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How are the Doctors affected by Reform

Physicians Beware

The Biggest Risk to U.S. Physicians: The AMA

As physicians, our first step in the health care debate needs to be clearing the air about who speaks for us on what topics. Today, I am joining the increasing waves of physicians who believe that the AMA no longer speaks for us.

As the founder and CEO of Sermo, this is a considerable change of heart, given the high hopes that I had when we first partnered with the AMA over two years ago. The sad fact is that the AMA membership has now shrunk to the point where the organization should no longer claim that it represents physicians in this country.

The AMA has drawn its power from the support of the physician community. The waning membership reflects our objection as the AMA has failed us consistently for over 50 years. Make no mistake, the debate within the AMA about how to stop their membership decline is not new. What is new is the lengths to which the AMA appears willing to go to deceive the public on this topic.

The AMA routinely claims that their membership is 250,000 practicing physicians. At best, this is 25 to 40 percent of practicing U.S. physicians and even that claim is based on some stretching of the truth. The 250,000 total includes a number of non-practicing constituencies, including medical students, residents, and subscribers of the AMA's journals. Paying membership is generally accepted to be far lower. How much lower? Actual numbers are remarkably difficult to come by.

At this critical moment in history, we cannot watch the AMA fail physicians so completely yet again. Nor can we stand by and let false perceptions about who speaks for physicians persist. At the very least, all parties should understand the intrinsic conflicts of interest that are in play, and the AMA should be held accountable to these truths. Better yet, physicians should call for sweeping changes within the AMA.

In the best-case scenario, the AMA will shed its relationships with insurers and abandon tactics that take advantage of physicians to generate millions of dollars in revenue. It is an inherent conflict of interest to claim advocacy for physicians while profiting from a reimbursement system that makes it increasingly difficult for physicians to practice medicine.

The flight from the AMA signals that physicians don't believe the AMA is willing to make these changes. The longer that the public and our lawmakers cling to the perception that the AMA represents the voice of U.S. physicians (and the AMA succeeds in perpetuating this), the more imperiled the medical profession will be and with it the broader U.S. health care system. It's time to turn to entities like Sermo where physicians are establishing a new voice to collectively discuss the future of our profession.

There can be no health care reforms that have any chance of succeeding without buy-in from physicians. As a country, we cannot risk another failed reform effort. As physicians, we cannot risk letting the AMA represent our interests. This is our time to educate the public about which voices truly represent us and our commitment to our patients.

FROM DONALD PALESTRANT, MD Founder of Sermo