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[[Image:2007 05010030.JPG|left|200px|right|thumb|The American Medical Association headquarters building in [[Chicago]]. Architect: [[Kenzo Tange]]]]
[[Image:2007 05010030.JPG|left|200px|right|thumb|The American Medical Association headquarters building in [[Chicago]]. Architect: [[Kenzo Tange]]]]


*'''1844''': A doctor named [[Nathan Davis]] serves in the New York Medical Society. He works to better medical schools and licensing.
*'''1844''': A doctor named Nathan Smith Davis serves in the New York Medical Society. He works to better medical schools and licensing.
*'''1845''': Davis introduces a resolution endorsing the establishment of a national medical association to "elevate the standard of medical education in the United States."
*'''1845''': Davis introduces a resolution endorsing the establishment of a national medical association to "elevate the standard of medical education in the United States."{{Citation needed|date=August 2009}}
*'''1847''': Nathan Davis founds the AMA at [[Academy of Natural Sciences]]. The Committee on Medical Education, Code of Medical Ethics, and first minimal standards for medical education are created. [http://www.ama-assn.org/ama/pub/about-ama/our-history/the-founding-of-ama/our-founder-nathan-smith-davis.shtml]
*'''1847''': Nathan Smith Davis founds the AMA at [[Academy of Natural Sciences]]. The Committee on Medical Education, Code of Medical Ethics, and first minimal standards for medical education are created. [http://www.ama-assn.org/ama/pub/about-ama/our-history/the-founding-of-ama/our-founder-nathan-smith-davis.shtml]
*'''1849''': AMA studies quack remedies and tells the public about the dangerous effects of such treatments.
*'''1849''': AMA studies quack remedies and tells the public about the dangerous effects of such treatments.{{Citation needed|date=August 2009}}
*'''1858''': AMA starts a Committee on Ethics.
*'''1858''': AMA starts a Committee on Ethics.{{Citation needed|date=August 2009}}
*'''1868''': AMA Committee on Ethics allows qualified female doctors.
*'''1868''': AMA Committee on Ethics allows qualified female doctors.{{Citation needed|date=August 2009}}
*'''1869''': [[Archives of Ophthalmology]] and Otology is created.
*'''1869''': [[Archives of Ophthalmology]] and Otology is created.{{Citation needed|date=August 2009}}
*'''1870''': AMA advises Congress to adopt [[quarantine]] rules.
*'''1870''': AMA advises Congress to adopt [[quarantine]] rules.{{Citation needed|date=August 2009}}
*'''1873''': AMA [[Judicial Council]] created.
*'''1873''': AMA [[Judicial Council]] created.{{Citation needed|date=August 2009}}
*'''1876''': [[Sarah Stephenson]] is the first female member. AMA promotes sanitary city water and sewers.
*'''1876''': [[Sarah Stephenson]] is the first female member. AMA promotes sanitary city water and sewers.{{Citation needed|date=August 2009}}
*'''1882''': Journal of Cutaneous Diseases (later [[Archives of Dermatology]])
*'''1882''': Journal of Cutaneous Diseases (later [[Archives of Dermatology]])
*'''1883''': [[Journal of the American Medical Association]] (JAMA) is created.
*'''1883''': [[Journal of the American Medical Association]] (JAMA) is created.
*'''1884''': AMA condones experiments on animals.
*'''1884''': AMA condones experiments on animals.{{Citation needed|date=August 2009}}
*'''1897''': AMA becomes incorporated.
*'''1897''': AMA becomes incorporated.{{Citation needed|date=August 2009}}
*'''1898''': AMA Committee on Scientific Research gives grants for medical research.
*'''1898''': AMA Committee on Scientific Research gives grants for medical research.{{Citation needed|date=August 2009}}
*'''1899''': AMA Committee on National Legislation is created, the AMA's special interest group. Council on Exhibits educates the public on health. AMA studies tuberculosis, and how to control it, educates the public, and advises the building of government sanitariums. AMA tells local boards of health to pass mandatory smallpox vaccination. [http://www.ama-assn.org/ama/pub/about-ama/our-history/illustrated-highlights/1847-1899.shtml]
*'''1899''': AMA Committee on National Legislation is created, the AMA's special interest group. Council on Exhibits educates the public on health. AMA studies tuberculosis, and how to control it, educates the public, and advises the building of government sanitariums. AMA tells local boards of health to pass mandatory smallpox vaccination. [http://www.ama-assn.org/ama/pub/about-ama/our-history/illustrated-highlights/1847-1899.shtml]
*'''1900 to 1939''': AMA creates the House of Delegates, inspects 160 medical schools, sets standards for internship, adopts standards for specialty training, and encourages the recognition of specialty boards.
*'''1900 to 1939''': AMA creates the House of Delegates, inspects 160 medical schools, sets standards for internship, adopts standards for specialty training, and encourages the recognition of specialty boards.{{Citation needed|date=August 2009}}
*'''1940 to 1960''': The AMA accredits programs for the MD degree and opens an office in Washington DC. The AMA forms the Joint Commission on Accreditation of Hospitals, the [[American College of Surgeons]], [[American College of Physicians]], [[American Hospital Association]] and the [[Canadian Medical Association]], Medical Association News, and the AMA Educational Foundation for financial aid to med students.
