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May 22

Physicians Say the AMA No Longer Their Voice

by Wayne Oliver, Vice President, Center for Health Transformation
Originally published in the Atlanta Journal Constitution on September 8, 2011

They say, “Perception is reality.”  If that is the case, the American Medical Association (AMA) is in serious trouble.

In a recent survey of physicians conducted by the Atlanta-based physician recruitment firm Jackson & Coker, doctors believe that the AMA no longer represents their views. A whopping 77 percent of physicians reject that premise that the AMA currently reflects their profession. Only 11 percent said the nation’s oldest doctors’ organization today stands for what they do. (To view the survey, go to: http://www.jacksoncoker.com/news/News.aspx?sc_cid=AMA)

When asked if they agreed with the AMA’s support of federal health reform, physicians said the organization sold out the nation’s medical profession.  The AMA’s high profile endorsement of ObamaCare has been questioned by AMA and non-AMA member physicians from every corner of the country.

So why did the AMA turn its back on the medical professional?

Many believe that the AMA is deeply conflicted. You see, the AMA was torn between generating revenue versus reflecting the position of America’s practicing physicians.  The AMA owns the mechanism by which the entire healthcare delivery system is reimbursed – a coding system used for Medicaid and Medicare reimbursements and then utilized in the private health insurance market. The contract for CPT codes or Current Procedural Technology belongs exclusively to the AMA.

In 2008, the AMA collected an estimated $70 million from books, workshops, and licensed data files related to CPT codes, according to the National Center for Policy Analysis.  Membership dues accounted for less than 16 percent of 2008 revenues, according to the NCPA.

Clearly, the AMA is conflicted between the revenue which is generated by the CPT coding system and doing what’s right for the medical profession.

And, the Jackson & Coker poll speaks volumes about this conflict.

When asked why former AMA member physicians dropped their AMA membership, over half pointed to the “CPT business is a conflict of interest.”

And the current CPT coding system is also a major barrier to fundamental, comprehensive and legitimate healthcare reform.

Most experts agree that ObamaCare was little more than a band-aid on a system which needs real change.  There are no CPT codes for creating a system which rewards improved health outcomes. There are no CPT codes which pay physicians and hospitals for providing outstanding patient care. The CPT coding system reinforces the status quo. So, when the AMA endorsed national health reform, it did so to preserve the current system which is clearly broken.

But what does this mean going forward?

First, the Jackson & Coker survey reaffirms that the AMA is out of touch with the thoughts and beliefs of most physicians.  More than 70 percent of the responding doctors said that the AMA no longer represents physicians.  Secondly, as more and more medical doctors leave the AMA, there will be opportunities for organizations like Docs for Patient Care (Docs4PatientCare) and state medical associations to step in to more accurately reflect the needs of physicians. Seventy-five percent of the physicians surveyed by Jackson & Coker indicate that “physicians need a more representative voice.”  And lastly, issues like tort reform, government over-regulation of the medical profession and legitimate healthcare reform will be addressed by some organization other than the AMA.

There is a fundamental difference between leadership and representation. Unfortunately for America’s physicians, the AMA is doing neither.

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