Interesting ACEP letter

I got an email from ACEP (my “Professional College”) with the usual laundry list of requests and information.

The last item in the email was interesting:

ACEP is encouraging its members to join the American Medical Association (AMA) to help strengthen emergency medicine?s voice in the House of Medicine.

ACEP is the only emergency physician organization with a vote in the AMA House of Delegates, the policymaking vehicle of the AMA. Since its birth as a specialty, emergency medicine has benefited from the support of the AMA on such issues as prudent layperson standard, overcrowding and professional liability reform.

AMA has informed ACEP that its membership must increase by the end of the year to retain ACEP?s four voting Delegates. ACEP would like to ensure that the voice of emergency medicine continues to be heard strongly within organized medicine.
(empahsis mine)

Well, now. The expensive AMA is aware that not a whole lot of the very very expensive ACEP members are also AMA members. I agree with their desire for representation by membership, but this also makes me aware of how much membership in all these organizations really costs versus their worth. I have written before about why I’m not an AMA member, and this will not change my opinion.

It does cause me to wonder if other colleges are getting the same messages. Also, whether the AMA needs to be more a coalition of the Colleges and their memberships, and less a direct-membership body.


  1. nancy reyes says:

    we got an almost identical letter from the AAFP.
    I quit the AMA accidentally (didn’t send in the dues) two years ago.
    But their increasingly clueless “ethics” council was turning me off and I just have better things to do with $500.

  2. Hell, I was unwilling to join for $65 (med student). I did join the TMA; it’s free, and they put more of an effort forth, IMHO, on prop 12 than the AMA did. I would laugh my ass off if someday the AMA found itself to be an association without any members.

  3. R.G. Lacsamana says:

    I have been a loyal member of the AMA for 35 years and continue to support it two years past my retirement. Over that period of time, I have heard the same complaints from many physicians on why they never felt membership in the AMA is not worth it.

    Well, things never really change. We see the same apathy, indifference, and lassitude that make close to 50% of physicians piggy-backing on the efforts of the one organization that has supported their profession all these years and that has fought all the battles that have have come up not only in Washington, D.C. but in every state legislature.

    We sometimes feel AMA is not doing anything concrete for its members, but what it has done and is doing are immeasurable. Some members sometime bitch because AMA does not always win.
    But that is something we ought to expect — what organization do we know of always wins its battles?

    What we know and should realize is that AMA always advocates for the best interests of its members and patients. Without the clout of AMA, the medical profession would be in a sorry mess, thrashed over and pounced upon by enemies on all sides, including its main nemesis — the trial bar.

    Complaining about dues is frivolous when we know that other professions are much more solidly organized and better financed than we are. Lawyers are obliged to become members of the bar or they cannot practice; one “alternative” group is known to have its members contribute close to $5,000 yearly just to be able to survive and maintain its legitmacy. And we are complaining about contributing a measly $500 to keep our profession strong and relevant?

    People ought to attend one AMA meeting to get a grasp of what it does for all physicians in America. The AMA, along with state and county medical societies, encourage every physician to participate actively in its activities, which run a spectrum of just about everything that we need both as practitioners and as advocates for our patients’ interests. If we don’t support the AMA, what organization will takes its place? Specialty societies are not enough; they often have narrow interests that don’t intersect with the larger interests of all physicians, and they cannot do the job that a united organization like the AMA is capable of doing.

    We don’t need a fractured organization, and we don’t need crybabies. Wake up, fellows!

  4. Well, Dr. Lacsamana, thanks for your comments. I understand your attachment to the AMA, and am glad you feel it’s worth supporting.

    I have a multitude of issues with the AMA, as do, apparently, 1/2 of the US doctors. To call this a successful membership organization is questionable at best. Physicians are’t stupid, and we’re pretty good judges about people and issues that support us. Witness Texas’ passage of Prop 12, after successful legislation in the state house to limit the trial lawyers’ extortion. This was done by the Texas Medical Association, which I have membership in, not the AMA. As I recall, the AMA has rather spectacularly failed to get any kind of tort limits passed, anywhere.

    The cost of the dues is, as you rightly point out, a side issue; more to the point is value, leadership and commonality of purpose for the dollar. That’s where I find the AMA sorely lacking. I am certain that if the AMA really did represent the “larger common interests” and limited itself to that (instead of a multitude of peripheral resource draining and divisive tasks) membership would rise. This latest shakedown of the Colleges (increase your members of OUR organization or you lose votes) is typical of AMA leadership.

