The American Medical Association met in convention this past week and set about establishing their officers, policies, and objectives for the coming year.  We thought that we would share with you a very small amount of the wide ranging content that the AMA considered.

First of interest is the report on the new AMA board of trustees found HERE.  This is of interest because if nothing else it explains the close ties between the Texas Medical Association and the American Medical Association as something more than just parent and sibling organizations.  There is nothing "sinister" in this representation, but on a 21 person board to have nearly 20% be from the State of Texas accounts a great deal about the TMA/AMA objectives in the TMA v TBCE lawsuit.  Two other states (New York and Pennsylvania) each have a some 14% membership on the AMA board, one state (Kentucky) has about 9% of the AMA board, and nine other states represent less than 5% each of the AMA board.  On a 21 person board there are 13 states represented.  The "physician types" represented on the AMA board are:  2 internists; pediatric neuroseurgon; 2 orthopedic surgeons; infectious disease physician; psychiatrist; 2 anesthesiologists, 1 of whom is  pain management physician; cardiologist; emergency medicine physician; obstetrician/gynecologist; oncologist; 3 family medicine; critical care; medical student; microsurgeon; lawyer; and a pediatrician.

The 165th president of the AMA provided some insight into the future direction of the AMA when he said in a REPORT FILED HERE that "“As physicians, we have the opportunity to heal and the responsibility to do no harm...At this historic time, we have the opportunity to assure that our county’s health care system bears the imprint of physicians and we have the responsibility to bring to that task a voice that is clear, firm and constructive.”

Further, says the report: "In his inaugural address as AMA president, Dr. Wilson spoke to the nation’s physician leaders and pledged to bridge differences in the medical profession and focus on improving the health care system for patients and physicians", which, to this author, leaves no doubt that the AMA considers only themselves when seeking to affect national and state policy regarding the healing arts.

The new AMA president "outlined his prescription to address four leading challenges to our health care system: Medicare physician payment, inefficiencies in health care delivery, medical liability and skyrocketing costs."  This author concludes that medical physicians and their patients will seek to profit at the expense of other healing arts practitioners.

The AMA also took note of the "physician shortfall" in the United States.  They REPORT HERE "The American Medical Association (AMA) adopted...new policies to strengthen the physician workforce to meet the nation’s growing health care needs. The United States faces a shortage of between 124,000 and 159,000 physicians by 2025. Already at least 22 states and 15 medical specialties have reported physician workforce shortages, including in medically underserved regions and front-line specialties including primary care and general surgery."

"New AMA policies focus on improving access to care in underserved areas and increasing the physician workforce through graduate medical education expansion. 

To ensure that medical students can complete their training and become physicians, the AMA will strongly advocate for funding from all payers, both public and private, for residency training positions. The number of U.S. medical school graduates is increasing, but the number of residency positions is not keeping up to because of lack of funding."

This author looks for this to mean that the AMA will seek public funding for medical physicians and their patients to the exclusion of other healing arts practitioners.  The article concurs by noting that the AMA will seek, "To ensure an adequate physician workforce; our nation needs an additional 15,000 residency positions in primary care, general surgery and other undersupplied specialties.” A part of their argument for needing more money will be “Physician shortage is a serious issue for the entire nation, but it is an even bigger challenge in regions with medically underserved patients.”

A very few of the very many additional policies that the AMA has established in the coming year are REPORTED HERE.  The AMA likes to call them "new scientific policies."

Says the AMA "In the wake of a Medicare meltdown caused by a 21 percent Medicare physician payment cut, the AMA voted to immediately formulate legislation for a new Medicare payment option. It would  allow patients and physicians to freely contract for payments that differ from the Medicare schedule, while allowing patients to use their Medicare benefits."  But, as the AMA sees everyone who is not an MD/DO as a "non-physician" don't expect the AMA to be inclusive of other healing arts providers when it states “Seniors deserve a Medicare benefit that allows them access to and choice of physicians.”

The AMA is also becoming ever more involved in legal matters and litigation.  A new policy adopted by the AMA notes "To help physicians identify and resolve diverse legal issues that affect patients’ health and well being, the AMA passed new policy today that encourages physicians to develop partnerships with nurses, social workers and attorneys. 'Through this partnership, the unmet legal or environmental needs of patients can be addressed before they reach crisis proportions,' said AMA Board Member David O. Barbe, M.D.  'The AMA encourages physicians to develop medical-legal partnerships, and we will help them do this by creating a model agreement and working with key stakeholders on education.'"  Look for more litigation as well as political actions from the AMA/TMA in the future.

In what seems to be an approach acknowledging the unique function of each individual "the American Medical Association (AMA) adopted...new policy to support personalized medicine as a way to enhance patient care. Personalized medicine (PM) refers to health care that is informed by a person’s unique clinical, genetic, and environmental information.  It has long been known that individual patients respond to the same disease and treatments differently, and the goal of PM is to identify these individual differences so that the  best treatments and preventions can be used."

But, it seems, that command and control of new technologies and a new source of revenue is the aim of the AMA:  "in order to maximize the benefit of PM, the health care workforce needs ongoing education about the use of genetic technologies in clinical care. Adequate oversight and regulation must be implemented, and coverage of clinically useful PM should be considered by insurers."

“Personalized medicine is an extension of traditional approaches in health care, further allowing physicians to refine diagnosis, treatment and prevention.  The AMA will inform physicians about emerging personalized medicine issues and develop educational resources and point-of-care tools to assist physicians in implementing personalized medicine.”  This author presumes that "non-physicians" will be excluded from such new science as it is the position of TMA/AMA that only [medical] physicians may render a diagnosis, and therefor treatment and prevention of conditions for which PM might be used.

On a positive note, however, the AMA has finally recognized a position long held in the chiropractic community:  "Over time antibiotics lose the ability to treat diseases because bacteria eventually becomes resistant to them. Antibiotics must be used only when necessary so that we can prolong their effectiveness" says the AMA. 

On a less positive note, however, the AMA wants newer and more powerful antibiotics: "These challenges are compounded by a lack of new antibiotics under development by pharmaceutical companies. Today the AMA passed policy to increase efforts to educate the public about antibiotic resistance and raise awareness of the lack of new antibiotics in the drug development pipeline. The AMA will also endorse the “10 x ’20” initiative which aims to create 10 new antibiotics by 2020."

These are but a very small part of the AMA's policies and plans for the near future.  As the AMA states: "Since 1847 the American Medical Association (AMA) has had one mission: to promote the art and science of medicine and the betterment of public health. Today, the core strategy used to carry out this mission is our concerted effort to help [medical] doctors help [their] patients."  Their mission is "medicine" and not "healing arts" promotion.  We can only hope that the leadership of our state and nation awaken to this fact as they develop public health policy.