The AMA, many say, needs to stem its membership decline-not in order to get fat and prosperous but, on the contrary, to add the muscle it needs to fight the good fight for doctors' interests in the rough and tumble arena of Washington politics.
That's why loyalists like Lexington, KY, internist Greg Hood-whose opinion piece on the AMA appears in this issue (see "The way I see it: The AMA should learn from AARP")-feel so strongly about the strength-in-numbers issue. Hood's membership-building advice-keep fees low, like a certain acronymic senior citizen organization has.
That's probably good advice, which senior AMA officials should take seriously. There's every indication that the AMA is taking to heart other things that doctors say are crucial-things like publicly championing the profession, as it's doing in a new media campaign.
One of his strategies is to reach out to doctors indirectly, through their patients. In a series of consumer ads that began running last summer, the AMA pays homage to the profession's "everyday heroes"-doctors across a variety of specialties who've touched peoples' lives in ways both large and small. Both the print and broadcast versions are powerful, tug-at-your-heart messages calculated to enhance public goodwill.
That should be the easy part of his job. In November, a Gallup Poll asked adults nationwide to rate the honesty and ethical standards of people in different fields. Business executives and congressmen did only slightly better than car salesmen and telemarketers-two groups the public loves to hate. But doctors did better than all other groups except nurses and pharmacists. Medicine as a career also scores high in surveys. In another Gallup Poll released last year, people offering career advice to young men and women recommended medicine more often than any other field, despite its well-publicized problems.
Besides goodwill, Epstein has two other goals in mind for the ad campaign, neither a slam-dunk.
The first is to add to the AMA's credit bank. "We hope doctors will credit the AMA for doing one of the key things they tell us we should be doing-celebrating the profession, being its champion," he says.
The second goal is equally daunting-to build a base of patients who are committed to advocating alongside doctors on crucial issues like medical liability reform; the uninsured; and, most recently, a Medicare payment fix. In the run-up to the payment debate this fall, Epstein says, "we signed up almost 600,000 patients to our "Patients Action Network," an AMA-sponsored site that encourages consumers to fight for their own healthcare rights by aligning themselves with physicians ( http://www.patientsactionnetwork.org). But more needs to be done, Epstein acknowledges, to motivate people to step up and take action.
Of course, Epstein is also reaching out to doctors directly, whether through snail mail or the Internet. The message-in the ever-splintering house of medicine, the AMA is the one unifying force.
Ultimately, the acid test for Epstein and the AMA will be how many new and former members sign on. Membership in 2004-the latest year available-was 244,530. (Total US physicians that year, both MDs and DOs, were 939,657.) While he won't cite hard numbers, he promises "very positive membership news for 2005."
That would be one sure sign that the brand-building campaign is working.