*'''1940 to 1960''': The AMA accredits programs for the MD degree and opens an office in Washington DC. The AMA forms the Joint Commission on Accreditation of Hospitals, the [[American College of Surgeons]], [[American College of Physicians]], [[American Hospital Association]] and the [[Canadian Medical Association]], Medical Association News, and the AMA Educational Foundation for financial aid to med students.{{Citation needed|date=August 2009}}
*'''1961 to 1979''': The AMA discourages smoking and allows students and residents to be members. The AMA publishes [[Current Procedural Terminology]] (CPT) and Guide to the Evaluation of Permanent Impairment. The AMA forms the American Medical Political Action Committee ([[AMPAC]]) a special interest group, the Resident Physicians Section, and the Medical Student Section.
*'''1961 to 1979''': The AMA discourages smoking and allows students and residents to be members. The AMA publishes [[Current Procedural Terminology]] (CPT) and Guide to the Evaluation of Permanent Impairment. The AMA forms the American Medical Political Action Committee ([[AMPAC]]) a special interest group, the Resident Physicians Section, and the Medical Student Section.
*'''1980s''': The AMA starts the AMA Consumer Publishing program, Organized Medical Staff Section (for hospital staff), resolution agaisnts AIDs patient discrimination, and National HIV Policy that urges doctors to help HIV patients. [http://www.ama-assn.org/ama/pub/about-ama/our-history/illustrated-highlights/the-1980s.shtml]
*'''1980s''': The AMA starts the AMA Consumer Publishing program, Organized Medical Staff Section (for hospital staff), resolution agaisnts AIDs patient discrimination, and National HIV Policy that urges doctors to help HIV patients. [http://www.ama-assn.org/ama/pub/about-ama/our-history/illustrated-highlights/the-1980s.shtml]
*'''1990s''': The AMA moves to Chicago and starts the AMA website. AMA discourages family violence, [[euphanasia]], gag clauses, rushed [[maternity]] stay, smoking ads aimed at kids, and gifts to doctors from the pharmaceutical businesses. The AMA starts Health Access America(greater health insurance coverage), Patient Protection Act II bill, Institute for Ethics, National Patient Safety Foundation, [[antitrust]] relief, training for quality end-of-life care (through [[EPEC]]), organ donation awareness program, Physicians for Responsible Negotiations ([[PRN]]), The Cultural Competence Compendium, AMA Alliance, and health insurance reform. AMA lobbies for the proposed Patients Bill of Rights.
*'''1990s''': The AMA moves to Chicago and starts the AMA website. AMA discourages family violence, [[euphanasia]], gag clauses, rushed [[maternity]] stay, smoking ads aimed at kids, and gifts to doctors from the pharmaceutical businesses. The AMA starts Health Access America(greater health insurance coverage), Patient Protection Act II bill, Institute for Ethics, National Patient Safety Foundation, [[antitrust]] relief, training for quality end-of-life care (through [[EPEC]]), organ donation awareness program, Physicians for Responsible Negotiations ([[PRN]]), The Cultural Competence Compendium, AMA Alliance, and health insurance reform. AMA lobbies for the proposed Patients Bill of Rights.{{Citation needed|date=August 2009}}
*'''2000s''': The AMA starts a health literacy campaign, National House Call campaign, Reducing Underage Drinking Through Coalitions (RUDC), Disaster Preparedness and Medical Response Web site, Restored Earnings to Lift Individuals and Empower Families Act of 2001 (financial aid to med students and residents), Covering the Uninsured initiative, "No Butts About It…Tobacco Stinks" project, AMA [[HIPAA]]Link, National Advocacy Conference in Washington, D.C., AMA National Summit on Obesity, AMA Member Connect, Patient Safety and Quality Improvement Act, Commission to End Health Care Disparities, Tsunami Relief Project, and "Voice for the Uninsured" Campaign. The AMA sets limits on residency hours and consecutive hours on call. The AMA successfully lobbies against the 4.4% cut and then 5% cut in [[Medicare (United States)|Medicare]] physician payments. [http://www.ama-assn.org/ama/pub/about-ama/our-history/illustrated-highlights/the-2000s.shtml]
*'''2000s''': The AMA starts a health literacy campaign, National House Call campaign, Reducing Underage Drinking Through Coalitions (RUDC), Disaster Preparedness and Medical Response Web site, Restored Earnings to Lift Individuals and Empower Families Act of 2001 (financial aid to med students and residents), Covering the Uninsured initiative, "No Butts About It…Tobacco Stinks" project, AMA [[HIPAA]]Link, National Advocacy Conference in Washington, D.C., AMA National Summit on Obesity, AMA Member Connect, Patient Safety and Quality Improvement Act, Commission to End Health Care Disparities, Tsunami Relief Project, and "Voice for the Uninsured" Campaign. The AMA sets limits on residency hours and consecutive hours on call. The AMA successfully lobbies against the 4.4% cut and then 5% cut in [[Medicare (United States)|Medicare]] physician payments. [http://www.ama-assn.org/ama/pub/about-ama/our-history/illustrated-highlights/the-2000s.shtml]


