When President Obama visited Chicago recently to discuss healthcare reform with the American Medical Assn., his reception was polite but not entirely friendly. After weeks of behind-the-scenes courting by the White House, the AMA had just come out against a public health insurance plan -- something the administration hopes will be included in healthcare reform.
It's easy to understand why elected officials court the AMA. For decades, the powerful group has opposed, and sometimes helped to kill, important healthcare reform efforts. Although less powerful than it used to be, it remains America's largest and best-known physician organization. If you're trying to win over doctors and want to be seen by voters as genuinely reaching out, the AMA's convention remains a required visit.
But lawmakers should take note: The AMA does not speak for all physicians. In the battle for the soul of American medicine, the AMA is often on the wrong side. At least, it's not clearly on the right side of key contested issues in this year's healthcare reform debate. If lawmakers really want to reach out to the medical profession, if the media really want to understand what doctors believe, we have some advice: Stop treating the AMA as if it's the only game in town.
At last count, the AMA claimed about 245,000 members, a number that has declined in recent years. Of these, 195,000 are practicing physicians. That's only about 20% of all practicing physicians in the U.S. The same day that Obama spoke to the AMA, seven national organizations representing physicians, medical students, residents and interns held a news conference to support a public health insurance plan. Membership in these organizations totals 215,000, a significant number even though the groups probably have some overlapping membership. As AMA membership declines, these growing organizations arguably represent the future of the medical profession. Their views are more in touch with the American public, which polls indicate overwhelmingly supports providing citizens with the option to purchase public coverage.
In our view, the AMA is stuck in an old model of special-interest politics -- one that represents an increasingly narrow segment of the medical profession. The doctors we know express many worries. Sure, they care about their incomes, but they care about other things too that strongly affect the well-being of their patients.
