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March 01, 2013 12:00 AM

Blog: What's driving increases in physicians association membership?

Andis Robeznieks
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    Membership in many physician associations had been flat or declining in recent years, but now appears to be on the upswing. This could be the result of better times, better marketing or the fear generated by the regularly repeated threats of precipitous Medicare pay cuts.

    Membership dues are often the first things to be sacrificed when the economy stalls. Docs rejoining groups like the American Medical Association or state medical societies could be a sign that better financial times lie ahead. It could also be a sign of a growing interest among physicians to advocate for their profession. Or, according to a theory put forth by Princeton University economist Uwe Reinhardt, it may not be a positive development at all.

    According to a California Medical Association news release, there are between 60,000 and 70,000 physicians in the state of California, and 37,222 are CMA members—which represents a more than 4% increase from the year before. The growth is significant, according to the release, because membership had been “relatively flat” for nine years.

    “The increase in membership is due to outreach to medical groups and more targeted recruitment and retention activities,” the release said. (The release didn’t mention that CMA dues for medical student, resident and fellow members were eliminated last year and that the CMA asked county medical societies to do the same.)

    While California boasts the highest population in the nation and one of the largest economies in the world, it does not have the biggest state medical society. That honor belongs to Texas, and the Texas Medical Association is growing as well. As of Feb. 26, the TMA had 47,033 members. According to its 2011 annual report, it “crossed the 45,000-member threshold” in 2011, and its former president, Dr. Michael Speer, had set an ambitious-but-unreached goal of reaching 50,000 by the end of 2012.

    As of Feb. 28, the Texas Medical Board reports that there were 70,999 physicians with active Texas medical licenses, and 58,071 were practicing in the state. (There are also 6,430 physician-in-training permit holders covering residents and others in advanced training programs.)

    In its annual report released last May, the AMA, the nation’s oldest and largest physician group, stated that it grew around 1% from 215,854 in 2010 to about 217,000 in 2011. Though small, it was the AMA’s first membership increase since 2007.

    The American Medical Group Association is one organization that has been experiencing steady growth, and 2012 was no exception. The AMGA recently reported its membership increased 12% last year with the addition of 51 new member medical groups in which some 13,000 doctors practice.

    While these membership increases could be the result of multiple positive factors, according to Princeton’s Reinhardt, they may also be the result of physician fear. Specifically, it’s fear that stems from the annual ritual of the federal government threatening to slash Medicare pay for physicians as directed by the sustainable growth-rate Medicare reimbursement formula.

    “A huge hue and cry goes up and the media has a field day writing stories and scaring doctors,” Reinhardt told Modern Healthcare recently.

    “The AMA finds this very useful because professional organizations essentially sell paranoia,” he explained. “They say, 'You need me or you'll be in deep doo doo.' ”

    Then, instead of the “calamity” of a deep pay cut, doctors are given something in the neighborhood of a 0.8% pay increase, which associations then spin into a victory, Reinhardt said. “Everybody wins.”

    Paul Hegyi, CMA vice president of membership and communications, admitted that the SGR fight has boosted his organization’s ranks, but he said there’s more to it.

    “I won’t deny that, when there’s a major challenge, that helps spike membership and political activism as well,” Hegyi said. He also explained how the sky always appears to be falling with the SGR, so over the last 10 years physicians have become deadened to the repeating cycle of a threatened pay cut followed by a last-minute temporary fix. What is maintaining physicians’ interest, though, is ACA implementation.

    He said the CMA is also engaging members by actively polling them about their priorities and then tailoring advocacy efforts to address those concerns.

    And, it’s offering deals. Hegyi acknowledged that 1.5% of the CMA’s more than 4% growth came from free resident and fellow memberships. But the CMA has also set an ambitious goal to increase paid memberships by 5% in 2013, he said, adding that, “We’re halfway there, just 45 days into the year.”

    Follow Andis Robeznieks on Twitter: @MHARobeznieks.

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