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*The AMA Foundation provides approximately $1,000,000 annually in tuition assistance to financially constrained students (who now have a median debt load of $150,000 after medical school and $220,000 after 4 yrs of negative amortization during residency)<ref>http://www.aamc.org/programs/first/timeline.pdf</ref>.
*The AMA Foundation provides approximately $1,000,000 annually in tuition assistance to financially constrained students (who now have a median debt load of $150,000 after medical school and $220,000 after 4 yrs of negative amortization during residency)<ref>http://www.aamc.org/programs/first/timeline.pdf</ref>.
*Funds awareness projects about health literacy.
*Funds awareness projects about health literacy.{{Citation needed|date=August 2009}}
*Supports research funding for students and fellows around the U.S.
*Supports research funding for students and fellows around the U.S.{{Citation needed|date=August 2009}}
*Provides grants to community projects designed to encourage healthy lifestyles (of diet and exercise, good sleep habits, etc.)
*Provides grants to community projects designed to encourage healthy lifestyles (of diet and exercise, good sleep habits, etc.){{Citation needed|date=August 2009}}
*The Worldscopes program has a goal of providing over 100,000 [[stethoscopes]] to third world countries, donated by physicians and students.
*The Worldscopes program has a goal of providing over 100,000 [[stethoscopes]] to third world countries, donated by physicians and students.{{Citation needed|date=August 2009}}


