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A student’s reflections on the American Medical Association

SMS (“Stanford Medical School”) Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

AMA picLast month, I had the opportunity to attend the American Medical Association’s interim meeting in Dallas, one of two annual conferences held by the organization. I went to the meeting to present at a research symposium, but I stuck around for a few extra days because I was curious about the inner workings of organized medicine. As someone interested in health-care systems and the delivery of medical care, I was aware of the AMA but wanted to learn more about its purpose and process. (Plus, I had heard they throw great conferences. They didn’t disappoint – among other things, I got to practice my lassoing skills).

To provide some background, the AMA is the oldest and largest physician organization in the United States and has historically played an important role in the development of American health-care policy. While membership has ticked upwards in recent years, the AMA has been struggling with a decades-long trend of declining involvement and fading physician interest.

There are a number of possible reasons for this decline. Some commentators cite an overarching shift in social norms, arguing that people today are simply less likely to join groups. Others attribute it to the changing needs of physicians. Physicians are now more likely to work for a hospital system rather than opening a private practice. Given that the AMA’s advocacy has traditionally focused on the interests of independent doctors, employed physicians may feel disengaged. Finally, the proliferation of local, state, and other national physician organizations have likely drawn members away from the AMA.

Such issues have brought up questions about the sustained relevance of the AMA. Going into the conference, I’ll admit I was somewhat skeptical about its continued impact. However, I came away feeling like participation in the AMA is highly worthwhile.

With reform underway and a health-care system in flux, it's more important than ever for health-care providers to understand how policy approaches influence patient care. The AMA offers a forum that serves two major roles. First, it gives medical students and doctors a way to learn about issues in health care. Topics like payment reform, the implementation of new health-care technology, and organ-transplant restrictions don’t come up in medical school in any significant way, but they have a huge impact on what we can do for patients. Every medical specialty has its share of conferences to make sure providers stay up to date on the latest developments in that field. The AMA helps people stay informed about the big-picture issues.

Second, conferences like the one I attended allow students and doctors to not only learn, but also to develop and exchange their own ideas on how to address issues in health care. The policy sessions at the conference often featured lively debates. While some physicians feel like the AMA doesn’t represent their views (it certainly didn’t represent some of mine), the best way to change that is to participate in these debates rather than disengaging. The AMA remains the single most important physician voice in policy discussions. If individuals don’t contribute to that voice, policymakers will no longer take the physician perspective into account when making decisions on health care.

The AMA is by no means a perfect organization. Like any political group, it comes with quite a bit of bureaucracy and the self-importance was occasionally irritating. Regardless, it serves as one of the best ways for medical students and physicians to become aware of the issues that affect our profession, and come up with solutions.

Akhilesh Pathipati is a second-year medical student at Stanford. He is interested in issues in health-care delivery.

Photo courtesy of Akhilesh Pathipati

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