If you’re not an AMA member, you have no right to complain

All American physicians should be members of the American Medical Association (AMA). And, while they are at it, they should also be members of their county, state, and principal specialty societies.

Why? Because they are the only games in town, and both security and safety are top Maslow imperatives.

The only real political power any physician has is the individual power of persuasion and participation (or not) and the power of a group.

American physicians, if united, would have huge clout, speaking with one voice. American physicians, divided as now, speak with hundreds of thousands of individual voices, a cacophony of futility.

As The Bard saith in Macbeth “… tales told by idiots, full of sound and fury, signifying nothing.”

If you are an American physician and you don’t like what the AMA has done and is doing, if you are not a member, shut your mouth, you have no right to complain.

If you blame the AMA for the sorry state of American medicine in 2012, you are at least partly correct. But there is plenty of blame to spread around to many other culpable individuals and groups.

Many physicians feel that the AMA has not represented their physician interests effectively enough. Since 85% of American practicing physicians are not AMA members, what right have they to blame the AMA? None.

The AMA has in fact represented the interests of American physicians a great deal. Perhaps even too much.

After all, the mission statement of the AMA is “to promote the art and science of medicine and the betterment of public health.” That statement takes into account the unselfishness that is supposed to characterize a learned professional … that patient and public interest trump personal interest.

If a large majority of American physicians disagree with that basic tenet, they should organize and seek to change federal and state laws that actively discourage formal collective bargaining by physicians. Form a real union, either by changing the AMA, or with a replacement national organization.

Frankly, I believe that a medical student should automatically become an AMA member the first day of medical school, and that such membership should be lifelong. Call it a “mandate for professionalism.”

Were there such a sea change, physicians really could exercise group power and begin to “signify something” with targeted collective sound and fury.

American medicine is entering a period of even more hazard for the concept of medicine as a learned profession. Togetherness is imperative.

And before any reader asks “how much did the AMA pay you to shill for them?”, be assured that, after my departure from the JAMA job in 1999 was settled out, I have received zero dollars from it. And, I still pay my dues as a member, since 1968.

Join us today. Change our world.

George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association.

Comments are moderated before they are published. Please read the comment policy.

  • Edward Stevenson

    not being a member is a form of complaining

  • familydoc


    Because they are the only games in town” No, they are not:
    http://docs4patientcare.org/

  • http://doctor-rob.org/ Dr. Rob

    Two reasons I haven’t joined the AMA: 1. I am a PCP, and their policies have favored a reimbursement formula that favors specialists, hurts me, and hurts my patients. 2. Since #1 is true (and since I am in the AAP and ACP), I don’t have money enough to pay dues to an association that hurts me and my patients.

    The reality is that primary care has fled the AMA because it favored the specialists, and the AMA has favored the specialists because primary care has fled. The onus has been on them to prove they are on our side.

  • Easton Jackson

    George, the AMA long ago poisoned the well. We’re not coming back. They sold us out time and time again. Why don’t you go get the AMA to endorse some toasters. Perhaps you can include a licensed copy of CPT with each toaster sold.

    Like Dr. Rob, I’m a PCP, and CPT has never represented primary care fairly.

    Perhaps a new organization, but never the AMA.

    I do belong to the AAFP.

  • bladedoc

    Sure, you’ll get your check the day after PETA cashes my membership check. I’m sure I can convince them to serve steak at their annual dinner.

  • http://twitter.com/elenaj_cooper Elena J. Cooper

    I am a first year medical student and at our interest group meeting, I decided not to join the AMA. Many first year/medical students are not concerned with the AMA’s agenda, they simply want the “free stethoscope”/”Netter Anatomy Flashcards”. You’re baited into joining and many students aren’t even aware that the AMA is an interest group supposedly representing physicians in Washington. I agree with Edward, not being a member is a form of complaining. I’m not giving them my dues. I prefer to purchase my own stethoscope, flashcards, and have my own thoughts. Skipping the AMA kool-aid.

