W

hen Donald Trump this week tapped a surgeon-turned-congressman to run the Department of Health and Human Services, the nation’s largest physicians group swiftly endorsed the choice.

The blowback started almost at once.

Liberal doctors peppered the American Medical Association with furious tweets decrying the group’s endorsement of Representative Tom Price as a betrayal of patients and physicians. And by Wednesday night, 500 doctors had signed an online open letter titled “The AMA Does Not Speak For Us” started by the Clinician Action Network, a left-leaning advocacy group.

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The outpouring of anger has exposed the bitter political rifts dividing doctors these days. Price is an AMA member, but he also belongs to a conservative doctors’ group that publishes a journal which has advanced discredited theories, such as the notions that abortions cause breast cancer, vaccines cause autism, and HIV does not cause AIDS. The same group shot into the spotlight during the presidential campaign by promoting conspiracy theories about Hillary Clinton’s health, including speculation that she’d had a seizure or a stroke.

There are left-leaning alternatives to the AMA, too, including one that has long advocated for gun control, pushes physicians to cut all financial ties with drug companies — and expressed dismay that any doctors group would back Price.

The AMA remains by far the biggest and most visible lobbying force representing doctors and medical students. The group spent $15 million just in the first nine months of this year to lobby Congress and the executive branch on everything from marijuana research to opioid prescribing to telemedicine, as well as traditional issues such as reimbursement and billing, according to federal filings.

But physicians are increasingly using social media to push back against the organization.

“The AMA is generally a force for the status quo in health care, a physicians’ guild in the old-school style of wheeling, dealing, and horse-trading to keep the billing flowing like a mighty stream into MDs’ coffers,” Dr. Zackary Berger, an internist at Johns Hopkins, said in an email. Berger, who is also the founder of Doctors Against Trump, has never belonged to the AMA.

The AMA has about 250,000 members, including doctors and medical students. Roughly 15 percent of practicing doctors in the US are full dues-paying members of the AMA, according to a 2011 estimate published in the journal of the Canadian Medical Association.

The organization has a lot at stake when a new administration comes to town: Working with Congress, the executive branch can shape everything from health insurance markets to hospital ratings systems to how much money doctors receive for treating patients on Medicaid and Medicare.

Back in 2009, when President Obama first nominated Kathleen Sebelius to run HHS, the AMA put out a statement within hours praising her “leadership skills.”

Within six hours of Trump officially nominating Price, the AMA urged quick confirmation in a tweet expressing strong support for the Georgia congressman, a former orthopedic surgeon. In a statement on its website, the group praised Price as “a leader” in developing “market-based solutions” to health policy and reducing “excessive regulatory burdens.”

The AMA didn’t mention that Price has been a vocal opponent of the Affordable Care Act. Or that he’s called for restructuring and sharply cutting federal aid to Medicaid, which primarily serves poor people. Or that he’s proposed controversial changes that could cut benefits to seniors under Medicare. Or that he has a 0 percent rating from Planned Parenthood and has opposed efforts to give women free access to birth control.

The endorsement infuriated some doctors.

Other physicians said they were glad they had cut ties with the AMA before the endorsement. “I left when I realized they certainly were not speaking for me,” said Dr. Jen Gunter, a Bay area OB-GYN who was an AMA member for a few years in the 1990s.

Gunter told STAT she found the AMA too slow to speak up in defense of reproductive health, too weak on promoting primary care physicians, and too slow to promote female leaders. Even so, she said she was “stunned” that the organization endorsed Price.

The outcry among doctors didn’t escape the notice of Sebelius, who served as HHS secretary for five years during the development and implementation of Obamacare (and who took heavy criticism from anti-abortion groups after her nomination).

“I wasn’t surprised to see some pushback” from doctors on Price’s nomination, Sebelius told STAT in a phone interview. She noted that the AMA has supported Medicaid expansion and been involved in outreach around the Affordable Care Act — and “clearly, this nominee does not share those views.”