== Political positions ==
== Political positions ==
Throughout its history, the AMA has been actively involved in a variety of medical policy issues, from [[Medicare (United States)|Medicare]] and [[HMOs]] to [[public health]], and [[climate change]].
Throughout its history, the AMA has been actively involved in a variety of medical policy issues, from [[Medicare (United States)|Medicare]] and [[HMOs]] to [[public health]], and [[climate change]].{{Citation needed|date=August 2009}}
*For most of the twentieth century, the AMA opposed [[publicly-funded health care]] because of concerns physicians have had over the financial and quality implications of such plans and the worries that a prominent government role in coordinating medical financing would inappropriately interfere with the doctor-patient relationship. When Progressive Era advocates proposed compulsory health insurance in the second decade of the twentieth century, the AMA initially took a cooperative and moderately open position to the idea, but by 1918 the Association had moved to a strongly oppositional position regarding compulsory health insurance. Ronald Numbers' 1978 book, ''Almost Persuaded: American Physicians and Compulsory Health Insurance, 1912-1920'', provides an account of the AMA's policy positions during this early period.
*For most of the twentieth century, the AMA opposed [[publicly-funded health care]] because of concerns physicians have had over the financial and quality implications of such plans and the worries that a prominent government role in coordinating medical financing would inappropriately interfere with the doctor-patient relationship. When Progressive Era advocates proposed compulsory health insurance in the second decade of the twentieth century, the AMA initially took a cooperative and moderately open position to the idea, but by 1918 the Association had moved to a strongly oppositional position regarding compulsory health insurance. Ronald Numbers' 1978 book, ''Almost Persuaded: American Physicians and Compulsory Health Insurance, 1912-1920'', provides an account of the AMA's policy positions during this early period.{{Citation needed|date=August 2009}}
*In the 1930s, the AMA attempted to prohibit its members from working for the primitive [[health maintenance organization]]s that sprung up during the [[Great Depression]]. The AMA's subsequent conviction for violating the [[Sherman Antitrust Act]] was affirmed by the [[Supreme Court of the United States|U.S. Supreme Court]]. ''American Medical Ass'n. v. United States'', {{ussc|317|519|1943}}.
*In the 1930s, the AMA attempted to prohibit its members from working for the primitive [[health maintenance organization]]s that sprung up during the [[Great Depression]]. The AMA's subsequent conviction for violating the [[Sherman Antitrust Act]] was affirmed by the [[Supreme Court of the United States|U.S. Supreme Court]]. ''American Medical Ass'n. v. United States'', {{ussc|317|519|1943}}.{{Citation needed|date=August 2009}}
*The AMA's vehement campaign against [[Medicare (United States)|Medicare]] in the 1950s and 1960s included the [[Operation Coffee Cup]] supported by [[Ronald Reagan]]. Since the enactment of Medicare, the AMA stated that it "continues to oppose attempts to cut Medicare funding or shift increased costs to beneficiaries at the expense of the quality or accessibility of care" and "strongly supports subsidization of prescription drugs for Medicare patients based on means testing". The AMA also campaigns to raise Medicare payments to physicians, arguing that increases will protect seniors' access to health care. In the 1990s, it was part of the coalition that defeated the health care reform proposed by [[President of the United States|President]] [[Bill Clinton]].
*The AMA's vehement campaign against [[Medicare (United States)|Medicare]] in the 1950s and 1960s included the [[Operation Coffee Cup]] supported by [[Ronald Reagan]]. Since the enactment of Medicare, the AMA stated that it "continues to oppose attempts to cut Medicare funding or shift increased costs to beneficiaries at the expense of the quality or accessibility of care" and "strongly supports subsidization of prescription drugs for Medicare patients based on means testing". The AMA also campaigns to raise Medicare payments to physicians, arguing that increases will protect seniors' access to health care. In the 1990s, it was part of the coalition that defeated the health care reform proposed by [[President of the United States|President]] [[Bill Clinton]].{{Citation needed|date=August 2009}}
*The AMA has given high priority to supporting changes in [[medical malpractice]] law to limit damage awards, which, it contends, makes it difficult for patients to find appropriate medical care. In many states, high risk specialists have moved to other states with such limits. For example, in 2004, not a single neurosurgeon remained in the entire southern half of [[Illinois]]. The main legislative emphasis in multiple states has been to effect caps on the amount that patients can receive for pain and suffering. These costs for pain and suffering are only those that exceed the actual costs of healthcare and lost income. Multiple states found that limiting pain and suffering costs has actually dramatically slowed increases in the cost of medical malpractice insurance. [[Texas]], having recently enacted such reforms, reported that all major malpractice insurers in 2005 were able to offer either no increase or a decrease in premiums to physicians. At the same time however, states without caps also experienced similar results; this suggests the cyclical nature of insurance markets may have actually been responsible. Some economic studies have found that caps have historically had a dubious effect on premium rates.<ref>[http://www.weissratings.com/News/Ins_General/20030602pc.htm Weiss Ratings News: Medical Malpractice Caps Fail to Prevent Premium Increases, According to Weiss Ratings Study<!-- Bot generated title -->]</ref> Nevertheless, the AMA believes the caps may alleviate what is often perceived as an excessively litigious environment for many doctors.
*The AMA has given high priority to supporting changes in [[medical malpractice]] law to limit damage awards, which, it contends, makes it difficult for patients to find appropriate medical care. In many states, high risk specialists have moved to other states with such limits. For example, in 2004, not a single neurosurgeon remained in the entire southern half of [[Illinois]]. The main legislative emphasis in multiple states has been to effect caps on the amount that patients can receive for pain and suffering. These costs for pain and suffering are only those that exceed the actual costs of healthcare and lost income. Multiple states found that limiting pain and suffering costs has actually dramatically slowed increases in the cost of medical malpractice insurance. [[Texas]], having recently enacted such reforms, reported that all major malpractice insurers in 2005 were able to offer either no increase or a decrease in premiums to physicians. At the same time however, states without caps also experienced similar results; this suggests the cyclical nature of insurance markets may have actually been responsible. Some economic studies have found that caps have historically had a dubious effect on premium rates.<ref>[http://www.weissratings.com/News/Ins_General/20030602pc.htm Weiss Ratings News: Medical Malpractice Caps Fail to Prevent Premium Increases, According to Weiss Ratings Study<!-- Bot generated title -->]</ref> Nevertheless, the AMA believes the caps may alleviate what is often perceived as an excessively litigious environment for many doctors.