  • DavidBehar

    I am a member of the AMA, of the Pennsylvania Medical Society, and my county medical society. I strongly urge all doctors to boycott these vile traitors to clinical care. The clinician and his interests have no chance of ever being advocated or even represented.

    They have a condescending attitude to the street clinician. They are run by left wing extremist, Ivy indoctrinated permanently, irremovable staff that are highly paid. They are in total collaboration with the lawyer enemies of the medical profession in total control of the three branches of government.

    They ignore or mock any suggestion that doctors should push back against the all out assault on clinical care, its plunder and defunding, and the decreased access to care for our patients. They refuse to engage in any negative feedback expressions, in litigation, let alone direct actions such as boycotts, personal attacks on the adversary, or even justified violent actions.

    I would support the formation of direct action group that would take the physical fight to the enemy. As an aged person, there will be no more expensive care for me in the near future, not even brand name medications. I feel physically, personally threatened, as a patient, by the left wing ideologues in government and their horrible, and implacable collaborators in organized medicine. Clinical care is under all out attack, from all sides, including from inside, by traitors in organized medicine.

    • Arvind Cavale

      Dr. Behar: I would suggest you join me in the PA Chapter of Docs4patientcare. We are doing exactly what you describe, opposite of the AMA, which is a defunct organization. Contact me if you need.

      • DavidBehar

        Will do it.

  • http://www.facebook.com/johnckeymd John Key

    Doctor Lundberg’s assertion that the AMA is one of the “only games in town” is prima facie evidence of out of touch AMA “elites” (and I use the term loosely) really are. The AMA has not done a good job of representing physicians in many decades, and there is not much reason to expect that to change in the future. Unfortunately most specialty societies seem to be trending in the same direction.

    Serious minded physicians who wish to preserve the doctor-patient relationship and independent medical care should investigate the American Association of Physicians and Surgeons. Thirty years ago I thought the AAPS was just a bunch of nuts, but of late I am coming to realize that the AAPS may truly be the “only game in town” for physicians.

  • dnarex

    Ever hear of the first amendment?

  • Freddosa

    Dr. Lundberg, there are quite a few of us who are FORMER members of the AMA. I joined as a medical student, became involved as a resident representative to the AMA, ran for (and won) a committee position, and continued to be active in the Young Physicians’ Section.

    After about 15 years in the AMA, I concluded that trying to change it from within was a losing proposition. I am not alone in that conclusion.

    Do we have a right to complain? Of course we do. Perhaps we have an even greater right to complain, having believed in the process and having been betrayed by it.

    And finally, no – the AMA is NOT the only game in town. Not by a long shot. Has my experience with the AMA turned me away from organizations representing physicians? From activism? It has not. I am a member of both AAPS and D4PC.

    If the AMA wants more members, perhaps it should strive to be more relevant to practicing physicians. In the mean time, pardon us while we eat your lunch.

    • DavidBehar

      The entire staff in Chicago must be purged. The doctors and elected officials are figureheads for the Ivy indoctrinated lawyers and professionals at headquarters. These are Obama friends, and part of the Chicago mob coming to plunder clinical care. Doctors have virtually no influence on AMA policy. The AMA severely punishes doctors who want to hit back even a little. I remember the pounding of a doctor suggesting a boycott of plaintiffs and lawyers who file false tort claims. Horrible collaborators with the enemy of clinical care. Boycotts have been fully validated up to the Supreme Court level, as a method of advocacy. Appalling AMA retaliation ensued, against the doctor, not against the lawyers.

  • http://www.facebook.com/people/Steven-Reznick/100000549195050 Steven Reznick

    I am a former AMA member. I belong to my county society and state society because they represent me well even if I do not agree with all their positions. The national organization has not been supportive or representative of primary care , general internal medicine or family practice in years. I do not give them my money because they do not represent my interests. When the AMA starts representing the mom and pop primary care practices of America and supports re establishing the doctor patient relationship instead of pushing CPT coding to the sixth digit I will reconsider.

