The normally staid American Medical Association took a radical step toward change yesterday with a vote that ultimately could convert the 155-year-old membership organization into an umbrella group with few members of its own.
The AMA House of Delegates, gathered in Chicago for its annual policymaking meeting, overwhelmingly approved the creation of a committee to develop a business plan for the proposed overhaul. The plan would be considered at the AMA's annual meeting next June in Chicago.
As an umbrella group -- an organization of organizations -- the AMA would derive its membership and almost all of its dues revenue from the nation's more than 100 state medical organizations and specialty societies. The member organizations would tithe a yet-to-be-determined portion of their dues revenue to the AMA.
Through affiliations, the AMA -- which now has a membership of 278,000, less than 30% of all practicing U.S. physicians -- would represent a far greater proportion of America's medical community, proponents of the plan said. As a result, it would be much more effective as a lobbying group, they said.
"We've been circling this issue for a decade," said Richard Roberts, M.D., chairman of the board of the American Academy of Family Physicians. "It looks to me like we're actually prepared to finally go forward. It's a little scary to a lot of us, but very exciting."
Implementing such far-reaching change is expected to take at least two years after approval of a business plan.
Authorization of the initial step forward came after nearly three hours of often-anguished debate by the 550-member House of Delegates.
There was considerable dissent over the AMA's future, with some delegates arguing that individual, direct membership is vital to the organization. What's more, some tricky aspects of the transition -- including cost, how much each society will contribute and what services the AMA will provide -- were not seriously discussed before the vote.
The new direction most likely would involve a reduction in AMA services and perhaps cutbacks in staff. As the core group for a "federation of medicine," the new AMA would avoid duplicating the services of specialty societies and would focus more of its efforts on advocacy, ethics and standards, officials said.
Jack Evjy, M.D., a delegate from Massachusetts, warned fellow members that changing the organization without considering the cost could be a "disaster." "If we're trying to treat a myocardial infarction, we should be careful not to be doing a craniotomy," Evjy said.