AMA can't win: 4,800+ physicians reject AMA's endorsement of Dr. Tom Price for HHS

More than 4,800 physicians signed an open letter railing against the American Medical Association's support for Rep. Tom Price, MD, R-Ga., chairman of the House Budget Committee, as secretary of HHS. The physician group wrote the AMA's backing of the nominee contradicts any support for patient well-being.

"We believe that in issuing this statement of support for Dr. Price, the AMA has reneged on a fundamental pledge that we as physicians have taken  —  to protect and advance care for our patients," the letter reads. It is unclear from the letter if the physicians are AMA members or not. The organization has roughly 250,000 members, according to an AMA spokesman. The letter claims the organization represents about a quarter of U.S. physicians.

In order to vet the physician signees, the organization responsible for the letter, the Clinician Action Network, manually removes duplicates and incomplete entries from the list of physician's names. "In doing so, we are finding that many of the signees are colleagues whose names we recognize and who we know to be practicing physicians," Jane Zhu, MD, one of the physicians who wrote the letter, said in an email. "For those who we do not know, we have taken random samples and conducted Google searches to confirm that they are physicians. That being said, there are a small number of medical students and non-physician clinicians who have signed this letter and whose names we have left because their participation is relevant."

After the Trump administration announced Dr. Price's nomination, AMA board chair Patrice Harris, MD, said in a statement, "The AMA strongly supports the nomination of Dr. Tom Price to become the next Secretary of HHS. His service as a physician, state legislator and member of the U.S. Congress provides a depth of experience to lead HHS."

The physicians who penned the letter did not take issue with Dr. Price's experience as a physician or a politician, instead writing in opposition to his proposed policies on Medicaid and Medicare.

"We cannot support the dismantling of Medicaid, which has helped 15 million Americans gain health coverage since 2014," the letter states. The physicians also oppose Dr. Price's proposal to reduce funding for the Children's Health Insurance Program.

The House budget for fiscal year 2017, "A Balanced Budget for A Stronger America," put forth by Dr. Price's committee, calls for a repeal of Medicaid expansion under the ACA in favor of providing states with block grants, or "State Flexibility Funds." This move intends to give states full control over fixed Medicaid funds. The budget would reduce federal spending on Medicaid by $7 billion in 2017, $67 billion in 2018 and up to $169 billion in 2026, according to projections from the Congressional Budget Office included in the report.

The letter states that these policies to reduce spending "threaten to harm our most vulnerable patients and limit their access to healthcare."

On Medicare, the physicians oppose Dr. Price's plan to privatize the program. This proposal has also been opposed by many Democrats, including Indiana Sen. Joe Donnelly, D, who called it a voucher program.

The 2017 budget outlines Medicare privatization plans, which include rolling Medicare Parts A and B together and allowing commercial payers to offer competitive alternatives to traditional Medicare plans, similar to Medicare Advantage. This plan would reduce federal spending on Medicare by $5 billion in 2017, $15 billion in 2018 and up to $108 billion by 2026, according to the CBO.

The AMA statement lauded Dr. Price for his leadership in healthcare policy. "Dr. Price has been a leader in the development of health policies to advance patient choice and market-based solutions as well as reduce excessive regulatory burdens that diminish time devoted to patient care and increase costs," Dr. Harris said in the AMA statement on his nomination.

The letter directly opposes this statement, concluding, "Americans ought to know that the AMA does not represent us, and that we do not ascribe to Dr. Price's views."

One physician, Carolyn Sax, MD, even decided to quit the AMA after it endorsed Dr. Price, she wrote in a contributed column for radio station WBUR. "The news filled me with so much disgust that I resigned my membership," Dr. Sax wrote. Dr. Sax is a pediatrician and part-time assistant clinical professor of pediatrics at Harvard Medical School in Boston. She opposes Dr. Price's views on the ACA, contraception and LGBT rights, as well as his membership in the Association of American Physicians and Surgeons, a conservative medical asssociation.

Dissent of the AMA endorsement is also trending on Twitter with #NotMyAMA.

 

AMA's Dr. Harris stood by her statements of support Thursday. "A mainstay through the years has been Dr. Price's commitment to seek out and hear the concerns expressed by the AMA and other physician organizations," Dr. Harris said in a statement. "Even so, our support for Dr. Price to lead HHS should not be taken as an endorsement of every policy position he has advocated."

The AMA has agreed with some of his policies, such as those on medical liability reform, and disagreed with others, such as his views on the ACA, Dr. Harris wrote. She underscored the importance of Dr. Price's experience as a physician — something only two other HHS secretaries have had — which will provide valuable perspective in the Trump administration, she said. "We look forward to continuing conversation with Dr. Price as we work together on the healthcare priorities where we share common ground," Dr. Harris said.

Update: The letter had more than 4,870 signatures as of 9:00 a.m. CT on December 5. Read the full text here.

Editor's note: This article has been updated to include indiviudal physician responses, Dr. Harris' response and the statement from the Clinician Action Network.

 

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