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Chicago
You would have thought it was Wrigley Field not the Hyatt Regency Chicago.
When President Obama told gathered physicians at the American
Medical Association's annual meeting in his home town this month, "I'm not
advocating caps on malpractice awards which I believe can be unfair to people
who've been wrongfully harmed," he was booed like Chicago Cub Milton
Bradey. "Yank him," was probably next.
Who remembered that in 1993 a similar message by his Secretary of
State--also a homey--received a standing ovation? (Though the long knives did
come out later.)
Of course the 236,000 member AMA which represents a fourth of the
nation's practicing physicians, has always been obstructionist--fighting
managed care, cost controls, posted fees, politicians, insurance companies,
nurses and even a physician "glut" in the past.
But its view of the nation's health problems is just as limited
critics say.
Will headlines after the next AMA meeting read, "AMA Decries
Use of Plastic Spatulas," or "Doctors Worried About Increase in
Planetary Tilt," asked Mark DePaolis, MD in the Star Tribune in 1994
thanks to the organization's penchant for grappling with cruise ship hygiene
and bad physician penmanship.
This year Vitamin D got more play than health care for troops and
veterans in two ongoing wars. Hello?
It's not that the AMA doesn't know the issues. It has taken up elder
abuse, bullying, corporeal punishment in schools, alcohol abuse, highway
safety, binge drinking, medical marijuana, cosmetic sun tanning, medical waste,
livestock antibiotics, organ donation, terminal care, physician assisted
suicide, women, gay and patient rights, AIDS ethics and patient privacy in the
past.
In the 1990's it confronted Big Tobacco--and embarrassment over its
own tobacco stock holdings--with a high profile, physician-led "Dump the
Hump," Walk a Mile Against Joe Camel parade in Chicago's Loop.
Nor has the AMA shrunk from addressing the "intentional
violence" of boxing, violent movies and video games, "private
ownership of rapid fire assault rifles" and physician involvement in
executions--though a resolution against the death penalty itself was defeated
in 2000. (It "wasn't the AMA's business," said Colorado AMA delegate
Steven Thorson, MD.)
It's just that some issues are more equal than others.
So even though AMA delegates passed a resolution against direct to
consumer (DTC) drug advertising in 1991-- the "ads mislead the public and
add to the cost of medication," it stated--and even though it reaffirmed
the stance in 2001--it's like a competition "to see who can sell more of
antihistamines or nasal sprays," said New Jersey AMA delegate Angelo Agro,
MD--the AMA reversed itself in 2005 and decided the notorious, ask-your-doctor
ads were a First Amendment issue.
And speaking of the First Amendment, the AMA's controversial and
semi-hidden practice of selling its physicians' personal prescribing
information to marketers was also called "free speech" in recent
court rulings in Maine and New Hampshire.
For more than 50 years, the AMA has profited by selling physicians'
personal data "to pharmaceutical companies, hospitals, medical colleges
and universities, medical equipment and supply companies, and other
institutions interested in supplying goods and services to physicians and group
practices," it admits on its website. "AMA's Database Licensees are
specialized in direct mail, telemarketing, sales call reporting, and other
database marketing services," it says.
Physicians are free to opt out of the $50 million a year scheme,
censured at the AMA's 2007 annual meeting by Lydia Vaias, MD of the National
Physicians Alliance and John Santa, MD of the Prescription Project, a group
against such access--if they know about it.
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