Even before the recent election, physicians felt perched on a precipice.

Changes sweeping health care have threatened their independence, income, and influence. An epidemic of burnout and depression shadows the profession. And the incoming Trump administration promises still more upheaval.

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  • To me, the bigger issue is that natural solutions done in other countries are shot down by the AMA. Like stuff by Royal Rife … called bioresonance or frequency healing in other countries … built into India’s Gayatri Mantra which is 3,000 years old. And we have record spending on chronic illness. Me, I search youtube for “rife [disease]”. It explains Alexa to me. And how Amazon is doing health benefits … preventative and curative rather than proprietary and proscriptive. Best I can tell, AMA tries to maximize revenue for it’s members … which puts it squarely in sickness benefits. Which is the opposite of health benefits.

  • The AMA and JAMA has extreme liberal bias in their publication, no longer objective or giving good research on social issues or even a dissenting voice in subjective matters. They present one lopsided viewpoint that is not healthy. No wonder good physicians have abandoned them.

    • I’m not convinced it’s liberal vs. conservative. Health is a fact thing. So it’s more of an “revenue generating extended sickness” vs. “healing” thing. We certainly don’t have more health under the AMA … when I look at portion of GDP spent on health over many years.

  • As you mentioned at one point, almost 80% of docs belonged, now down to around 20%. The AMA has eroded because it no longer has anything to do with the Medical Doctors of America. It is a left leaning policy influencer and lobbying outfit, that makes money by endorsing orange juice machines, and trying to sell me life and car insurance. Under thier watch, the cost of health care has consumed the GDP, has become a beuracratic nightmare, access to care is low, and quality of care even worse. We are slaves to the EMRs, the government, the insurance companies, admnistrators and lawyers. The AMA is at the center of all of this. Their recommendation to ban assault weapons is ludicrous and childish. Automatic assault weapons are already illegal, nearly every gun in modern existence is semi-automatic including the original Armalite (AR) which is just a semi automatic platform that is modular, and hence, preferable. There are 500 deaths/per year with rifles, but that pales in statistics to planes, cars, alcohol, cigarettes and garden and household chemicals, but I dont see the AMA ganging up on them because its not part of thier loony leftist agenda and they advertise in thier periodicals. The AMA was for Obamacare which codified into law the worst parts of health care, Insurance Companies power of healthcare, Pharmaceutical prices, Hospital overcharging, Government red tape, and the cost of healthcare. THe AMA is responsible for more evil in the world than practically any other lobbying group in US history, and that includes the tobacco and alcohol, lobbies

    • I agree with almost everything you say here, Mr. Neuro-Guy. However, I would add one thing to your post. The number of deaths every year by all of those means that you enumerated above put together x 10 <= the number of deaths caused by Preventable Medical Errors (excuse me, I meant Adverse Events).

    • Larry,
      The number of deaths due to medical errors in the US/yr is around 250,000, so yes that is an insane number. Maybe the AMA be recommending dont go to doctors or hospitals!!

    • Mr. Neuro-guy (Neuro, as you know, is a very generic name, there are so many sub-specialties):
      First, I want to completely eradicate any notion that I support the AMA in any way. I think it should be eviscerated.
      Second, the best, reasonable, estimate of Preventable Adverse Events (don’t ya just love euphemism) — factoring in the search limitations of the GTT in medical records — is in excess of 400k annually in the U.S. That number can be extrapolated by a factor of 10 – 20x when applied to Preventable Serious Harm. I do not post this to be argumentative or condemning, but to simply state that the Medical Profession needs transparency regarding it’s failings. No problem is ever solved without first admitting there is one. And this is a big one.

  • I joined the AMA only for one year of my 45 years of medical practice because I did not think they believed in the Hippocratic Oath; they had no interest in residents’ rights,; the will not stand up to pill splitting (into unequal portions); they do not care that MDs and JDs change medical records after bad outcomes; they do not protect whistleblowers trying to clean up the medical swamp; the have allowed “patient rights” to be rewritten by Kaiser (a medical cult – “the less we do the more money we make”); etc. The AMA is primarily self serving even hiding its income and expenses from being found on the Internet – probably the CPT Code books being the most lucrative. Some 700 rural hospital ERs closed since 1983 – the AMA does little about this. The various medical societies and state medical boards have been taken over by the business MDs who overcharge everyone possible – e.g. $33 billion per the OIG report in 2010. It is hard to imagine a more destructive organisation to pretend to stand up for the MIddle Class patient. In fact, after 20,000 hours of study I believe Dr. Robert Mark Pearl (“Robbie”) in Oakland controls the AMA – 6000 MD partners frightened he might take away their pensions if not doing whatever he wants – even sedating patients to death on Tuesdays. I have tried to get to some of this in my new book Kaiser-fornia – 2017. Like such books as The Jungle, I hope it turns public policy upside down; the corruption has got to stop and a for profit group of Permanente physicians can not have so much power achieved so corruptly.

