The AMA’s endorsement of Tom Price hurts doctors and patients alike

The American Medical Association’s (AMA) endorsement of Tom Price, President-elect Donald Trump’s nominee for secretary of Health and Human Services, prompted an intense, widely publicized backlash from physicians nationwide.

Many doctors are enraged that the AMA, which claims to represent American physicians, would support a nominee who is intent on dismantling the Affordable Care Act (ACA), Medicaid, and Medicare without any offering any viable alternatives for ensuring high-quality, financially sound healthcare access for all Americans; who has worked to systematically undermine women’s health reproductive rights at every turn; and who belongs to a fringe medical organization, the Association of American Physicians and Surgeons, that promotes frank medical quackery and conspiracy theory.

{mosads}Reasonable individuals may hold widely divergent views on issues such as healthcare reform, but Price’s overtly anti-science views and dismal track record in promoting divisive and discriminatory policy make him a uniquely dangerous choice. As such, the AMA’s endorsement of Price shines a spotlight on the corruption and obsolescence of an organization that has far outlived its original mission.

The AMA was established in 1847 with the express goals of uniting physicians in scientific advancement; unifying standards of medical education and ethics; and improving public health. It remains, in the public eye, the organization that speaks for doctors, yet it has proved that this is no longer its priority.

Only 17 percent of physicians hold membership in the AMA today, half of whom are retired from practice. The AMA has tried to dismiss declining membership as a byproduct of the general trend away from society memberships among younger physicians. But the writing’s on the wall: the majority of physicians are not aligned with the AMA, and are dissatisfied with its inability and refusal to accurately reflect their values and to effectively lobby on behalf of ethically and financially sound treatment of doctors and patients.

The AMA has a consistent record of corruption and political ineffectiveness. It has an intimate entanglement with the federal government dating back to 1983, when the group’s Current Procedural Terminology system became the sole codes used for medical billing in the United States. This monopoly on profits from the medical reimbursement process was successfully challenged in 1997, but by then Medicaid and Medicare had already adopted the CPT method of medical billing, virtually guaranteeing the obsolescence of all other billing systems

The AMA does not report its revenue from CPT coding, which was estimated to be approximately 71 million dollars in the early 2000s based on publicly available documents, a figure likely to be significantly higher today. The remainder of its revenue is derived from its journal (JAMA), the insurance policies it markets, and the CPT coding books and workshops it sells; at most, membership dues could account for only 14 percent of total revenue.

The AMA has also been implicated in numerous scandals, most notably the 1997 Sunbeam incident in which the AMA signed a deal to officially endorse the small home appliance company’s products in exchange for royalty payments.

When an agency has so little fiscal stake in representing its membership, it is no wonder that representing the broad voice of America’s doctors is a low priority. The AMA itself admits that its endorsement of Price is based primarily on his willingness to play ball: Board of Trustees chair Dr. Patrice Harris states that while the AMA disagrees with Price on certain important policy issues, they have a “relationship … going back decades,” and he has been “willing to listen” to the AMA’s concerns.

In one fell swoop, the AMA thus acknowledges that it does not matter if Price cares about the diversity of voices and challenges — across the political spectrum — within medicine and healthcare today, as long as it has in office a collaborator who will help promote the group’s questionable agenda. Humanistic and reasonable policy, fair and balanced representation of physicians, and promotion of the health of this nation matter far less to the AMA than does having a friend in Washington who will listen.

We support those who have spoken out already against Price and the AMA’s egregious endorsement, but it would be a mistake to view this as an isolated incident when it is actually a window onto the deep-seated and insidious corruption and ineffectiveness that plague the AMA.

The organization would have been wise to stay silent, profiting quietly from its billing codes on the sidelines, but this gross miscalculation has provided an opportunity to view its true nature and appreciate the danger of its continued existence. In a political atmosphere that has become openly hostile toward science and humanism, now more than ever we must strive for reason and integrity in medicine and health. The AMA is a partisan, profit-driven organization so far removed from the lives of physicians and patients that it now actively opposes the interests of so many of those for whom it purports to stand. This is not the only slap in the face that Americans have experienced at the hands of the AMA, but we hope it will be the last.

Drs. Rebekah Diamond and Phoebe Danziger are resident physicians training in pediatrics. They live in Ann Arbor, Mich.

The views expressed by contributors are their own and not the views of The Hill.