  • DavidBehar

    I strongly urge Dr. Lundberg to publicly and loudly resign from the AMA if he cares anything about patients and about the future of clinical care. Then I would like to see a series of class action lawsuits defund and eradicate this left wing extremist, lawyer collaborating, treasonous organization. They are in Chicago, Ivy educated staffed, good friends with that mortal enemy of clinical care, Obama. They are totally in bed with that mortal threat to patient care. To deter.

  • kjindal

    I echo the many sentiments expressed in response to Dr.Lundberg.
    I am now 41 yrs old, and after med school eagerly and proudly joined the AMA, MSSNY, NY county med society, and the ACP. I decided that one way to truly advocate for us would be to join committees at MSSNY and be one of the voices at the table representing the doctors “in the trenches”. After a couple of meetings with the Long Term Care (LTC) committee I quickly learned that they were more about entertainment for the 75-yr-old MDs who didn’t see patients but enjoy meetings (with lunch), than they were about making change. Almost no issues were resolved at all, let alone quickly. I then stopped paying the obscene dues to these organizations (in the thousands of dollars annually).
    That approach was validated by AMAs support of mid-level providers, the multitude of new variations on HMO-style care (ACOs, “medical homes”, etc.), and the CPT code scam.
    Now in the last couple of years I see a real change – the headaches and daily stressors that PCPs (like myself) have been crying about for years is actually expanding into almost all specialties. And this is resulting in a divide more between PRACTICING MD’s and ivory tower types, than the former divide between specialists and PCPs. So now I have rejoined MSSNY (still about $800), which at least claims to represent physicians, as opposed to the AMA, which openly states “patient and public interest trump ” the interest of physicians (???). As if they are mutually exclusive.
    So far I have presented 2 issues to MSSNY, one involving difficulties with a managed care company. No serious help yet, but this avenue maybe the only one available to PCPs- I do agree wholeheartedly with the notion that we must have a unifying advocacy organization. And to weed out the self-destructive positions of such organizations, practicing MDs must be at the table. For example, MSSNY has recently sponsored a fundraiser for trial lawyer & NY assemblyman Sheldon Silver. Of course he has continually opposed tort reform in NY.
    So I am conflicting, alternating (over years) between hopelessless for the future of physician advocacy, and optimism that the frustration level is so high that us practicing MDs “in the trenches” are really feeling like we MUST make some positive changes soon.

  • DavidBehar

    I have explained elsewhere how the Commie Care of France killed Princess Diana (no EMT, no trauma supervisor, no telemetry, no jaws of life ($300 used on Ebay), no helicopter, 45 minutes to extrication from the car, an hour and half ride to the hospital 4 miles away at midnight with no traffic, to do street resuscitation, no trauma center, no trauma team; she was talking for 30 minutes, the entire Golden 2 Hours were spent in the street). The point is if Commie Care will kill a princess, what chance do any of us have?

    To prove that point, in another example, 11,000 nursing home patients died in a heat wave. No $20 window fans nor glasses of water for the French. The bodies were stacked in refrigerated tractor trailers. The Commie Care officials of France were so stupid, they could have place the elderly in those trailers before they died.

    So Commie Care is cheap care that kills.

    Once the killing of our patients begins under Obamacare, violence by doctors against the rent seeking subhuman lawyers in total control of health care policy, will have full moral, formal logic, and policy justification. All collaborators get some too.

    An example of what violent doctors are capable of? 9/11.

  • http://twitter.com/kilani19 Marwa Kilani, M.D.

    You are not looking too popular based on the comments already mentioned! I will say that I believe AMA has the ability to advocate on our behalf because of their size and lobbying capacity. But, I agree with many of those comments, they are not in touch with the physicians that are actually doing the majority of the clinical work. Likely, that’s why the local organizations do a better job at it.