    Charles Roy Phillips, MD – retired – aka Rural Doc and Hospital Cop – cphil49401@aol.com. Would not mind the title Mad Dog Phillips as I also
    volunteered to stay in a war zone during Desert Storm to keep running the best Emergency Room in the Middle East (though I have not yet been to Israel).

    Copy this to my email for my records.

    • That was awesome! I love it when people go off their meds and crank out a sweet rant. You sir, are Mad Dog in my book.

    • Well, William you may need to go ON some meds to recognise when “awesome” and “true” end up on the same page. I am Mad as Hamlet pretended to be mad to catch the King with in the Play. You are Mad … as in Hatter. Chuck

    • Altering records is as common these days as the actual creation of the record. I’ve seen records altered after “bad outcomes”, which is a euphemism for serious harm or death (which is also referred to as “adverse events” for anyone who doesn’t know), and after a problem-solving protocol which used a logic chain that must have been created by a bad psychiatrist. People die or end up incapacitated in some way and all anyone concerns themselves with is how to best ameliorate the liability and save face with their colleagues. The entire situation within the profession is nauseating.

  • I will give you some content, Barbara. Medical errors are not even acknowledged ninety percent of the time, let alone reported. Only twelve percent of adverse events are collected by hospital reporting tools. Over four hundred thousand people are dying each year from these events and millions are suffering serious harm; and yet the AMA does nothing, says nothing about it. Except to lobby legislators on the behalf of insurers, not docs; because since the inception of tort reform in the 1970’s insurance premiums for docs have not gone down, but gone up, yet the number of lawsuits filed has fallen, as has the amounts of settlements and judgments. If the medical profession would begin admitting when mistakes are made and addressing the patients involved, the numbers of attempted lawsuits would diminish and the esteem of the medical profession would rise dramatically in the eyes of the American people. When medical errors are not reported or acknowledged in any way, it is not only the patient that is harmed. The medical profession is harmed; and it is delegitimized.

    • Your emails Larry Pierce sound like you are very well informed – perhaps a hospital employee or paramedic. Yes, the common law equity that we pay when we harm each other is gone. In Kaiser-fornia it is worse – adding in forced arbitration (another swamp). Sometimes just a good apology would help with all the grief, but the folks in charge are pretty cold. It is getting worse. Saint Agnes Hospital in Fresno went from Ruth the nun as CEO to Nancy as the opposite. Then an $18 billion merger – “Dignity Health” but I see no dignity in it. I have only found one Church hospital I thought actually walked the walk – Saint Lukes Hospital in San Francisco. And, in fact, the worldwide Adventists have rejected Adventist West (many hospitals) due to CEOs’ fancy homes on a Lake. Gag me with a stethoscope. Chuck

    • Chuck, you are one of the few clear-eyed physicians I have ever talked to or seen post on this board. I am not a medical professional. I managed a medical practice for over 15 years. My wife held a PhD in Clinical Psychology and had a private practice within the medical practice I managed. I have read thousands of medical records and I knew long ago how docs treat records. Then my wife became ill, was inappropriately biopsied and therefore misdiagnosed. They treated her for an indolent follicular lymphoma when she had a very aggressive form of large b cell lymphoma, probably Burkitt lymphoma. Her oncologist claimed in a transfer summary to a major cancer center that we had refused a second biopsy. Can you imagine someone doing that who had an IQ over 60? No other notation regarding such a thing anywhere in her entire record. My wife died within 90 days of her “diagnosis”. If it was Burkitt, there is a ninety percent cure rate if it is attacked immediately with a very strong chemo regimen. I have been doing daily research for the past year. All of this is why I know what is happening and continues to happen within the medical community. We need more docs like yourself, and docs that will stand up when they make a mistake, admit it and try to do something about it, instead of hiding their heads and lying to the patient.

