10 Things to Know about the American Medical Association

The American Medical Association is one of the largest physician lobbying groups in the United States with the goal of "promot[ing] the art and science of medicine and the betterment of public health."

Here are 10 things to know about the AMA.

1. The AMA is one of the oldest, longest-standing medical associations in the United States. The AMA was founded in 1847 by Nathan Smith Davis, a 30-year old physician who was serving in the New York Medical Society and proposed establishing a national medical association. Dr. Davis received his Doctor of Medicine degree at the age of 20 from the Medical College of Western New York. Throughout his professional life, Dr. Davis attended 47 of the first 50 annual AMA meetings, serving as president from 1864-1865. He was also named the first editor of the Journal of the American Medical Association in 1883. In current day, the AMA awards the "Dr. Nathan Davis Awards for Oustanding Government Service" recognizing elected officials and government employees committed to contributing to the advancement of public health.

2. Dr. Ardis Dee Hoven is the current president of the AMA. Dr. Hoven is the 168th president of the AMA, assuming duties in June 2013. She has served on the AMA board of trustees since 2005, serving as secretary for 2008-2009 and chair for 2010-2011. Prior to serving on the board of trustees, Dr. Hoven held a member and chair position on the AMA Council on Medical Service, served on the AMA Foundation board of directors and the Group Practice Advisory Council of the AMA and was appointed to the Practicing Physicians Advisory Commission. Before serving the AMA, Dr. Hoven was president of the Kentucky Medical Asosciation from 1993 to 1994, and she served as a delegate to the AMA from Kentucky. Dr. Hoven is board-certified in internal medicine and infectious disease and is a fellow of the American College of Physicians and the Infectious Disease Society of America.

3. Although it is one of the largest lobbying groups for U.S. physicians, less than one-third of physicians are members of the AMA. The AMA's House of Delegates, the legislative body of the AMA, represents more than 185 outside physician groups. However, according to the AMA, only 30 percent of American physicians, or approximately 300,000, are members of the association. Physicians with doctor of medicine or osteopathic medicine degrees, resident physicians and medical students in approved programs are eligible for membership.  

4. The AMA did not agree with CMS' "data dump" of physician claims data. While the association maintains it is committed to transparency and providing necessary information, it disagrees with the manner in which CMS published the physician claims data earlier this spring. In a released statement, AMA said the data was published without context, leaving the numbers prone to inaccurate interpretations. "Thoughtful observers concluded long ago that payments or costs were not the only metric to evaluate medical care," reads the statement. "Quality, value and outcomes are critical yardsticks for patients. The information released by CMS will not allow patients or payers to draw meaningful conclusions about the value or quality of care."

5. A recent report by the AMA shows physicians produced $1.6 trillion in revenue in 2012. The findings of the latest AMA Economic Impact Study estimate patient care physicians supported 10 million jobs nationwide. The study was conducted by IMS Health, a private firm, and the AMA to examine the economic impact the healthcare industry has on national and state economies. The report shows each individual physician supported an average of $2.2 million in economic output and an average of 13.84 jobs. For every dollar applied to physician services, $1.62 was generated in other business activity, according to the report.

"The study illustrates that physicians are strong economic drivers that are woven into their local communities by the jobs, commerce and taxes they generate. These quality jobs not only support the caring role of physicians, but also generate taxes that support schools, housing, transportation and other public services in local communities," AMA president Dr. Hoven said in response to the report.

6. The AMA has long been an opponent of the Medicare sustainable growth rate, pushing for its repeal. Despite bipartisan and bicameral agreement to repeal the sustainable growth rate, the Senate passed a short-term "doc fix" in March to delay physicians' Medicare payment cuts. The payments this year were supposed to be cut by approximately 24 percent. The AMA has been pushing to repeal the SGR, saying the system is outdated, "irreparably flawed" and creates barriers for physicians to implement innovative systems to improve patient care quality. The AMA claims the cost of the doc fixes have exceeded the cost of solving the problem for good.  Congress has implemented a doc fix every year since 2003. The latest patch prevents physician payment cuts through March 2015.

7. The AMA's Medical Code of Ethics is widely recognized and accepted, with other associations adapting it to fit their individual specialties. The Medical Code of Ethics was first drafted in 1847 when the AMA was founded. Since then, it has been revised and updated to reflect changes in medicine and healthcare delivery practices. The AMA's Medical Code of Ethics was recently brought into consideration in the botched Oklahoma prison executions. "The American Medical Association is troubled by continuous refusal of states to acknowledge the ethical obligations of physicians that strictly prohibit involvement in capital punishment. The AMA's policy is clear and unambiguous — requiring physicians to participate in executions violates their oath to protect lives and introduces deep ambiguity into the very definition of medical care," reads an AMA statement regarding physician participation capital punishment.

However, the Code of Ethics is not a legally binding document. Instead, the code simply provides recommendations for physicians. "The ethical guidelines of the American Medical Association are just that — guidelines. The harshest punishment the association could dole out is revocation of AMA membership, which is not much of an enforcement mechanism," wrote Ty Alper, clinical professor of law at the University of California, Berkeley, School of Law, in an opinion piece in The New York Times regarding physicians' role in executions.

8. The AMA has called for revisions to the EHR meaningful use programs, asking for additional time and flexibility for implementation. In February, the AMA wrote a letter to former HHS Secretary Kathleen Sebelius saying physicians require extra time and flexibility to properly implement EHRs to achieve meaningful use. The AMA maintains the current meaningful use requirements are hurried, and the timeline and criteria present challenges that physicians and vendors need more time to sort through.

"The AMA is increasingly alarmed that the meaningful use program continues to move full steam ahead without regard to the challenges faced by physicians, hospitals and vendors during the past few years," said AMA president Dr. Hoven in a news release. "Continued difficulties experienced in the current program are a clear sign that federal requirements must be revised. Greater flexibility for physicians is needed to meet the meaningful use requirements and avoid unfair penalties, and less proscriptive certification criteria will help vendors better focus on the clinical needs of their physician customers."

9. The gap between medical education and meeting the future needs of healthcare is widening, and AMA is taking initiative to fix it. The AMA's Initiative to Transform Medical Education focuses on transforming the medical education environment, including requirements for medical school admission and physician re-entry. In 2013, the AMA launched an $11 million competitive grant initiative for medical schools to develop new methods for assessing physician competency, promote exemplary methods to achieve patient safety and physician performance, improve the understanding of the overall healthcare system during training and optimize the learning environment. The five-year initiative hopes to lead to shared best practices and improved medical education to advance clinical excellence for the generations of physicians to come.

10. The AMA Foundation is the philanthropic arm of the AMA, providing monetary support to advance public health and medical education. Since its creation in 1950, the AMA Foundation has provided more than $60 million in scholarships and more than $40 million in grants to medical students, public health initiatives and organizations. In 1962, the AMA Foundation established the Student Loan Guarantee Program, providing low-cost loans to medical students, interns and residents. Medical education support has since then grown to include scholarships for minorities, academic excellence, need-based students and a research grant program. In terms of public health, the AMA provides grants for organizations to carry out educational programs and physician-led clinics for underserved, vulnerable populations.

More Articles on the AMA:

AMA: Physicians Generate $1.6T in Economic Activity
The SGR Issue: What Another Temporary Patch Means for Physicians
AMA: ICD-10 7 Step Training Checklist

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