Kevin Campbell, MD, is a cardiologist based in Raleigh, North Carolina, and CEO of PaceMate. In addition to his weekly video analyses on MedPage Today, he is the official medical expert at WNCN in Raleigh and makes frequent guest appearances on other national media outlets such as Fox News and HLN. The opinions expressed in this commentary are the author's.
The following transcript has been edited for clarity:
The American Medical Association had its annual meeting this past week in Chicago. During their meeting of delegates they touted their self-proclaimed accomplishments and the fact that they have been growing in membership numbers in the last two years. Nothing could be further from the truth.
This is what the AMA has to say about its membership numbers:
They write that membership has been growing steadily over the last 3 years but then cleverly bury the part about how revenue on membership has decreased every year (at least for the last five years) because the "new members" are actually mostly group practices, students, residents, fellows in training, retirees, and so called "sponsored memberships" which have much lower average membership rates. Retirees, students, and residents are a large proportion of this so-called growth -- not practicing MDs.
According to publicly available records, it appears that the AMA has also spent more money each year on marketing efforts focused on member retention.
So, the bottom line is that the AMA is spinning the overall increase in membership but the organization fails to mention how many are actually practicing physicians. I expect that, in reality, they are likely losing more and more members each year. Remember the important rule from your Freshman statistics class when you attempt to analyze a database -- "garbage in equals garbage out." And as one of my mentors at Duke once said, "If you torture the data long enough, it will confess to anything."
So let's break it down further and take a closer look at the AMA's membership numbers ... -- there are 1,341,682 physicians/medical students/residents/Fellows in the U.S. today -- there are 250,253 AMA members. According to the AMA's own numbers, 22.5% of AMA members are students and 24.7% are residents (this number in 2016 was 235,000 or 1/6th of America's physicians).
Yet students only make up 8.1% and residents, 10.4% in the U.S., so if you remove them from the AMA's published numbers, you get 1,093,472 physicians, and then remove the percentages of students and residents from the previous numbers I quoted, ultimately there are only 132,133 practicing physicians who are AMA members. That's 12.1%. A drop. A decline that has continued for decades.
It's an interesting angle that the AMA paints a picture of membership growth in their marketing literature but skirt the fact that it's essentially like a fraternity claiming growth by rushing tons of freshmen the first day they get to college, with not many of them ever becoming full dues paying members and staying active for the 4 years of college.
Beyond the membership spin -- What is it about the AMA that America's Doctors really detest?
-- The AMA touts itself as speaking for all of us -- but rarely listens to any of us -- they work to fill their own pockets with dollars from big pharma and government
-- The AMA tends to have a narrow minded political view and works to stifle any dissenting opinions (in an effort to continue to align with the government agencies that line the pockets of AMA executives with taxpayer money)
-- The AMA has collaborated with the government to expand irrelevant and unfair payment codes (the hated CPT codes and ICD 10) -- this has significantly contributed to the disparity in pay for different specialties.
-- The AMA has spent more (of dues paying member money) than almost any other company on lobbying in the last 20 years -- to a tune of $347 million -- only the U.S. Chamber of Commerce and the National Association of Realtors have spent more.
-- The AMA receives nearly twice as much money from the U.S. government as it does from membership dues, and has since the Clinton Administration when the AMA signed on to support price controls for physician services -- in exchange for Washington leaving it to the AMA to decide how the shrinking pot of money for physician payments would be divided up between medical specialties. (Yes, this is all about how the self serving AMA determines CPT codes.) In 2010 alone, the AMA made 72 million in royalties and credentialing products sold to the U.S. government.
I think it is clear that the AMA is desperate. They are an organization that relies on government payments for its revenue -- which line the pockets of its executives. Membership is declining and the Majority of U.S. physicians DO NOT believe that the AMA represents their interests -- or the interests of their patients. Let's call a spade a spade -- the AMA is not the association for the U.S. doctor -- it's a money-making machine from the few who lead the way for the AMA in Washington D.C.