Although the AMA's membership problems have been well publicized, I'm not one of the many physicians who have opted out. As a practicing internist, I've been a member for 15 years.
One reason I've kept my AMA membership is because I believe the debate on how to fund and fix the US healthcare delivery system requires national representation of physicians. Whether we like it or not, we're an "interest group," and as such we must be represented by organizations and lobbyists. The intensity of our voice depends on the validity of our representatives' arguments and the group's strength in numbers.
Physicians perform poorly in the latter regard. Membership rates are low. Indeed, AMA membership has dropped for four consecutive years: from 290,357 in 2000, to about 245,000 in 2004 (2005 figures weren't available at press time). Only about one in four of the 1 million doctors and medical students nationwide belong to the AMA. It once had four-fifths of US doctors signed up.
Many AARP members belong without knowing the organization's political positions, or even in spite of them. Why? Because they believe AARP will look out for their best interests-and because it's cheap. How many would join AARP if they had to pay $1,000 a year for the privilege?
Many physicians simply don't see why they have to pay a three- or four-figure sum to sign up with the AMA. In a way, they're right: The AMA's work proceeds, albeit less effectively, even though most physicians aren't members. Thanks to technology, the opportunity now exists to eliminate this financial obstacle and bring the AMA to near total physician representation. The AMA already maintains demographic information on every physician in the country. It also has member services, available 24/7 at http://www.ama-assn.org that can be made available to an unlimited increase in membership without any appreciable increase in cost to the AMA. These include discount programs and AMA eVoice, a weekly customizable news summary that reaches physicians and medical students via the Internet.
I believe that the sacrifices that each of us has made in medical school, residency, and practice have earned us a seat in the house of medicine. I therefore propose that every physician be offered "general" AMA membership at a nominal cost of $25. If all 940,000 MDs and DOs join at this rate, that's more than $23 million in the AMA's coffers. Medical students, who currently pay $20 for a single-year membership, should be able to join for half that-or for free. A healthy membership roster will serve to raise the importance of the AMA in our collective consciousness and expand the influence of AMPAC, the AMA's political action committee. Physicians who want additional AMA services-periodicals, and enhanced web features, say-would pay additional dues.
In attracting more members, the AMA can substantially increase its role in defining and controlling the national healthcare debate.