When I became a doctor, the most prestigious organization that represented doctors was the American Medical Association (AMA). That was 1979 and today is 2021. A lot of water has passed under the bridge since then and the AMA is no longer representing most doctors.
In 1991 I left the AMA because they were promoting abortion. Membership in the AMA was already declining since the days of my training and in 1979 they represented only 27% of all physicians in the U.S. Today that number continues to decline, despite attempts by the AMA to cover up this fact.
Two years ago, Kevin Campbell, MD, a cardiologist from North Carolina, analyzed the data and came up with the following figures for 2019:
- There were 1,341,682 physicians, medical students/residents/ fellows in the U.S.
- There were 250,253 AMA members – 18%
- According to the AMA, 22.5% of AMA members are students; 24.7% are residents
- If you remove these numbers, there are 1,093,472 practicing physicians in the U.S.
- 132,133 of these physicians are AMA members – 12.1%
Therefore, the AMA represents only about 12% of U.S. physicians. This decline has been continuing for decades. Campbell says, “It’s an interesting angle that the AMA paints a picture of membership growth in their marketing literature but skirts the fact that it’s essentially like a fraternity claiming growth by rushing tons of freshmen the first day they get to college, with not many of them ever becoming full dues paying members and staying active for the four years of college.”
Why is this important?
The continuing decline of AMA membership reflects the organization’s continuing deviation from the values of American doctors. I left because they promoted abortion; others left because their voices were never heard and the AMA promoted political views they disagreed with. A classic example is the AMA’s promotion of ObamaCare even though most physicians opposed this move toward socialized medicine.
The latest controversy is the AMA’s move toward progressive politics. The Wall Street Journal editorial board says, “The American Medical Association is a lobby of doctors that’s supposed to promote policies that improve public health and medicine. But it seems to be evolving into another arm of progressive politics, like the teachers unions.”
The AMA delegates met last week for a policy-making meeting. Delegates spent much of the time discussing systemic racism in health care and adopted guidelines for workplaces to establish training requirements for explicit and implicit bias and microaggressions. AMA trustee Willarda Edwards called systemic racism “the most serious barrier to the advancement of health equity and appropriate medical care.” This is just as ludicrous as President Biden calling climate change the most serious threat to our country. Both ignore the real problems in favor of “woke” platitudes.
I am proud to say that medicine is perhaps the most egalitarian profession in the world. I have never in my forty-six years of medical training and practice experienced an incident where race, religion, or economic status influenced the treatment of individuals by me or any other healthcare provider in my presence. Racism is not a problem in the world of medicine.
The most serious problem in medicine today is access to healthcare. This is influenced by economic status, not race. Not all healthcare insurance is the same. Medicaid is the worst form of insurance available, not because of racism, but because of low reimbursement rates for treatment. Doctors who refuse to accept Medicaid do so because they don’t want to lose money, not because they are racist.
I have been an outspoken critic of ObamaCare because it doesn’t solve the problem of access to healthcare; it actually made it worse. ObamaCare is largely an expansion of Medicaid by federal government changes in eligibility and subsidies. This expansion of Medicaid has only exacerbated the problem of access to healthcare by giving millions of Americans an inferior form of healthcare which most doctors will not accept.
Medicaid is not just bad healthcare insurance; it is actually worse than no insurance at all. This alarming fact was discovered in a 2007 study called the Oregon Health Insurance Experiment. This ongoing study has taught us that Medicaid does not improve health, at least in standard measurements of blood pressure, blood sugar, and cholesterol. Medicaid reduced observed rates of depression by 30%, but increased the probability of being diagnosed with depression. It also significantly increased the probability of being diagnosed with diabetes, but did not have a positive impact on lowering blood sugar.
The reason for these surprising findings is the lack of access to healthcare. Patients with Medicaid have great difficulty getting doctor appointments because so few doctors accept Medicaid, and those that do usually limit the number of such appointments in their schedule. The uninsured, however, do not have this problem. They can always get a doctor’s appointment quickly because they pay cash and nearly all doctors will give generous discounts for cash patients. Medicaid patients cannot do the same because it is unlawful for doctors to accept cash payments from Medicaid enrollees.
Sadly, the AMA no longer represents the interests of most physicians. Specialty organizations, which represent only those in their specialty, have become the voice of most doctors, but there is no organization speaking out for the majority of doctors. The AMA, with its new political wokeness, is becoming just as irrelevant to doctors as most teachers unions are to teachers.