Questions of organizational propriety--or impropriety--prompted another round of closed-door sessions at the interim AMA House of Delegates meeting held last month in San Francisco.
Following more than eight hours of closed-door debate, the AMA's 549-member ruling body adopted several recommendations aimed at ending a pattern of debacles that have tarnished the group's image amid declining membership and revenue.
House speaker John Knote, M.D., will appoint a five-member oversight committee to examine the relationships among the AMA's executive vice president, its general counsel and the board of trustees.
The panel also will critique previous internal governance reviews to determine whether they were enacted properly. The committee is to report any findings to the house at its annual meeting in June.
The internal overhaul was prompted by controversy over the handling of the Sunbeam contract in 1997 and a $5 million lawsuit filed against the AMA last summer by its former executive vice president, E. Ratcliffe Anderson Jr., M.D.
Anderson accused the AMA and certain board members of breach of contract and defamation of character. He claims he was not allowed to fire the AMA's top attorney over a real estate sale that may have caused the association to lose more than $13 million. Anderson was fired soon after.
Anderson's suit was filed during the annual delegates meeting last summer in Chicago, inspiring what officials at the time said was the first closed-door general session delegates' meeting in AMA history.
The house in December voted to give the executive vice president responsibility for hiring or firing executive counsel following consultation with the board of trustees. Current policy gives the board this power following consultation with the executive vice president, the association's chief executive.
In addition, the delegates approved mandatory inclusion of binding arbitration clauses in senior management employment contracts, such as the one recently signed by new chief Michael Maves, M.D. They called for greater transparency of board actions, too, including clarification of criteria for executive, closed and limited sessions, "with the goal to utilize such procedures as infrequently as possible."
Specific details related to Anderson and the lawsuit will remain secret, says President Richard Corlin, M.D.
"In no way did the house consider action be taken to validate Anderson's lawsuit," Corlin says. "The board of trustees believes the suit is totally without merit. If the tactic is to delay, we'll stay the course."
About $600,000 was spent on the Anderson lawsuit task force. Meanwhile, the AMA is looking at a 2001 operating loss of $2.9 million, including $2.3 million attributed by officials to advertising losses and startup costs for an Internet-based joint venture with Axciom.
Membership dues revenue was down $3.5 million for 2001, to about $54.2 million.
The group has about 291,000 members, representing some 30% of the nation's physicians. The AMA is budgeting an operating profit of $100,000 for 2002.
The delegates also adopted a board plan to develop best practice guidelines for use of physician data that the AMA makes available to national databases. Many doctors chafe at the use of such data by drug company sales representatives to build prescribing profiles.