*Another top priority of the AMA is to lobby for change to the federal tax codes to allow the current health insurance system (based on employment) to be purchased by individuals. Such changes could possibly allow millions of currently uninsured Americans to be able to afford insurance through a series of refundable tax credits based on income (for example, the lower your income, the greater your credit).
*Another top priority of the AMA is to lobby for change to the federal tax codes to allow the current health insurance system (based on employment) to be purchased by individuals. Such changes could possibly allow millions of currently uninsured Americans to be able to afford insurance through a series of refundable tax credits based on income (for example, the lower your income, the greater your credit).{{Citation needed|date=August 2009}}
*The AMA has made efforts to respond to health care disparities.
*The AMA has made efforts to respond to health care disparities.
**As such the AMA created an Advisory committees to assess the nature of disparities within different racial and ethnic groups<ref>[http://www.ama-assn.org/ama/pub/category/7639.html AMA (Public Health) Eliminating health disparities<!-- Bot generated title -->]</ref>. One such committee focuses on the health of the Gay, Lesbian Bisexual and Transgender community. In 2005, the AMA president [[Edward Hill|Edward Hill, MD]] gave a keynote address to the [[Gay and Lesbian Medical Association]] at its annual conference.<ref>[http://www.ama-assn.org/ama/pub/category/15741.html AMA (GLBT) News release from the Gay and Lesbian Medical Association<!-- Bot generated title -->]</ref> Since that time, the AMA has worked closely with GLMA to develop AMA policy towards better health care access for LGBT patients and better working environments for LGBT physicians and medical students<ref>[http://www.ama-assn.org/ama/pub/category/14754.html AMA (GLBT) AMA policy regarding sexual orientation<!-- Bot generated title -->]</ref>.
**As such the AMA created an Advisory committees to assess the nature of disparities within different racial and ethnic groups<ref>[http://www.ama-assn.org/ama/pub/category/7639.html AMA (Public Health) Eliminating health disparities<!-- Bot generated title -->]</ref>. One such committee focuses on the health of the Gay, Lesbian Bisexual and Transgender community. In 2005, the AMA president [[Edward Hill|Edward Hill, MD]] gave a keynote address to the [[Gay and Lesbian Medical Association]] at its annual conference.<ref>[http://www.ama-assn.org/ama/pub/category/15741.html AMA (GLBT) News release from the Gay and Lesbian Medical Association<!-- Bot generated title -->]</ref> Since that time, the AMA has worked closely with GLMA to develop AMA policy towards better health care access for LGBT patients and better working environments for LGBT physicians and medical students<ref>[http://www.ama-assn.org/ama/pub/category/14754.html AMA (GLBT) AMA policy regarding sexual orientation<!-- Bot generated title -->]</ref>.
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http://health.usnews.com/usnews/health/articles/070720/20clinics.htm In-store clinics, retrieved 2007-07-22</ref>
http://health.usnews.com/usnews/health/articles/070720/20clinics.htm In-store clinics, retrieved 2007-07-22</ref>
*In 2008, the AMA issued a policy statement on [[global climate change]] declaring that they "support the findings of the latest [[Intergovernmental Panel on Climate Change]] report, which states that the Earth is undergoing adverse global climate change and that these changes will negatively affect public health." They also "support educating the medical community on the potential adverse public health effects of global climate change, including topics such as population displacement, flooding, [[infectious disease|infectious]] and [[Vector (epidemiology)|vector-borne diseases]], and healthy water supplies."<ref>[http://www.ama-assn.org/ama/pub/category/20275.html AMA policy statement on climate change]</ref>
*In 2008, the AMA issued a policy statement on [[global climate change]] declaring that they "support the findings of the latest [[Intergovernmental Panel on Climate Change]] report, which states that the Earth is undergoing adverse global climate change and that these changes will negatively affect public health." They also "support educating the medical community on the potential adverse public health effects of global climate change, including topics such as population displacement, flooding, [[infectious disease|infectious]] and [[Vector (epidemiology)|vector-borne diseases]], and healthy water supplies."<ref>[http://www.ama-assn.org/ama/pub/category/20275.html AMA policy statement on climate change]</ref>
*In July 2008 the AMA focused its energy on blocking cuts to Medicare. Through advocacy efforts and communications campaigns, the AMA and all the specialty societies and state medical societies it comprises came out with a temporary victory. Despite a presidential veto, H.R. 6331, the “Medicare Improvements for Patients and Providers Act of 2008,” passed with wide, bi-partisan majorities in both the U.S. House of Representatives and the U.S. Senate.
*In July 2008 the AMA focused its energy on blocking cuts to Medicare. Through advocacy efforts and communications campaigns, the AMA and all the specialty societies and state medical societies it comprises came out with a temporary victory. Despite a presidential veto, H.R. 6331, the “Medicare Improvements for Patients and Providers Act of 2008,” passed with wide, bi-partisan majorities in both the U.S. House of Representatives and the U.S. Senate.{{Citation needed|date=August 2009}}
* The AMA has affirmed, through continual policy statement (policies H-460.957,H-460.974,H-460.964,and H-460.991 for example), its support for appropriate and compassionate use of animals in biomedical research programs, and its opposition to the actions of other groups that impede such research, such as some actions from animal rights groups, and its opposition to legislation that unduly restricts such research.
* The AMA has affirmed, through continual policy statement (policies H-460.957,H-460.974,H-460.964,and H-460.991 for example), its support for appropriate and compassionate use of animals in biomedical research programs, and its opposition to the actions of other groups that impede such research, such as some actions from animal rights groups, and its opposition to legislation that unduly restricts such research.{{Citation needed|date=August 2009}}
* The AMA's [[Office of Alcohol and Other Drug Abuse]] promotes [[temperance]] and lobbies for a reduction of alcoholic beverage advertising and an increase in alcoholic beverage taxes, amongst other activities.
* The AMA's [[Office of Alcohol and Other Drug Abuse]] promotes [[temperance]] and lobbies for a reduction of alcoholic beverage advertising and an increase in alcoholic beverage taxes, amongst other activities.{{Citation needed|date=August 2009}}


