The American Medical Association will add a layperson to its 20-member board of trustees to help the nation's largest physician organization take the pulse of public opinion and avoid another Sunbeam Corp. fiasco.
But that single board member, who won't be approved for about two years, will be a solitary voice with a limited tenure, restricted to no more than six years of service. By comparison, doctors on the board are eligible to serve consecutive four-year terms.
AMA officials acknowledge that the plan to add a public voice to the association's board was triggered by the AMA's decision three years ago to endorse Sunbeam products, which quickly evolved into a public-relations disaster.
"Let's put it this way," said Edward Hill, M.D., a board member who is a family physician in Tupelo, Miss. "The Sunbeam issue was just the stimulus for significant changes that needed to have taken place at the American Medical Association anyway--and probably should have taken place before. That issue brought everything to a head," Hill said.
The AMA came under a blistering attack when it voted in 1997 to offer its endorsement of Sunbeam's home-health products in exchange for royalties. It canceled the deal but was forced to pay Sunbeam nearly $10 million in a breach-of-contract settlement.
Similar ethical concerns were raised after the AMA announced plans this fall to form a joint venture with Little Rock, Ark.-based Acxiom to market its database of 650,000 physicians through a new company called HealthCarePro Connect. The arrangement has generated concerns even though the AMA has made its membership list available for marketing purposes for about five decades.
"The business side of the AMA operates like a house of prostitution--whether it's Sunbeam or real-estate deals or this," said Sidney Wolfe, M.D., director of Public Citizen's Washington-based Health Research Group. "This is not a good move. In their zeal to make money, they tend to drop some principles."
The nonphysician board member probably will not be named for about two years, Hill said, because the house of delegates must first approve changes to the AMA's constitution and bylaws, a process that requires two readings.
The first step will occur at the AMA's interim meeting next month in Orlando, Fla. A second reading will take place at the June 2001 annual meeting in Chicago, followed by the appointment of a seven-member selection committee to nominate a public member at the 2002 annual meeting, the earliest point at which the new member can be installed.
The public member will be appointed to the board for a two-year term, with a limit of three terms. Physician members are eligible for two four-year terms.
Public Citizen's Wolfe said the addition of a single nondoctor to the board probably wouldn't have helped avoid the Sunbeam fiasco.
"I've always felt it was a good idea to have well-informed citizens being able to take on a medical group," said Wolfe. "But the AMA screwed up, and it was not the absence of a consumer that caused it."
The new member will be a meaningless token, Wolfe said, unless the AMA selects someone who is "willing to take on the doctors."
When the recommendation to add a public member was made at an AMA meeting last December in San Diego, a report from a council on long-range planning said the change would "create a litmus test for how the external world may perceive the AMA's actions."
Hill said the issue generated considerable controversy in the AMA. Opponents argued about the potential dangers of appointing a layperson who doesn't understand the principles and ethics of the medical profession, or who might unknowingly release proprietary or sensitive information.
Hill and others disagreed, maintaining that a public member--the 21st seat on the board--would help boost the AMA's credibility with the public.