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AMA, I Hardly Knew Ye

— Group's annual meeting folds its tent, but that tent has really changed

MedpageToday

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CHICAGO -- I've been covering the American Medical Association, a.k.a. AMA, a.k.a. "our AMA," since before there were electronic health records, so I think I am fully qualified to state that the AMA in 2017 is not your father's AMA. Neither is it your mother's AMA, nor your older sibling's AMA.

For decades the AMA House of Delegates was a really large old boys club -- not ole boys' club because the "boys" were really old as in they were old enough to vote when Kennedy and Nixon debated in 1960, and that's when the voting age was 21. And those old guys were also white, whiter, and whitest.

I was covering the AMA when it elected its first black president, Lonnie Bristow, and its first woman president, Nancy Dickey.

How much has it changed?

Well, this year the delegates made it AMA policy to meet only in venues that offer gender-neutral restroom facilities.

Those same delegates also asked the AMA board to consider a state or city's policy on physician gag rules (e.g., making it against the law for a physician to ask patients if there are guns in the home) before booking a meeting in that locale.

This new AMA also offered childcare during this year's 4-day meeting, which tells you that there are delegates who have kids young enough to need care.

And -- this was a real shocker for me -- the AMA actually came out foursquare against cutting Medicaid through caps on coverage, including the use of block grants, while at the same time it authorized a feasibility study of a public option for private market insurance. Wowza.

But here is the bad news: back when the AMA was telling presidents (knock, knock Mr. Johnson; yoo hoo, Mr. Nixon; hey, there Mr. Carter; hello Mr. Reagan) that "blood would run in the halls of Congress" if Medicare became the law of the land, or if chiropractors were allowed to bill insurers, or if information about physicians disciplined by licensing boards was made public -- in those days, most doctors in America were card-carrying members of the AMA.

Today when the AMA is willing to champion more than physician pocketbooks (and it is still very willing to do that) the AMA can only claim about a quarter to a third of America's docs as members, and that is probably bad news for Americans.

Why do I say that?

I say it because in 2017 when healthcare -- the quality of care, the cost of care, and access to care -- is on everyone's mind and everyone's Facebook page, we really need an AMA. We need an organization of professionals who understand disease and how to treat it to stand side-by-side with us.

And in the end, we need the AMA to carry the big stick, but we had better hope it can still wield that big stick with fewer members and when most physicians in Congress are not in agreement with the policies of the "new" AMA.