==Criticisms==
==Criticisms==

Revision as of 09:43, 15 August 2009

American Medical Association
Formation1847
Typeprofessional association
HeadquartersChicago, Illinois
Location
Membership
245 000
Official language
English
President
Nancy H. Nielsen, M.D.
Key people
President-elect J.James Rohack, M.D., Chair Joseph M. Heyman, M.D.

The American Medical Association (AMA), founded in 1847 and incorporated 1897,[1] is the largest association of physicians and medical students in the United States, representing around 20% of practicing physicians[citation needed]. The AMA's stated mission is to promote the art and science of medicine for the betterment of the public health, to advance the interests of physicians and their patients, to promote public health, to lobby for legislation favorable to physicians and patients, and to raise money for medical education. The Association also publishes the Journal of the American Medical Association (JAMA), which has the largest circulation of any weekly medical journal in the world.[2] The AMA also publishes a list of Physician Specialty Codes which are a standard method in the U.S. for identifying physician and practice specialties. Ronald M. Davis MD finished his term as President on June 17, 2008 at which time Nancy H Nielsen MD, PhD was sworn in as the Association's 163rd President. [3]

History

File:2007 05010030.JPG
The American Medical Association headquarters building in Chicago. Architect: Kenzo Tange
  • 1844: A doctor named Nathan Smith Davis serves in the New York Medical Society. He works to better medical schools and licensing.
  • 1845: Davis introduces a resolution endorsing the establishment of a national medical association to "elevate the standard of medical education in the United States."[citation needed]
  • 1847: Nathan Smith Davis founds the AMA at Academy of Natural Sciences. The Committee on Medical Education, Code of Medical Ethics, and first minimal standards for medical education are created. [1]
  • 1849: AMA studies quack remedies and tells the public about the dangerous effects of such treatments.[citation needed]
  • 1858: AMA starts a Committee on Ethics.[citation needed]
  • 1868: AMA Committee on Ethics allows qualified female doctors.[citation needed]
  • 1869: Archives of Ophthalmology and Otology is created.[citation needed]
  • 1870: AMA advises Congress to adopt quarantine rules.[citation needed]
  • 1873: AMA Judicial Council created.[citation needed]
  • 1876: Sarah Stephenson is the first female member. AMA promotes sanitary city water and sewers.[citation needed]
  • 1882: Journal of Cutaneous Diseases (later Archives of Dermatology)
  • 1883: Journal of the American Medical Association (JAMA) is created.
  • 1884: AMA condones experiments on animals.[citation needed]
  • 1897: AMA becomes incorporated.[citation needed]
  • 1898: AMA Committee on Scientific Research gives grants for medical research.[citation needed]
  • 1899: AMA Committee on National Legislation is created, the AMA's special interest group. Council on Exhibits educates the public on health. AMA studies tuberculosis, and how to control it, educates the public, and advises the building of government sanitariums. AMA tells local boards of health to pass mandatory smallpox vaccination. [2]
  • 1900 to 1939: AMA creates the House of Delegates, inspects 160 medical schools, sets standards for internship, adopts standards for specialty training, and encourages the recognition of specialty boards.[citation needed]
  • 1940 to 1960: The AMA accredits programs for the MD degree and opens an office in Washington DC. The AMA forms the Joint Commission on Accreditation of Hospitals, the American College of Surgeons, American College of Physicians, American Hospital Association and the Canadian Medical Association, Medical Association News, and the AMA Educational Foundation for financial aid to med students.[citation needed]
  • 1961 to 1979: The AMA discourages smoking and allows students and residents to be members. The AMA publishes Current Procedural Terminology (CPT) and Guide to the Evaluation of Permanent Impairment. The AMA forms the American Medical Political Action Committee (AMPAC) a special interest group, the Resident Physicians Section, and the Medical Student Section.
  • 1980s: The AMA starts the AMA Consumer Publishing program, Organized Medical Staff Section (for hospital staff), resolution agaisnts AIDs patient discrimination, and National HIV Policy that urges doctors to help HIV patients. [3]
  • 1990s: The AMA moves to Chicago and starts the AMA website. AMA discourages family violence, euphanasia, gag clauses, rushed maternity stay, smoking ads aimed at kids, and gifts to doctors from the pharmaceutical businesses. The AMA starts Health Access America(greater health insurance coverage), Patient Protection Act II bill, Institute for Ethics, National Patient Safety Foundation, antitrust relief, training for quality end-of-life care (through EPEC), organ donation awareness program, Physicians for Responsible Negotiations (PRN), The Cultural Competence Compendium, AMA Alliance, and health insurance reform. AMA lobbies for the proposed Patients Bill of Rights.[citation needed]
  • 2000s: The AMA starts a health literacy campaign, National House Call campaign, Reducing Underage Drinking Through Coalitions (RUDC), Disaster Preparedness and Medical Response Web site, Restored Earnings to Lift Individuals and Empower Families Act of 2001 (financial aid to med students and residents), Covering the Uninsured initiative, "No Butts About It…Tobacco Stinks" project, AMA HIPAALink, National Advocacy Conference in Washington, D.C., AMA National Summit on Obesity, AMA Member Connect, Patient Safety and Quality Improvement Act, Commission to End Health Care Disparities, Tsunami Relief Project, and "Voice for the Uninsured" Campaign. The AMA sets limits on residency hours and consecutive hours on call. The AMA successfully lobbies against the 4.4% cut and then 5% cut in Medicare physician payments. [4]

Charitable activities

  • The AMA Foundation provides approximately $1,000,000 annually in tuition assistance to financially constrained students (who now have a median debt load of $150,000 after medical school and $220,000 after 4 yrs of negative amortization during residency)[4].
  • Funds awareness projects about health literacy.[citation needed]
  • Supports research funding for students and fellows around the U.S.[citation needed]
  • Provides grants to community projects designed to encourage healthy lifestyles (of diet and exercise, good sleep habits, etc.)[citation needed]
  • The Worldscopes program has a goal of providing over 100,000 stethoscopes to third world countries, donated by physicians and students.[citation needed]

Political positions

Throughout its history, the AMA has been actively involved in a variety of medical policy issues, from Medicare and HMOs to public health, and climate change.[citation needed]

