The AMA Doth Protest Too Much

The Independent  Physician©

There’s a reason why the AMA lost 12,000 members during the last year–they have taken an ideologic road which is divorced from the disposition of the majority of the 750,000 practicing doctors in America.

There’s a reason why 100% of medical students in America, who have free AMA memberships, transition to only about 15% persistent continued AMA membership in private practice.  If you subtract out academic practice physicians, who have their memberships paid for in bulk at discount rates (sometimes automatically), the percentage of docs in independent private practice in America have a collective AMA membership rate of closer to 10-12%. The AMA does not break out their numbers in such detail.

We do know that docs pay hundreds annually to be members of the AMA; we know that they pay, on average, about $1,000 to their local medical societies annually; and we know that most local medical societies were conspicuously silent on the PPACA legislation in the aftermath of the AMA’s endorsement of that piece of legislation.

We also know that there are financial relationships between local medical societies/state medical associations and the AMA. We know that these regional societies and associations, which are geographically closer to their community physicians, had little choice but to stay silent (or at least neutral) on the ‘Affordable Care Act’ debate because they neither wanted to stir passions locally nor lose their gravy train from the AMA.

Local medical societies like to tout their ‘wins’ at the state level against various legislative assaults on the medical profession. These fights usually involve such topics as ‘corporate bar’ (to prevent hospitals/corporations from employing docs in states where such arrangements are still illegal) and ‘scope of practice’ (to prevent non-M.D.s/non-D.O.s from competing with physicians). These associations also occasionally sue insurance companies and these wins can net each local doctor money–all good!

The PPACA dilemma, however, is significant and profound, and trumps other accomplishments by local medical societies; asking the following questions help to understand why this is so: 

• How many doctors can point to their medical society having used their vast resources and contact information databases to ever take a poll of local physicians on the ‘Affordable Care Act’?
• How many local medical societies conducted true open debates on the subject of the PPACA?
• How many medical associations actually listened to the National Doctors Tea Party, the Heritage Foundation, the Galen Institute, the Association of American Physicians and Surgeons, Docs4PC, Sally Pipes, the Pacific Research Institute, countless blogs, and most importantly their local doctors’ lounge conversations?

If the AMA and their local/regional medical societies had done even one of the activities listed above, they would have known that everything we are seeing coming to pass today (ICD-10, EMRs, the wave of scope of practice issues associated with the PPACA, and a host of other concerns) was clearly voiced by countless concerned doctors over the past two to three years in the United States.

Short of an apology and open about-face on the issue, and a series of national debates on the impact of Obamacare literally ‘yesterday’, we have to call the health care reform quagmire for what it is:  a huge failure on the part of the American Medical Association.

The AMA/local medical societies have literally destroyed medicine for the very people they were supposed to be protecting and representing.

Since the average participating doctor will pay about $2,000 to their local medical society + state medical association + AMA annually, we at AMS only ask one question:  what did these doctors get for the four thousand pre-tax dollars that they had to earn to pay for those memberships?

The ICD-10 debacle only further highlights this disaster. For all of the $120-plus million dollars annually in AMA executive/staff salaries, what about the PPACA legislation and potential coding changes did the AMA miss in their research? Did they really not know what was coming down the pike?  Efforts to act outraged and complain now just ring hollow and disingenuous…

…”The lady doth protest too much, methinks.”

Shakespeare’s Hamlet, Prince of Denmark  Act III, Scene II

From the PMICONLINE.com Blog:  The American Medical Association (AMA) House of Delegates voted on November 15th at the semi-annual policy making meeting in New Orleans to work vigorously to stop implementation of ICD-10 (The International Classification of Diseases and Related Health Problems, 10th Revision), a new code set for medical diagnoses.

ICD-10-CM has about 69,000 codes and will replace the 14,000 ICD-9-CM diagnosis codes currently in use. “The implementation of ICD-10 will create significant burdens on the practice of medicine with no direct benefit to individual patients’ care,” said Peter W. Carmel, M.D., AMA president. At a time when we are working to get the be value possible for our health care dollar, this massive and expensive undertaking will add administrative expense and create unnecessary workflow disruptions.

The timing could not be worse as many physicians are working to implement electronic health records into their practices. We will continue working to help physicians keep their focus where it should be – on their patients.”

A 2008 study found that a small three-physician practice would need to spend $83,290 to implement ICD-10, and a 10-physician practice would spend $285,195 to make the coding change.

ICD-10 is scheduled to replace ICD-9 effective for all health insurance claims filed on or after October 1, 2013.

America’s physicians deserve better than the duplicitous leadership of the AMA.  Period.