Some Docs Upset at AMA's Public Plan Stance

McCoy said those comments indicate the AMA's position "is driven by out-dated political ideology that blindly supports private industry."

A volley of letters to the New York Times on Sunday questioned why the AMA would make such a statement before details of a public plan are understood. For some, it seems the latest AMA stance was consistent with its policies in the 1960s when it opposed the creation of Medicare and Medicaid.

"The AMA is considered by many in the medical community as out of touch and only caring about medical malpractice costs and reimbursement," said Bryan Liang, MD, of the California Western School of Law. AMA doctors, he said, tend to be older, male, more conservative, and used to "the good old days" before managed care, a time when they had more autonomy, he said.

Last week, the AMA's position on a public plan option crystallized opposition against the organization for many younger doctors who may have been sitting on the fence.

Mandy Krauthamer, MD, a primary care physician in Washington D.C., and spokeswoman for Doctors for America, a coalition of 13,000 physicians across the country who are upset with the AMA, says the organization "no longer speaks for physicians."

"We took a survey and in the first 48 hours, 2,000 of our members said they would like a public plan considered," she says. "There's healthy debate within the House of Medicine. And taking the AMA's voice as ‘the voice of all physicians' is not the way to go anymore," she said.

In reality, many doctors are not happy with Medicare or Medicaid and bridle at the obstacles put in front of them by private health insurance. But they also see their ability to do their jobs threatened by paperwork, insurance, government bureaucracy, and rising healthcare costs that all too often prompt patients to seek care too late. They are willing to give something else a try, and feel that this may be their last real chance.

The California Medical Association, which represents about one-third of California's doctors, has not yet taken a position on a public plan option, says spokesman Ned Wigglesworth. But Wigglesworth says a key concern on the West Coast is that "people in Washington should focus less on expanding coverage, which has often been a false promise, and more on expanding meaningful access to healthcare."

"Many doctors don't fully embrace either private insurance or public programs as the foundation for health system reform because they and their patients have had such problems with both," he says.

For Priver, it's important for doctors to "think over carefully the option for a public plan" and keep their place in the discussion. "We need to decide what will be the legacy we leave behind. We don't want to follow in the footsteps of the AMA. Some of us may not be happy about what's being talked about, but if you stamp your feet and walk away, you'll like the situation even less."