  • For most of the twentieth century, the AMA opposed publicly-funded health care because of concerns physicians have had over the financial and quality implications of such plans and the worries that a prominent government role in coordinating medical financing would inappropriately interfere with the doctor-patient relationship. When Progressive Era advocates proposed compulsory health insurance in the second decade of the twentieth century, the AMA initially took a cooperative and moderately open position to the idea, but by 1918 the Association had moved to a strongly oppositional position regarding compulsory health insurance. Ronald Numbers' 1978 book, Almost Persuaded: American Physicians and Compulsory Health Insurance, 1912-1920, provides an account of the AMA's policy positions during this early period.[citation needed]
  • In the 1930s, the AMA attempted to prohibit its members from working for the primitive health maintenance organizations that sprung up during the Great Depression. The AMA's subsequent conviction for violating the Sherman Antitrust Act was affirmed by the U.S. Supreme Court. American Medical Ass'n. v. United States, 317 U.S. 519 (1943).[citation needed]
  • The AMA's vehement campaign against Medicare in the 1950s and 1960s included the Operation Coffee Cup supported by Ronald Reagan. Since the enactment of Medicare, the AMA stated that it "continues to oppose attempts to cut Medicare funding or shift increased costs to beneficiaries at the expense of the quality or accessibility of care" and "strongly supports subsidization of prescription drugs for Medicare patients based on means testing". The AMA also campaigns to raise Medicare payments to physicians, arguing that increases will protect seniors' access to health care. In the 1990s, it was part of the coalition that defeated the health care reform proposed by President Bill Clinton.[citation needed]
  • The AMA has given high priority to supporting changes in medical malpractice law to limit damage awards, which, it contends, makes it difficult for patients to find appropriate medical care. In many states, high risk specialists have moved to other states with such limits. For example, in 2004, not a single neurosurgeon remained in the entire southern half of Illinois. The main legislative emphasis in multiple states has been to effect caps on the amount that patients can receive for pain and suffering. These costs for pain and suffering are only those that exceed the actual costs of healthcare and lost income. Multiple states found that limiting pain and suffering costs has actually dramatically slowed increases in the cost of medical malpractice insurance. Texas, having recently enacted such reforms, reported that all major malpractice insurers in 2005 were able to offer either no increase or a decrease in premiums to physicians. At the same time however, states without caps also experienced similar results; this suggests the cyclical nature of insurance markets may have actually been responsible. Some economic studies have found that caps have historically had a dubious effect on premium rates.[5] Nevertheless, the AMA believes the caps may alleviate what is often perceived as an excessively litigious environment for many doctors.
  • Another top priority of the AMA is to lobby for change to the federal tax codes to allow the current health insurance system (based on employment) to be purchased by individuals. Such changes could possibly allow millions of currently uninsured Americans to be able to afford insurance through a series of refundable tax credits based on income (for example, the lower your income, the greater your credit).[citation needed]
  • The AMA has made efforts to respond to health care disparities.
    • As such the AMA created an Advisory committees to assess the nature of disparities within different racial and ethnic groups[6]. One such committee focuses on the health of the Gay, Lesbian Bisexual and Transgender community. In 2005, the AMA president Edward Hill, MD gave a keynote address to the Gay and Lesbian Medical Association at its annual conference.[7] Since that time, the AMA has worked closely with GLMA to develop AMA policy towards better health care access for LGBT patients and better working environments for LGBT physicians and medical students[8].
    • The AMA responded to the government estimate that more than 35 million Americans live in underserved areas by stating it would take 16,000 doctors to immediately fill that need, and the gap is expected to widen due to rising population and aging work force. "And that will mostly be felt in rural America," said Sen. Kent Conrad, D-N.D., adding, "We're facing a real crisis." Fueling the shortage crisis are the restrictions on allowing foreign physicians to work in the U.S. post the September 11, 2001 attack, and may become more restrictive after the attempted terrorist bombings June 2007 in Britain, still under investigation, linked to foreign[5][6]doctors.[9][10]
  • In June 2007, at its annual meeting, the AMA, discussed its opposition to a fast-spreading nationwide trend for medical clinics to open up in supermarkets and drugstores. The AMA identified at least two problems with in-store clinics: potential conflict of interest, and potential jeopardized quality of care. The AMA went on to rally state and federal agencies to investigate the relationship between the operating clinics and the pharmacy chains to decide if this practice should be prohibited or regulated. Dr. Peter Carmel, neurosurgeon and AMA board member asked, "If you own both sides of the operation, shouldn't people look at that?" The AMA also noted some employers reduce or waive the copayment if an employee goes to the retail clinic instead of the doctor's office, inferring that this practice might negatively affect quality of care.[11]
  • In 2008, the AMA issued a policy statement on global climate change declaring that they "support the findings of the latest Intergovernmental Panel on Climate Change report, which states that the Earth is undergoing adverse global climate change and that these changes will negatively affect public health." They also "support educating the medical community on the potential adverse public health effects of global climate change, including topics such as population displacement, flooding, infectious and vector-borne diseases, and healthy water supplies."[12]
  • In July 2008 the AMA focused its energy on blocking cuts to Medicare. Through advocacy efforts and communications campaigns, the AMA and all the specialty societies and state medical societies it comprises came out with a temporary victory. Despite a presidential veto, H.R. 6331, the “Medicare Improvements for Patients and Providers Act of 2008,” passed with wide, bi-partisan majorities in both the U.S. House of Representatives and the U.S. Senate.[citation needed]
  • The AMA has affirmed, through continual policy statement (policies H-460.957,H-460.974,H-460.964,and H-460.991 for example), its support for appropriate and compassionate use of animals in biomedical research programs, and its opposition to the actions of other groups that impede such research, such as some actions from animal rights groups, and its opposition to legislation that unduly restricts such research.[citation needed]
  • The AMA's Office of Alcohol and Other Drug Abuse promotes temperance and lobbies for a reduction of alcoholic beverage advertising and an increase in alcoholic beverage taxes, amongst other activities.[citation needed]