Even Dr. Steven Croft, a Texas neurologist who is a member of the same right-wing physicians group as Price, said he was “shocked” — and pleased — to see the AMA back Trump’s nominee, given the group’s support for Obamacare.

“It seems that they switched sides (for the better),” Croft said in an email.

Dr. Patrice Harris, who chairs the AMA’s board of trustees, said the group’s endorsement stems from its “relationship with Dr. Price going back decades.”

The AMA has not always agreed with Price on “important policy issues,” Harris wrote in an emailed statement, but he has “consistently recognized the many challenges facing patients and physicians, and he has been willing to listen” to the group’s concerns.

And the blowback from doctors? “We understand that our diverse membership will never agree on every position the AMA takes,” Harris wrote.

The AMA wasn’t the only medical group to back Price.

“A strong choice,” said the Association of American Medical Colleges.

“An indispensable voice,” said the American Academy of Orthopaedic Surgeons.

America’s Essential Hospitals lauded Price’s health care background. The Advanced Medical Technology Association said “we look forward” to his confirmation.

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Meanwhile, the National Physicians Alliance, which identifies as nonpartisan but generally backs liberal policies, put out a statement taking those other groups to task: “We are dismayed that other large physician organizations have endorsed Dr. Price without consideration of the harm his policies would inflict on our collective patients.”

The group’s president, Dr. Manan Trivedi, told STAT that he believes many physicians share his sense that they have been betrayed by “organizations that they thought represented them and patients but in fact were focused on personal pocketbook issues.”

His view of Price? “No [health secretary] nominee in recent memory has been such a threat for basic health care for our patients,” Trivedi said.

Price’s congressional office did not respond to a request for comment. Neither did Trump’s transition team.

Dylan Scott contributed reporting from Washington.

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  • When y’all are voted president, your thoughts will count. President Trump made his choice so show some respect.

    • Dear STAT: I think that superbug y’all are reporting on just gained access to a keyboard and an internet connection. It has become resistant to democracy and common sense but is still sensitive to ban-icillin and block-ofloxacin.

  • This literally terrifying. Thank goodness for those who are speaking up with the necessary seriousness to protest the situation.

  • A few of Mr. Price’s votes:

    • Voted YES on the Ryan Budget: Medicare choice, tax & spending cuts. (Apr 2011)
    • Voted YES on repealing the “Prevention and Public Health” slush fund. (Apr 2011)
    • Voted NO on regulating tobacco as a drug. (Apr 2009)
    • Voted NO on expanding the Children’s Health Insurance Program. (Jan 2009)
    • Voted YES on overriding veto on expansion of Medicare. (Jul 2008)
    • Voted NO on giving mental health full equity with physical health. (Mar 2008)
    • Voted NO on Veto override: Extend SCHIP to cover 6M more kids. (Jan 2008)
    • Voted NO on adding 2 to 4 million children to SCHIP eligibility. (Oct 2007)
    • Voted NO on requiring negotiated Rx prices for Medicare part D. (Jan 2007)
    • Voted YES on denying non-emergency treatment for lack of Medicare co-pay. (Feb 2006)
    • Voted NO on reauthorizing the Violence Against Women Act. (Feb 2013)
    • Voted YES on banning federal health coverage that includes abortion. (May 2011)
    • Voted NO on expanding research to more embryonic stem cell lines. (Jan 2007)
    • Voted NO on allowing human embryonic stem cell research. (May 2005)
    • Voted YES on restricting interstate transport of minors to get abortions. (Apr 2005)

