You have to give the American Medical Association credit. Its House of Delegates meetings are models of parliamentary discipline yet also showcases of free-flowing debate.
The American Hospital Association, conducting its annual convention this week in San Francisco, would do well to adopt this kind of open forum, although not without ironing out some serious wrinkles in the AMA system.
Frankly, the AMA has been losing steam and credibility in recent years as the perception grows that it's living in the past. The association is having trouble attracting younger members, and its operating budget remains strained.
Part of the problem is a reflection on the AMA's policymaking body itself. The delegates are a less than demographically correct representation of the association's membership. Even less do they resemble the body of American physicians.
The median age of U.S. physicians, for example, is 45. The average AMA member is 46. The average age of delegates is 63. Among the U.S. physician population, 19.2% are female. AMA members are 14.5% female. AMA delegates are 6.7% female, according to a report using 1993 data.
Although the report doesn't show data for race, anyone with eyes can see how very few blacks or other minorities are represented in the 432-member House of Delegates.
This year the delegation from California proposed a remedy: term limits. They asked the House to consider a limit of four two-year terms for delegates and alternates, with a maximum of 16 years of service.
Alas, the term-limits proposal was voted down by delegates. Yet, the Californians are on to something. For the AMA to attract younger and more diverse physicians, it needs to cultivate a less patriarchal and gerontocratic image. Actually, progress already has been made in this regard: In 1983, the median age of delegates was 70, and only 1.8% of them were female.
Still, the House of Delegates meeting takes place on Golden Pond, cloaked in nostalgia for a time when doctors were doctors, not managed-care orderlies. At times, the same can be said for other groups that represent providers and executives.
In the rapidly evolving world of healthcare, the AMA, AHA and other provider trade associations need revitalized, forward-looking leaders. Those preoccupied with yearning for the days of yore should make room for some new blood.