  • I joined the AMA as a student back in the 1990’s because of a simplistic belief that the AMA was an organization that stood for the professionalism and autonomy of physicians, and the general advance of medicine. I was quickly disabused of that notion.

    Bluntly stated, the AMA has a liberal/progressive and anti-primary care bias. Politically, the AMA is a perfect illustration of O’Sullivan’s First Law: “All organizations that are not actually right-wing will over time become left-wing.” This explains how an organization which once opposed Medicare is now enthralled with ObamaCare, gun control and transgender politics. And this has led in part to their neglect of the issues which are causing physicians such distress: they pursue their pet liberal social issues instead of protecting physicians of every political leaning from oppressive government policies.

    As a new physician, I read the JAMA and the Pulse student section, and as a Republican Family Practice physician, I found little to interest me, and much to alienate me. In 2002, I was already questioning whether the AMA represented my interests when then-president Richard Corlin’s uneducated and illogical gun control stance. That was the last straw for me.

    If the AMA wants to be a left-wing group for specialists, that’s okay, but if they want to represent all physicians, they need to recall that primary care makes up about 40% of all physicians, and the country is 50% Republican.

  • I have never been a member during my career as a practicing physician because for me the AMA always represented an out of touch group of old wrinkly pricks.

    • Your comment would be more powerful for me if you omitted the personal attack (old wrinkly pricks) and focused on the content.

  • Apparently, the AMA never learned from its prior faux pas picking industry favorites when it climbed into bed with Sunbeam. A redux of such questionable judgment by early endorsing Congressman Price further exacerbates the belief that the AMA does not understand exactly who its stakeholders are–just its members.

    Just like other large organizations that used to have prominence in the debates over health care, the AMA has devolved into an overly generic approach to everything, lacking the expertise it formerly was known to contribute to such debates. Indeed, all we have is a compendium of the absence of the AMA’s position projected for its members:
    -Where was the AMA to be the standard bearer of physician ethics to appreciate how a high toleration of fraud and abuse would only be to the detriment of the physician community?
    -Why did it require repeated Stark amendments to Medicare regs to control the overuse of PETs?
    -Why did it require CMS/FDA to issue strict guidelines to reign in the overuse of EPO drugs?
    -Why did the AMA not speak-out against the insurance industry and Big Pharma conniving over the “brown-bagging” of drugs that overtly threatened the quality and efficacy of such drugs?
    -Why was the AMA silent in not supporting USP797 as a national program to ensure a safer environment for pharmacies in community practices?
    -Given the increased pressure upon physicians caught between Big Pharma and their patients’ needs, why has the AMA chosen silence over stepping in with both feet?

    A classic example of this sitzkrieg approach to issues was the AMA’s unwillingness to create CPT codes for medical oncology as it moved out of the hospital setting into community practices, by failing to properly compensate for physician cognitive time and how drugs were to be reimbursed. To compensate, oncology could negotiate the best possible deals at AWP with the many GPOs; that margin spread tended to cover the gap in reimbursement allowed by the AMA. However, when the GPOs were whittled down by the power of Big Pharma, and Medicare switched to ASP+6%, the AMA did not have the oncologists back, particularly in the community settings carrying the costs for their own pharmacy and higher skilled nurses. Consequently, as a result of the AMA, is their a correlation today between this changed reimbursement environment impacting community oncology practices and the increased incidence of fraud in such neighborhood settings?

    In essence, the AMA needs to step-up its game to be relevant and respected again–by the physicians and overall community.

  • The AMA has become a bureaucracy, not a physician advocacy organization. State medical associations have done the same. By doing so AMA has lost the ability to represent doctors and our freedom to practice medicine. These organizations agendas have strayed from protecting physician practices and well being to more and more advocating for patients. The rise in the number of doctors choosing their specialty organizations to represent them is because specialty organizations are more focused on how physicians work and less on patient advocacy. While patient advoacacy is important, it is not why the AMA and State medical associations were established.

  • Yes the AMA is letting the Government control them and The Doctors they are not what they use to be they should not let the DEA or the FDA telling them how to treat patients and what Drugs they can give them it has become so bad the Government and Insurance companies are controlling the Doctors and patients do something AMA stand up for us and fight

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