    • Voted NO on four weeks of paid parental leave for federal employees. (Jun 2009)
    • Voted YES on maintaining work requirement for welfare recipients. (Mar 2013)
    • Voted NO on providing $70 million for Section 8 Housing vouchers. (Jun 2006)
    • Voted YES on prioritizing spending in case debt limit is reached. (May 2013)
    • Voted YES on terminating the Home Affordable mortgage Program. (Mar 2011)
    • Voted NO on $192B additional anti-recession stimulus spending. (Jul 2009)
    • Voted NO on modifying bankruptcy rules to avoid mortgage foreclosures. (Mar 2009)
    • Voted NO on additional $825 billion for economic recovery package. (Jan 2009)
    • Voted NO on monitoring TARP funds to ensure more mortgage relief. (Jan 2009)
    • Voted NO on $15B bailout for GM and Chrysler. (Dec 2008)
    • Voted NO on $60B stimulus package for jobs, infrastructure, & energy. (Sep 2008)
    • Voted NO on defining “energy emergency” on federal gas prices. (Jun 2008)
    • Voted NO on revitalizing severely distressed public housing. (Jan 2008)
    • Voted NO on regulating the subprime mortgage industry. (Nov 2007)

    • Voted NO on enforcing against anti-gay hate crimes. (Apr 2009)
    • Voted NO on expanding services for offenders’ re-entry into society. (Nov 2007)
    • Voted NO on additional $10.2B for federal education & HHS projects. (Nov 2007)
    • Voted YES on barring EPA from regulating greenhouse gases. (Apr 2011)
    • Voted NO on enforcing limits on CO2 global warming pollution. (Jun 2009)
    • Voted NO on tax credits for renewable electricity, with PAYGO offsets. (Sep 2008)
    • Voted NO on tax incentives for energy production and conservation. (May 2008)
    • Voted NO on tax incentives for renewable energy. (Feb 2008)
    • Voted NO on investing in homegrown biofuel. (Aug 2007)
    • Voted NO on criminalizing oil cartels like OPEC. (May 2007)
    • Voted NO on removing oil & gas exploration subsidies. (Jan 2007)
    • Voted NO on deterring foreign arms transfers to China. (Jul 2005)
    • Voted YES on reforming the UN by restricting US funding. (Jun 2005)

    • Voted NO on increasing minimum wage to $7.25. (Jan 2007)
    • Voted NO on protecting whistleblowers from employer recrimination. (Mar 2007)

    • Voted YES on extending the PATRIOT Act’s roving wiretaps. (Feb 2011)
    • Voted NO on requiring FISA warrants for wiretaps in US, but not abroad. (Mar 2008)
    • Voted NO on Veto override: Congressional oversight of CIA interrogations. (Mar 2008)
    • Voted YES on removing need for FISA warrant for wiretapping abroad. (Aug 2007)
    • Voted NO on restricting no-bid defense contracts. (Mar 2007)
    • Voted YES on allowing electronic surveillance without a warrant. (Sep 2006)
    • Voted YES on continuing intelligence gathering without civil oversight. (Apr 2006)
    http://www.ontheissues.org/GA/Tom_Price.htm#Principles_+_Values

  • Orthopods have never been known for their academic brilliance. An old medical school joke: how do you hide a $100 bill from an orthopedic surgeon? Answer: put it in a textbook.

    • There are two qualities necessary to be an orthopedic surgeon. Be strong as an ox and twice as smart

  • “by promoting conspiracy theories about Hillary Clinton’s health, including speculation that she’d had a seizure or a stroke.”

    Did you see the video of Hillary freaking out in front of a bunch of journalists? Or her being dragged into a van after she left the 9/11 memorial ceremony? Looked like something was very wrong with her…

  • How a doctor can be affiliated with a group that publishes bunk theories is beyond me but apparently fits in well with the other know-nothings in Trump’s Administration.

    • Talk about journalists reporting from within a bubble. I work as a nurse in a large medical center … and I have yet to meet ONE doctor who did not have a major beef with the ACA. (And the issues are not always what you think. Many are angry that their ability to provide free health services has been in effect outlawed. They felt good about the money (and red tape) they saved both the patient AND the taxpayer.

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