    If you want more AMA participation, decrease the fee dramatically or make it free if the physician is a part of their local or state chapters! For instance, in our state of California, LACMA/CMA is $319 and AMA is $420 for one year! This doesn’t include that I am also a member of ACP ($485 considering I am over 8 years out of medical school) and AAHPM (another $415). That’s a lot of money for “advocacy”…

    Medicine has changed dramatically in the last 20 years. We all do our best to represent our field at the patient level. AMA has not represented the voice of physicians at the patient level. Start with this, lower the membership fee, and your membership numbers will improve!

  • http://twitter.com/Joe6pk narayanachar Murali

    What has AMA done for you? Nothing but harm.

  • http://www.facebook.com/larry.whitlock1 Larry Whitlock

    This is one of most offensive statements I have ever read. I will never pay up to$2000/ year again for a bunch of conventioneers to sell out to Obama again

  • http://www.facebook.com/karanan Kartik Ananth

    If you are a member of the AMA, you don’t stand a chance of even choosing your flavor of kool aid. There is a reason why physicians have left the AMA in droves and the time is better spent analyzing what changes need to be made in order to attract members back. In the meantime, every physician in the US should complain about the AMA loudly, until our voices are heard.

  • drdavemd

    I have been to a lot of AMA meetings and have friends inside and outside of medicine across the political spectrum. I am always fascinated to hear from the right how the AMA is run by elitist commies and how left-leaning single-payer advocates deride the AMA as private practice docs looking out only for their own pocketbooks.

  • rswmd

    “85% of American practicing physicians are not AMA members”

    Um, maybe that indicates that it’s the AMA that needs to do a self-analysis, not the docs . . .

  • http://www.facebook.com/people/Maggie-Keavey-Kozel/1383572933 Maggie Keavey Kozel

    I have to disagree. This is like saying if you disagree with the GOP platform, then you need to joing the Republican Party or keep your mouth shut. There are other parties out there. My favorite is Doctors for America. I do agree with you on one point – doctors need to join or support something. We need to be active.

  • MarylandMD

    When I read this, I had a sense of déjà vu. Then I went back and searched the archives and sure enough, I found an article posted here 6/20/2011 by Kevin Pho titled “Why the AMA is in decline, and should doctors care?” The comments to that article read pretty much the same as the comments you see here. Dr Pho’s article last year was actually just talking up George Lundberg’s 6/20/2011 article on MedPage Today titled “Why Do So Many Physicians Hate the AMA?” That article was a snarky attempt to shame doctors into joining the AMA. Now George tries a different tack by essentially saying: “If you don’t like the current state of the healthcare industry, you should either join the AMA or just shut the #*@& up.” Yeah, way to go George. That’ll get me to sign up! Hey, George, let me give you a big tip that I learned in medical school: if you want someone to change, heaping insult on abuse is not generally considered a productive strategy.

    Since Dr Lundberg is essentially reposting his ‘berate physicians to get them to join the AMA’ article, I will just repost my comments to last year’s article. Maybe if we just keep reposting our comments, he will get the message. (I am also hoping he gets some counseling, as it seems he has some serious anger issues with the majority of US physicians!)

    Here goes:

    Dr Lundberg pretends he wants to find out why doctors aren’t joining the AMA, but asks questions like this:”Maybe they reject the ethic that physicians should care for all in need, regardless of their ability to pay, an AMA position since 1846.”

    Heh. Yeah, right, George.

    If the AMA wants members, they are going to have to make the case. Have George Lundberg come to a local meeting of the Maryland Academy of Family Physicians, tell us why we should join, and then take a few questions.

    I have seen nothing that the AMA has done or could do for me that would justify spending $420/year on dues. Lower the dues to $20/year and show me what the AMA specifically does for me, a primary care FP, and I will think about it.

    Maybe the AMA should institute a new dues policy: “Join us and pay for dues what you think we are worth.” Maybe that will help membership?

