Physicians Say the AMA No Longer Their Voice

They say, “Perception is reality.”  If that is the case, the American Medical Association (AMA) is in serious trouble.

In a recent survey of physicians conducted by the Atlanta-based physician recruitment firm Jackson & Coker, doctors believe that the AMA no longer represents their views. A whopping 77 percent of physicians reject that premise that the AMA currently reflects their profession. Only 11 percent said the nation’s oldest doctors’ organization today stands for what they do. (To view the survey, go to: http://www.jacksoncoker.com/news/News.aspx?sc_cid=AMA)

When asked if they agreed with the AMA’s support of federal health reform, physicians said the organization sold out the nation’s medical profession.  The AMA’s high profile endorsement of ObamaCare has been questioned by AMA and non-AMA member physicians from every corner of the country.

So why did the AMA turn its back on the medical professional?

Many believe that the AMA is deeply conflicted. You see, the AMA was torn between generating revenue versus reflecting the position of America’s practicing physicians.  The AMA owns the mechanism by which the entire healthcare delivery system is reimbursed – a coding system used for Medicaid and Medicare reimbursements and then utilized in the private health insurance market. The contract for CPT codes or Current Procedural Technology belongs exclusively to the AMA.

In 2008, the AMA collected an estimated $70 million from books, workshops, and licensed data files related to CPT codes, according to the National Center for Policy Analysis.  Membership dues accounted for less than 16 percent of 2008 revenues, according to the NCPA.

Clearly, the AMA is conflicted between the revenue which is generated by the CPT coding system and doing what’s right for the medical profession.

And, the Jackson & Coker poll speaks volumes about this conflict.

When asked why former AMA member physicians dropped their AMA membership, over half pointed to the “CPT business is a conflict of interest.”

And the current CPT coding system is also a major barrier to fundamental, comprehensive and legitimate healthcare reform.

Most experts agree that ObamaCare was little more than a band-aid on a system which needs real change.  There are no CPT codes for creating a system which rewards improved health outcomes. There are no CPT codes which pay physicians and hospitals for providing outstanding patient care. The CPT coding system reinforces the status quo. So, when the AMA endorsed national health reform, it did so to preserve the current system which is clearly broken.

But what does this mean going forward?

First, the Jackson & Coker survey reaffirms that the AMA is out of touch with the thoughts and beliefs of most physicians.  More than 70 percent of the responding doctors said that the AMA no longer represents physicians.  Secondly, as more and more medical doctors leave the AMA, there will be opportunities for organizations like Docs for Patient Care (Docs4PatientCare) and state medical associations to step in to more accurately reflect the needs of physicians. Seventy-five percent of the physicians surveyed by Jackson & Coker indicate that “physicians need a more representative voice.”  And lastly, issues like tort reform, government over-regulation of the medical profession and legitimate healthcare reform will be addressed by some organization other than the AMA.

There is a fundamental difference between leadership and representation. Unfortunately for America’s physicians, the AMA is doing neither.

Oliver is a vice president at the Center for Health Transformation, founded by former Speaker Newt Gingrich.

21 comments Add your comment

Dr Nathan

September 8th, 2011
11:03 am

Stories that demonize the AMA are just cheap shots by self-absorbed “experts” who are either bashing physicians to promote a narrow agenda or who are too lazy to discover the truth.

Wayne Oliver - vice president, Center for Health Transformation

September 8th, 2011
11:15 am

My intent was not to “demonize” the AMA. It was my hope to create an awareness that the AMA is out-of-touch with their members. When healthcare professional organizations do things based on their income stream as opposed to doing what is in the best interest of physicians and their patients, both lose.

Dr Nathan

September 8th, 2011
2:15 pm

It’s unfair to demonize the AMA for taking direction from the majority view expressed by the representatives of the nation’s grassroots physicians.

I was there when physicians representing every state and specialty voted by a two-third majority to affirm the AMA’s commitment to health reform and endorsed bedrock principles encompassed in the Accountable Care Act.

I was there again when physicians representing every state and specialty voted by a two-third majority to affirm the requirement to purchase health insurance.

These votes regarding the course of the AMA’s health care agenda were intense. The opinions were passionate and the debate was sometimes fierce. Ultimately there was a clear final product – a shared vision for health reform.

