The American Medical Association's ballyhooed "unity" project is on life- support, struggling against a growing tide of indifference by many doctors' specialty societies.
Despite a budget for the project that will approach $500,000 this year, the AMA has not received expected financial backing or strong philosophical support for a plan to create a unified federation that would immediately boost the membership and annual dues of the Chicago-based doctors' association.
Under the proposal, the 154-year-old AMA, which has struggled with dwindling membership in recent years, would be designated the "core organization" for a new medical federation. In that role, it would receive a portion of the annual dues paid by members of all of the nation's specialty societies.
The consolidation was expected to strengthen the 290,000-member AMA, the nation's largest and most influential medical group, and reduce much of the duplication that exists among the dozens of specialty societies promoting limited agendas and interests.
Despite budget problems and a distinct lack of interest among many doctors, the unity idea still is expected to come to a vote in December when the AMA hosts its House of Delegates meeting in San Francisco.
"There will be a plan and a recommendation for the house to vote on," declared D. Ted Lewers, the outgoing chairman of the AMA's board of trustees who spearheaded a committee formed to pursue the unity plan.
A report released about a week ago during the AMA's annual meeting in Chicago painted a grim picture of the prospects for the plan, which has generated considerable opposition from some specialty groups that don't want to relinquish power-or membership money.
The AMA's board of trustees, according to the report, "is concerned about the continued lack of `buy-in' by (other doctors' groups) for the unity project, both financially as well as philosophically."
A plea for financial support has generated contributions of about $80,000 from specialty groups and state societies, far less than AMA leadership anticipated.
"It is the AMA board's opinion that a lack of sufficient financial support from the federation to support the work process indicates a similar lack of support for the eventual product of that work," according to the report.
It also noted that the plan itself has not "been discussed in any detail" by many leaders of specialty groups, which have "not taken sufficient time to review the recommendations" of the plan.
"The market research done early in the work (on the unity project) clearly indicates that physicians believe that there is too much wasteful duplication of effort across organized medicine and too little coordination, especially on critical public policy issues, and they want organized medicine to `get its act together.' "
The AMA has contributed about $100,000 in funding and about $195,000 worth of in-kind services, including salaries and benefits paid to AMA staffers involved in the project. A revised budget for the 2001 calendar year calls for about $134,000 in expenses to pay for travel costs related to the proposal.
State medical societies have contributed about $35,000 to the project, with specialty societies kicking in $34,000 and county societies adding another $9,250. Top AMA officials reportedly had expected to raise as much as $150,000 in contributions from medical specialty societies alone.