American Medical Association

The American Medical Association (AMA) is the largest association of medical doctors in the United States. Its purpose is to advance the interests of physicians, to promote public health, to lobby for medical legislation, and to raise money for medical education. The AMA also publishes the Journal of the American Medical Association (JAMA) and runs the Stop America's Violence Everywhere, or SAVE, program.

The AMA Physician Specialty Codes are a standard in the United States for identifying physician and practice specialties.

History

 * 1847, Dr. Nathan Smith Davis and others established the AMA at the University of Pennsylvania. He wanted to "elevate the standard of medical education in the United States." It was considered "impractical, if not utopian" by some. The goals of the AMA were scientific advancement, standards for medical education, launching a program of medical ethics, and improved public health. 250 delegates from 28 states attended the founding meeting at the Academy of Natural Sciences of Philadelphia, Pennsylvania. Dr. Nathaniel Chapman was the first president of the AMA.
 * 1848, the AMA notes the dangers of secretive remedies and patent medicine.
 * 1858, the AMA established the Committee on Ethics.
 * 1864-1865, Dr. Davis was president of the AMA during the American Civil War.
 * 1873, AMA Judicial Council is founded.
 * 1884, the AMA supports experimentation on animals.
 * 1897, the AMA is incorporated.
 * 1898, AMA creates the Committee on Scientific Research to provide grants for medical research.
 * 1899, AMA creates Committee on National Legislation to represent AMA's interests in US Government.
 * 1902, AMA gets its first permanent headquarters in Chicago.
 * 1904, AMA establishes the Council on Medical Education to accelerate campaign to raise educational requirements for physicians.
 * 1905, AMA creates the Council on Pharmacy and Chemistry to set standards for drug manufacturing and advertising. The Council also fights against quack patent medicines.
 * 1912, The Federation of State Medical Boards is created. It accepts the AMA's rating of medical schools as authoritative.
 * 1927, AMA Council on Medical Education and Hospitals publishes first list of hospitals approved for residency training.
 * 1935, Social Security Act is approved.
 * 1937, the 1937 Marijuana Tax Act is passed, which the AMA opposed.
 * 1943, AMA opens an office in Washington DC.
 * 1950, AMA started a medical student section, called the Student American Medical Association (SAMA), initially as a pipeline into organized medicine. SAMA eventually broke away from the AMA in the 1960s to become the indepedent, student-run, AMSA, the American Medical Student Association.
 * 1952, House of Delegates adopted a council report condemning fee splitting in health care.
 * 1960, AMA states that a blood alcohol level of 0.1% should be accepted as evidence of alcohol intoxication.
 * 1970, AMA encourages the Federal Aviation Administration to require all airlines to separate nonsmokers from smokers.
 * 1974, AMA gives recommendations to insure adequate protection of individuals used in human medical experimentation.
 * 1976, AMA Section on Medical Schools is created.
 * 1982, AMA urges each state medical society to support laws to raise the legal drinking age to 21.
 * 1987, in Wilk v. American Medical Association, U.S. District Court Judge Susan Getzendanner found that the AMA violated § 1 of the Sherman Act, 15 U.S.C. § 1, by conducting an illegal boycott in restraint of trade directed at chiropractors (895 F.2d 352)
 * 1988, AMA creates the Office of HIV/AIDS.
 * 1995, AMA starts campaign for liability reform.
 * 1999, AMA creates Physicians for Responsible Negotiations (PRN, a labor organization to represent doctors, allowing them to advocate on behalf of their patients.
 * 2000, AMA supports Patients' Bill of Rights legislation in Congress.
 * 2001, Shortly after Sept. 11th disaster, the AMA provided the government with a list of 3,500 volunteer doctors who were ready to help. The AMA educated U.S. patients and doctors about bioterrorism and disaster preparedness through public service announcements and by posting updated information on its Web site.

Charitable activities
The AMA Foundation provides approximately $1,000,000 annually in tuition assistance to financially constrained students (who now graduate medical school with an average debt load of well over $100,000 each). It funds awareness projects about health literacy. It supports research funding for students and fellows around the US. It provides grants to community projects designed to encourage healthy lifestyles (of diet and exercise, good sleep habits, etc.) The Worldscopes program has a goal of providing over 100,000 stethoscopes to third world countries, donated from physicians and students.

Political positions
For much of the twentieth century, the AMA opposed publicly-funded health care. When the 1937 Marijuana Tax Act was passed in the U.S., the AMA protested the law soon after, both on the grounds of actual disagreement with the law and the supporters' lies on the subject. Harry J. Anslinger (Bureau of Narcotics Commissioner) and others had claimed the AMA had vocalized support when, in fact, the opposite was true.

In the 1930s, it attempted to prohibit its members from working for the primitive health maintenance organizations that had 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,.

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 has 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.

The AMA has given high priority to supporting changes in medical malpractice law to limit damage awards, which, it contends, contribute inability of 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 have found that limiting these costs have actually dramatically slowed increases in the costs of medical malpractice insurance. Texas, having recently enacted such reforms has 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. Nevertheless, 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 (ie: the lower your income, the greater your credit).

Criticisms
Critics of the American Medical Association, including economist Milton Friedman, have asserted that the organization acts as a government-sanctioned guild and has attempted to increase physicians' wages and fees limit by influencing limitations on the supply of physicians and non-physician competition. They assert that these actions have not only inflated the cost of healthcare in the United States, but have also have caused a decline in the quality of healthcare.

Criticism of the AMA

 * Medical Control, Medical Corruption