COMMENTARY

Is It Time to Modernize Medical Organizations?

Arthur L. Caplan, PhD

Disclosures

September 11, 2017

Hi. I'm Art Caplan from the Division of Medical Ethics at the NYU Langone Medical Center. Do medical organizations have any relevance in the 21st century?

The American Medical Association (AMA) recently, for the first time, elected a president who's a small-town rural family doc. That's a step forward in terms of diversifying its membership. There have also been efforts by the AMA to say, "If you come to our convention, you had better behave yourself." This means that tougher standards about sexual harassment are being reflected in that organization. There's a sensitivity to the fact that there are many more women in healthcare and many more women in medicine.

Other organizations have been speaking out about things like the efforts to repeal and replace Obamacare. Is that model of an organization—that lobbies, and you go to a meeting—really a way to achieve the best influence or what doctors really want in the 21st century? I don't think so. I think the idea of going to meetings is slowly becoming passé. After all, there's nothing that happens in terms of talks and lectures that you couldn't put on the Internet as a webcast or some type of social media interaction. The cost and hassle of travel are getting serious; [people are asking themselves], am I really going to go to the annual convention?

Some people even have a little bit of heartburn about organizations that are just seen as lobbying arms, whether it's for looking at doctor's salaries, fending off competition from nonphysicians, or taking political points of view. I think those functions are fine. I don't have any difficulty with medical groups speaking up in the political arena. I think the American people expect that, but more has to happen. We're living in a social media age. Again and again, I talk to doctors who say that they want connectivity. They want to be able to interact with peers in their specialty or across the board in medicine, or maybe internationally to talk about day-to-day practice issues, questions—even ethics questions.

I think the professional societies in medicine really have to pay attention to that desire to not bowl alone, to really be in a situation where sociability and having a sense of community is met by the organization. It used to be in person, shaking hands, going to dinner. Those days are being replaced by electronic interaction.

Another thing I hear doctors saying is that they want somebody to speak up for them to make sure that, as technology comes into medicine—think the electronic medical record (EMR) here—that it really is user-friendly and that the EMR is not just pushed in by insurance companies who want to bill them a certain way, or by health system administrators. Doctors feel that a lot of their time is being yanked away to do administrative tasks, to feed electronic machines. They don't have enough time with patients, and they have other gripes as well.

The professional groups really have to get into this and start talking to the leaders of healthcare organizations, as well as to the companies that make the software and the hardware. I think people are going to expect that if they're going to belong to an AMA, an ACP (American College of Physicians), or any other medical society or organization, then it's going to have to do more than say, "Meet us at the convention center. You'll hear some good talks, you'll see some of your friends who made it here, and we'll all go out for a meal." I think those days are gone. I think it's time to modernize how professional societies act and the values that they serve in 21st-century America.

I'm Art Caplan from the Division of Medical Ethics at NYU. Thank you very much for watching.

Talking Points

Issues to Consider: Is It Time to Modernize Medical Organizations?

  • In the early 1950s, about 75% of US physicians were AMA members.[1]

  • As of 2013, the most recent year for which member data are available, the number of members at the AMA had increased to 228,000, with medical students and residents helping to drive the spike.[2]

  • In 2016, 78.5% of physicians were members of specialty societies.[3]

  • Elections, speeches, and leadership positions at house meetings are among the activities that association members feel least engaged in, according to a member engagement report by Abila, an association management company.[4]

  • A recent informal survey of several state medical associations by the Medical Association of Georgia found that only 15% of county societies in Illinois were holding regular meetings, 10% were functioning in Ohio, and only four of 28 in Minnesota were staffed.[5]

  • State societies that have eliminated their House of Delegates in the past 15 years include Maine, Oregon, Delaware, Iowa, Colorado, New Mexico, and Connecticut, according to several reports.[6,7,8,9]

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