This broad-based, representational-style policymaking process is what makes the AMA, without question, the umbrella organization of American medicine.

Wayne Oliver - vice president, Center for Health Transformation

September 9th, 2011
8:29 am

Adain, Dr. Nathan, while I appreciate the role of organized medicine (I started my career with the Medical Association of Georgia), I was reporting a nationwide survey of physicians about THEIR perception of the AMA. No demonization. Just reporting the beleifs of real physicians dealing with real frustrations with the organization which purports to reporesent them.

John

September 9th, 2011
11:14 am

I read the survey results: It has a 1.44% response rate. There is no reason to put any confidence in the results when 98.56% of those sent survey invitations did not respond. Authors do not go into how they selected people either.

Tom

September 9th, 2011
11:26 am

The majority of respondents are people who dropped their AMA membership. Seems to be a bit biased, wouldn’t you say? I appreciate the breakouts by membership status, but you’d be doing more of a service if Total results were weighted to national distribution of AMA member status.

id_doc

September 9th, 2011
11:28 am

I do research at the AMA and I also care for patients at the University of Chicago – so perhaps that gives me 2 strikes by your anti-AMA, anti-academic reckoning. But there is some value in knowing something about survey research.

The survey you are ‘reporting’ on is worthless as research (regardless whether you see it as useful for propaganda against health reform). Check out slides 13 and 20. The response rate was 1.44% (slide 13) and the geographic distribution is very skewed towards the south (see slide 20). There is no indication of how this firm chose physicians to send the survey to or whether the data have even been weighted to account for the skewed respondent population.

The bottom line is that there are over 600,000 physicians in the US, and of these, a very select 1,600 replied to this survey. So the only thing these results show is that it’s easy to find a cluster of docs who both oppose AMA positions and don’t understand how the AMA works (i.e., that is is a representative assembly with every state and specialty society voting).

American Medical Association

September 9th, 2011
11:33 am

Physicians in our nation face a variety of challenges and opportunities – they hold a wide range of views that reflect the diversity of the profession and are not easily summarized from this small group: less than 1.5 percent of those who received the survey chose to respond. The extremely low response rate and the type of survey conducted make it hard to say this is representative of all physicians.

To suggest a quid pro quo on the AMA’s support for health reform and CPT is absurd – since the Reagan Administration chose the AMA’s Current Procedural Terminology (CPT) in 1983, not a single taxpayer dime has been paid to the AMA for the use of CPT in the Medicare and Medicaid programs.

The AMA recognizes that physicians’ attitudes around health system reform are diverse. The AMA is leading the charge to address flaws and repeal problematic parts of the legislation like the Independent Payment Advisory Board (IPAB) during the implementation of the health reform law and to advocate for policies that help physicians and patients thrive as we keep moving medicine forward together. The AMA continues to have concerns about other issues in our health care system and we are leading efforts to pass comprehensive medical liability reform, repeal the broken Medicare physician payment formula, and improve care coordination and quality while addressing cost through new models of care delivery. We have long had policy in favor of covering the uninsured and are pleased that the new law extends insurance coverage to more Americans while retaining our uniquely American system, which includes a private and public mix of insurers.

Dr Merthin

September 9th, 2011
2:17 pm

The membership numbers of the AMA speaks louder than any survey. I think about only 20% of physicians in the USA belong to the AMA, and of those, many are medical students/residents who are given free or reduced membership and retired physicians.

The AMA represents itself. It does not represents the best interests of medical doctors or their patients. Support for Obamacare by the AMA is proof positive. Obamacare invites the most invasive, malignant bureaucracy ever devised by man into the physician patient relationship…the Federal Government.

American Medical Association…a joke. Real name…Association of Medical Asshats.

awmd

September 9th, 2011
2:19 pm

“To suggest a quid pro quo on the AMA’s support for health reform and CPT is absurd – since the Reagan Administration chose the AMA’s Current Procedural Terminology (CPT) in 1983, not a single taxpayer dime has been paid to the AMA for the use of CPT in the Medicare and Medicaid programs.”

This is a non-sequiter. The AMA needs its CPT monopoly to reap dividends from private insurers. The government guaranteed that monopoly. It is not “absurd” to believe that the AMA’s backing of health care reform was tit-for-tat.