who bills private insurance, PPO, HMO, and in many ways, Medicare, are the entities that use the bait and switch/war of attrition policies that deny or cut our reimbursements. Healthcare providers of different disciplines who used to engage in turf wars, have long since changed to share much more in common, with one another, as they face the true enemy. Our professional organizations can only do so much. We are all sick of watching insurers reap millions in profits, salaries, perks and bonuses, while we are earning what we did back in 1980, and patients are routinely denied care that they need with explanations like: not a covered benefit, not medically necessary, not scientifically supported.
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