Formed in 1847, the American Medical Association (AMA) originally was concerned with education, ethics and public health. Indeed, their mission statement is to “Promote the art and science of medicine and the betterment of public health”. Much of their early history was involved with increasing the quality of medical education and improving the ethical standards of doctors. They subsequently claimed to represent the interests of doctors in the public and private sectors.
Recent history, however, has demonstrated a growing schism between the positions of the AMA and those of the doctors they purport to represent. In 2008 they supported the findings of the International Panel on Climate Control (IPCC) concerning global warming and the contribution of man made factors. As scientists, many doctors challenged their stand at that time and subsequent events have made their position even more untenable. According to their annual report, their crowning achievements of 2009 were to highlight the number of uninsured in America and to initiate a “green” movement for the organization. These were hardly the most pressing issues for their membership.
The proverbial straw that broke the camel’s back, however, came with their support of HR 3200 or Obamacare. They took this position despite the fact that few state medical societies supported the bill and over 20 medical societies opposed it. In a back room deal, the AMA agreed to endorse legislation that was clearly not in the best interest of doctors or patients in return for a nebulous promise to fix Medicare reimbursements to physicians. Each year Medicare payments are scheduled to go down (this year by 21%) in an attempt to balance the Medicare budget. Each year Congress postpones the scheduled cut for fear that doctors will stop seeing Medicare patients. The AMA tried to negotiate a deal that would eliminate these cuts forever. Instead, the Democrats used their endorsement to help propel the legislation and then reneged on their promise to revoke the reimbursement reduction. Physicians were rightfully angry that their organization was increasingly divorced from what was best for them and their patients.
The real reason the AMA does not represent the doctors of this country began in 1968. In that year, the AMA first formulated Current Procedural Terminology (CPT) codes. This is the numerical coding system that doctors, hospitals, and all health care providers use to file claims for reimbursement. In a secret deal, the AMA agreed to provide these codes free to government agencies. In return they gained the exclusive right to sell these codes to providers and insurers. The sale of coding books and software provides annual revenues of $77 million vs $44 million from membership dues. Congress has the ability to end this monopoly at any time with a simple rules change. As a result, it is unlikely that the AMA would do anything to alienate the Congress. This obvious conflict of interest prevents the AMA from effectively representing their physician members.
It is clear that the AMA no longer speaks for the majority of American physicians. Last year they represented only 17% of the 800,000 doctors in the country. Many more refused to renew their membership this year. Much of the AMA consists of academicians, medical students, and public health officials. They are increasingly out of touch with the majority of regularly practicing physicians. These remaining 680,000 doctors are looking for a new entity to be their voice in these challenging times. To that end we have formed Docs4PatientCare. We stand ready to represent the interests of this silent majority and their patients. We invite you to visit us at www.D4PC.org to see what we can do for you.
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