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AMA Faces a Crossroads

Joe Cantlupe, for HealthLeaders Media, July 29, 2010

 The AMA has not commented on the Florida Medical Association resolution.

 "This is definitely heavyweight stuff," Moffit says of the Florida resolution. "Doctors want to change the whole way in which they deal with Washington—different from this whole business of going along, and getting along. That's what the AMA does. We are at a watershed."

 "Florida has a huge group of doctors who serve Medicaid patients, and also serve Medicare patients," Moffit adds. "Physicians are going to be on the receiving end of basically a price controlled payment system, which limits their outcome and also limits their options.

The Florida vote may be a big deal, or it simply could be one physician's resolution that will be shouted down in a chorus of "nays." That's what basically happened in May in Texas, where a resolution to have the Texas Medical Association be removed from the AMA was discussed, Susan Rudd Bailey, MD, president of the Texas Medical Association, told me.  The group, which represents 45,000 members, quickly dispatched the idea, she says.

"I think we and the AMA have not really differed widely in our opinions about what needs to be done in health system reform," Bailey says. "The major differences have been in strategies and tactics that were used when the bill was debated in Congress."

"The biggest question is whether the AMA should have fallen on its sword over SGR. Should they have withdrawn (their support) for the rest of the bill because the SGR fix wasn't in it? They decided not to. A lot of physicians are frustrated and angry. But the AMA is a very easy scapegoat."

 "There needs to be a national organization that speaks for all physicians regardless of specialties, regardless of where they are in their careers. If the AMA fails or ceases to exist, we have to create another one like it," Bailey says.

In addition, the reach of the AMA should not be misjudged, she says. "The AMA does so much more than advocacy," she says. "If we lose the AMA, we lose all those other things as well." The AMA has about 240,000 members, representing about 20% of U.S. physicians. Critics believe it will see a cascade of lost membership in the wake of healthcare reform.

Bailey says she believes the AMA is strong, but may need to change. It may have to become a "different type of organization," she says, such as an "organization "become an organization (that represents) various organizations of physicians."

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