Doctors Group Struggles With Image

By LINDSEY TANNER : AP Medical Writer
Jun 20, 2003 : 3:37 am ET

CHICAGO -- The American Medical Association, suffering from sagging membership and sometimes dueling missions of serving public health while protecting doctors' pocketbooks, ended its annual meeting without finding a cure for its ills.

Not much happened at the six-day meeting that ended Thursday to change critics' perception of the nation's largest doctors' trade group.

Delegates endorsed human embryo cloning only for research purposes -- a stand opposed by the Bush administration but identical to views many mainstream scientists have held for years.

The group also reiterated its support of a ban on dietary supplements containing ephedra. And it strengthened its policies against alcohol abuse and tobacco -- issues the group has long championed.

The group adopted a policy against drug company sales representatives paying doctors to sit in on patient exams but did not seek an outright ban on a practice some labeled despicable.

But while AMA delegates endorsed a policy proclaiming that improving the public health "is our highest goal," AMA leadership said its top legislative priority is medical liability reform -- fighting huge jury awards against doctors and escalating malpractice insurance costs.

"There's always this difficulty in any membership organization of trying to take an ethical stand that is opposed to the pocketbooks of their members," said Dr. Jerome Kassirer, a former editor of the New England Journal of Medicine and former AMA member.

"No matter how you couch it," Kassirer said, "they're always going to be torn between those two conflicting" missions.

New Orleans surgeon Dr. Donald Palmisano, the AMA's new president, said the group's goals aren't competing.

"Jackpot justice" and skyrocketing insurance costs in many states have forced some doctors to move their practices or leave the profession -- limiting patient access to health care, Palmisano said.

"Remember, all our miraculous medical advances and insuring the uninsured are ultimately meaningless if you can't find a physician," he told members Wednesday night in his inaugural address.

The AMA also took action to streamline its internal operations and reaffirmed its policy urging delegates to vote on the basis of what's best for patients and American medicine.

The organization rejected a restructuring plan that would have transformed the AMA from a group of individual members into an "organization of organizations" in which medical specialty societies would have paid dues based on the size of their organizations.

Some had hoped the plan would help attract new members to the AMA, which counted 260,455 members as of December 2002. That's down nearly 18,000 from the previous year and compares with 951,853 physicians and medical students nationwide.

AMA officials had no concrete answers when asked what they would do next about membership. "We haven't found a solution," trustee Dr. William Plested said.

Dr. Erica Frank, who sponsored the public health measure, said the AMA's reputation as a self-interested trade group is "somewhat valid." But she added, "there is no other organization that can legitimately purport to represent U.S. doctors."