Monday, September 20, 2010

RESOLVED, Joining the AMA

So far, I have been to two events associated with the AMA (American Medical Association). 

One event was the first local chapter meeting, held by the Massachusetts Medical Society (probably best known for its publication, The New England Journal of Medicine).  It was one of eight annual meetings, entirely student-run, and attended by several dozen students from the four medical schools in Massachusetts--Harvard, Boston University, Tufts, and the University of Massachusetts.  After giving the newcomers an overview of the organization's history, membership, and goals, the governing councilors had break out sessions to learn more about advocacy and policy, community service, leadership, and membership.

Our school chapter receives quite generous funding from the AMA and the MMS to hold events and lectures, organize community service activities, and attend national conferences. 

The AMA has a shaky reputation for being overly conservative to some, both among inside and outside the profession.  At its peak in the 1960s (when it spent heavily to block Medicare), it encompassed about 70% of physicians.  Today, it represents less than one third of physicians, and about half of those are retired.  The AMA remains opposed to any national insurance health care plan.  Although it eventually supported the recent health care reform bill, it successfully lobbied against the 5% tax on elective cosmetic surgery.

The AMA founded the Student American Medical Association (SAMA) in 1950, to provide medical students a chance to participate in organized medicine.  However, in 1967, SAMA cut ties from the AMA and became the independent and student-governed AMSA (same words, rearranged).  The organization took stands on more typically social justice medical issues, such as civil rights, universal health care, and global health.

Both the AMA and AMSA are represented here at HMS.  I understand the reasons for creating a separate student chapter that consists of more like-minded members (such as pursuing certain goals without facing resistance at each step), but I want to stick with the AMA.  I believe the best way to help control a system is to do it from within.  The AMA is an organization that reflects the views of its members, and if we want certain views represented, then it is best to participate.  The AMA encompasses students.  It specifically has different chapters for medical students, residents, "young physicians," and physicians, in which each group can mingle with those in their own or those outside their own.

Recently, drafts of student resolutions (which will eventually be passed along to the AMA) were due.  Over 40 ideas were presented, including an opt-out organ donation policy, improved student health insurance standards, disability resource services, promoting a standard nutrition education for primary and secondary schools, interstate Medicaid cooperation, and broader regulation of direct-to-consumer genetic testing.  Interestingly, only about one fourth of the resolutions applied to medical students.  The rest applied to society at large.

Though I am certain I want be a participating member of the AMA, that doesn't mean I don't have mixed feelings about the organization in general.  The AMA is a special interest group, and it protects the interests of its members.  Because of its lobbying efforts, I will enjoy a high salary, job security, and a certain amount of autonomy.  But tell someone (even another physician) that you are part of a lobbying effort to keep doctors' salaries high, and you are painted in a certain light.  Somehow, I get the feeling that unions for other professions are seen as more necessary and "legitimate" than unions for doctors, since we are seen as more privileged and powerful. 

But to get to where we are today, a lot of people needed to be self-interested.  To stay where we are, a lot of people still do.  Admittedly, I probably would not enthusiastically undertake these efforts myself, but I will be the first to admit that I appreciate the benefits, whether I approve of the methods or not.  I am grateful that because of them, I have the opportunity to help shape policy for those in less fortunate positions.  At the local chapter meeting, a second year student from HMS submitted a project grant application requesting funding for a community service activity in which medical students prepare and serve dinner for a local residence for cancer patients and their families.  It was unanimously granted.  It's a small step, of course, but I can firmly say this represents my views.


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