    Other valued AMA leadership: let’s all get on board with these HMO’s (which has helped to make health care in America the same for everyone: crap); let’s license the AMA imprimatur to Sunbeam for blenders; maybe there is something to this single payor system; pro journals crammed with ads while telling us not to listen to drug reps; etc. I see the specialty societies eventually forming their own organization, with restricted but common goals, instead of this ineffective bureaucratic organization, and leaving the AMA as a figurehead tool.

    The idea that we must spend money because the trial lawyers do is specious, and deriding those of us who choose not to join an ineffective organization as ‘cyrbabies’ is an interesting recruitment tecnique.

  5. R.G. Lacsamana says:

    In reply to GruntDoc, I never said physicians are stupid nor implied that I was recruiting physicians for AMA membership by calling some of them as crybabies. I was merely criticizing the attitude that splintering into several factions would be a better way, which certainly it is not.

    If you are critical of AMA leadership and its goals, you can do something. Join your county and state medical societies, participate actively, and elect those who you feel can do the job. But that is always how it has been done for years. Even better, you can even have your society sponsor your candidacy, and I am certain they would elect you as one of its leaders if you can convince your colleages you have something better than what the current leadership is doing.

    I need to correct your impressions that the AMA has embraced HMOs or that it has been advocating the idea of a single-payor system. (This was from the American College of Surgeons.) If you are also complaining about ads from drug companies in AMA-sponored journals, you must understand that it costs quite a bit of money to publish these journals, in the same way that newspapers and magazines need to have enough advertising to survive.

    Did the AMA make mistakes in the past? It sure did, some of which you mentioned. But those mistakes have been recognized and corrected. An organization, of whatever kind, grows and matures through experiences and occasional mistakes.

    Relative to your claim that the AMA has not done anything in terms of tort reform, I must beg to differ. AMA has spearheaded efforts in Congress to pass such a bill. It passed in the House, failed in the Senate, and endorsed by President Bush. Just remember that the Senate has always been the big stumbling block for such reform for the past several years, mainly because of its members’ clsoe ties with the trial bar. Passage of similar legislation in such states as Texas and Florida was done mainly through the state medical societies, but AMA president Dr. Donald Palmisano made several appearances in my state (Florida) to support the FMA in passing a tort reform bill two months ago. AMA’s help has been indispensable in planning strategies to help state medical societies in vital matters like this.

    Physicians in this country ought to be united, not divided. We need to have one unified voice,
    not several voices representing disparate agenda. ACEP cannot do it alone; nor can other specialty societies acting on their own. It would be tragic for physicians not to learn the lessons of history and repeat their mistakes.

  6. GREG GARCIA says:




  7. First, it’s a caps lock key. Get familiar with it. Reading all caps is proven to be annoying and more difficult to read.

    Second, I’m glad you like the AMA. I do not. The very simplistic idea that ‘you’re for our profession or you’re not’ is just that, simplistic.

    At issue, to me, is whether the AMA is the group I should support to advance my profession or, as I contend, my Specialty Society. Although I have some differences with my College, I do know they’re looking out for my patients and my interests. Also, although they are also afflicted with the ‘take a postiton on every single issue in the world’ disease, it’s to a much lesser extent than the AMA.

    For example, the AMA decided to oppose Californias’ Prop 54 ( ). Why in the world do I need to support an organization that, in my opinion, panders to race-based politics? I would love to support the AMA, but why does the National Physician Organization have to get involved in divisive politics? Instead of taking meaningless stands on divisive issues, the AMA should be taking stands on issues that directly affect physicians.

    I will say it again: for me, the AMA doesn’t represent my particular interests, my college does. My college gets my support, the AMA doesn’t.

  8. AMEN, Gruntdoc!

  9. Scott Tidwell says:

    Just a note to you rich, whiney spoiled doctors. (Just kidding you know). We lawyers have a similar dilemma, to be members of the State Defense Counsel program, we also have join the national Defense Research Institute. They are both pretty good groups, and they give us pretty good info to pass on to you guys. Scott

  10. Have to agree with Grunt Doc and Dr. Reyes. I have trouble giving my money to an organization that spends it supporting political agendas I don’t agree with.