  • LBENT

    The AMA is a bogus organization, unresponsive to its members. I was a member fro 20 years and never once was asked about what I thought should be the direction of the AMA and the interests of physicians in the US.
    Self-serving and dwindling. It should disappear and the revenues that it gets from the coding business should go back to all of us who so loyally pay dues. I am still a member of my state and county societies and my specialty societies.

  • http://twitter.com/sarasteinmd Sara Stein MD

    This is the dumbest, most partisan post I’ve ever seen on this site. The AMA is a special interest lobby heavily tied to industry. Whether the AMA represents the interests of physicians is questionable, but it clearly represents the interests of Pharma and the device industries, hospitals and health care institutions. Seriously George, use your editing skills.

    Sara Stein MD, Proud FORMER member of the AMA

  • Conzag

    When I started family practice in the 1950′s, membership in the AMA was mandatory if you wanted hospital privileges or if you wanted to join the state and local medical societies.. As soon as these very restrictive barriers were removed, I dropped AMA membership since it was irrelevant to my interests. I never regretted my decision.

  • http://www.facebook.com/people/Roy-M-Poses/757544028 Roy M Poses

    With all due respect,

    Based on the latest 990 from the AMA available to the public (from 2010, available here: http://www.guidestar.org/organizations/36-0727175/american-medical-association.aspx
    the AMA gets only about 16% of its total revenue ($38,291,369 of $236,011,567) from membership dues. Furthermore, unlike the case for most true membership organizations, and most non-profit organizations, the AMA pays its board members at least five figures, some more. This strongly suggests that the AMA is more of a marketing and communications firm than a membership organization.

    If the AMA executives know that most of their money is coming from sales of services, not membership dues, how much should we expect them to attend to the concerns of their members? There are some answers below.

    I am no longer an AMA member because I feel the organization is not at all responsive to its rank and file. The principal evidence of this is how it uses the RUC to tilt the physician payment playing field at the expense of primary care and cognitive specialties (look here: http://hcrenewal.blogspot.com/search/label/RUC and here:http://www.replacetheruc.org/)

    If the AMA really wants the majority of US doctors to join, it should act like it will represent all of them, and put their values first.

  • LeoHolmMD

    Spoken like a true elitist totalitarian.
    That settles it. It is no longer enough to deride or ignore the AMA. An organization this toxic and out of touch needs to be eliminated. Voice of American Medicine my donkey.

  • http://www.mywhitecoatisonfire.com/ Lumi St. Claire

    FYI – bullying and shaming: not effective tactics for recruitment. In addition to the large number of poignant comments made below, why would I WANT to be part of an organization with representation like this?

  • buzzkillersmith

    If you’re not a part of the Nazi party, you have no right to complain about it.
    If you don’t own slaves, you have no right to criticize slaveholders.

    The AMA does not have my interests at heart. Never has, never will.

  • http://www.facebook.com/LLWalker67 Linda Fogacci-Walker

    The AMA can never make up their mind ….they supported Obamacare.. how’s that working for them now? They continually sell physicians out and throw them right under the bus. THAT is why their membership suffers. It’s all politics!!

  • kidsdoc

    Seriously dude, the AMA is DNR ever since they sold doctors and patients out with PPACA. ICD10 will be the nail in the coffin. I quit and joined D4PC. This about sums it up: http://www.washingtontimes.com/news/2012/feb/1/our-dead-american-medical-association/

  • http://twitter.com/DrBob_Southlake Robert Sewell, MD

    Well, I am a member of the AMA and a Delegate to the AMA House of Delegates, so I guess based on this guy’s argument I have every right to speak out. The reason 85% of American Physicians are not members of the AMA is because the AMA has been hijacked by Left-Leaning Academics and Medical Students. When arguments are made that would steer the AMA back toward its conservative roots they are invariably treated as old fashioned and out of touch with the post-modern world. I will be attending my LAST HOD meeting in November because I am tired of butting my head against their brick wall. I wrote this piece more than a year ago. http://www.spiritofhealthcare.com/2011/06/22/iceberg-dead-ahead-for-the-ama/

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