Criticisms

Critics of the American Medical Association, including economist Milton Friedman, have asserted that the organization acts as a guild and has attempted to increase physicians' wages and fees limit by influencing limitations on the supply of physicians and non-physician competition. In Free to Choose, Friedman said "The AMA has engaged in extensive litigation charging chiropractors and osteopaths with the unlicensed practice of medicine, in an attempt to restrict them to as narrow an area as possible."

Profession and monopoly, a book published in 1975 is critical of the AMA for limiting the supply of physicians and inflating the cost of medical care in the United States. The book claims that physician supply is kept low by the AMA to ensure high pay for practicing physicians. It states that in the United States the number, curriculum, and size of medical schools are restricted by state licensing boards controlled by representatives of state medical societies associated with the AMA. The book is also critical of the ethical rules adopted by the AMA which restrict advertisement and other types of competition between professionals. It points out that advertising and bargaining can result in expulsion from the AMA and legal revocation of licenses. The book also states that before 1912 the AMA included uniform fees for specific medical procedures in its official code of ethics. The AMA's influence on hospital regulation was also criticized in the book.[13]

Membership

Physician membership in the group has decreased to lower than 19% of practicing physicians. In 2004, the AMA reported membership totals of 244,569, which included retired and practicing physicians along with medical students, residents, and fellows. The medical school section (MSS) reported totals of 48,868 members, while the resident and fellow section (RFS) reported 24,069 members. Combined they account for almost 30% of AMA members. [7] If every other member of the AMA was a fully qualified practicing physician then the AMA would represent 19% of America's practicing physicians (There are currently approximately 900,000 practicing physicians in America). However, MedPage Today estimates that the AMA only represents 135,300 "real, practicing physicians" as of 2005 (15.0% of the United States practicing physicians). [8] When asked about this, Jeremy Lazarus, MD, a speaker in the AMA House of Delegates, stated that membership was stable, avoiding commenting on the low overall numbers (2005 AMSA annual meeting, AMA vs. PNHP healthcare debate, Arlington, Virginia). This has been seen as a major reason why physicians, on the whole, are less successful in lobbying for their positions than other professional and paraprofessional societies.

See also

References

  1. ^ "AMA (AMA History) 1847 to 1899". Retrieved 2009-02-16.
  2. ^ About JAMA: JAMA website
  3. ^ AMA (Comm) Ronald M. Davis, MD, named AMA president-elect
  4. ^ http://www.aamc.org/programs/first/timeline.pdf
  5. ^ Weiss Ratings News: Medical Malpractice Caps Fail to Prevent Premium Increases, According to Weiss Ratings Study
  6. ^ AMA (Public Health) Eliminating health disparities
  7. ^ AMA (GLBT) News release from the Gay and Lesbian Medical Association
  8. ^ AMA (GLBT) AMA policy regarding sexual orientation
  9. ^ http://www.boston.com/yourlife/health/diseases/articles/2007/07/22/shortage_of_doctors_affects_rural_us/ Shortage of doctors affects rural U.S., retrieved 2007-07-22
  10. ^ http://www.philly.com/philly/health_and_science/20070722_Why_foreign_doctors_are_in_shorter_supply.html Short supply of foreign doctors, retrieved 2007-07-22
  11. ^ http://health.usnews.com/usnews/health/articles/070720/20clinics.htm In-store clinics, retrieved 2007-07-22
  12. ^ AMA policy statement on climate change
  13. ^ Berlant, Jeffrey (1975). Profession and Monopoly: a study of medicine in the United States and Great Britain. University of California Press. ISBN 0520027345. {{cite book}}: Cite has empty unknown parameter: |coauthors= (help)

Further reading

  • Burrow, James G. AMA: Voice of American Medicine. Baltimore: Johns Hopkins Press, 1963.
  • Campion, Frank. The AMA and U.S. Health Policy Since 1940. Chicago: Chicago Review Press, 1984.
  • Fishbein, Morris. History of the American Medical Association, 1847-1947. Philadelphia: W.B. Saunders, 1947.
  • Numbers, Ronald. Almost Persuaded: American Physicians and Compulsory Health Insurance, 1912-1920. Baltimore: Johns Hopkins University Press, 1978.
  • Poen, Monte. Harry S. Truman versus the Medical Lobby: The Genesis of Medicare. Columbia, MO: The University of Missouri Press, 1979.
  • Starr, Paul. The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry. New York: Basic Books, 1982.

External links