Faced with dwindling membership and conflicting views about its mission, the American Medical Association (AMA) is considering eliminating its individual membership base and transforming itself into an umbrella organization of state and specialty societies. The move would mean that it would collect funds from all groups under the umbrella, not from individual members.
The suggestion comes as AMA membership continues to plunge. Supporters of restructuring note that the AMA lost more than 12 000 members last year, and with only 278 000 members it now represents less than 30% of American physicians. A special committee examining the restructuring proposal is to report back in June 2003.
The impetus for the unprecedented suggestion for action originated in a report from a “Special Advisory Group Extraordinaire” (SAGE), which was created by the AMA Board of Trustees, at least in part, to seek unity within the medical profession.
If the group's recommendations are followed, physicians would belong to the AMA through “entry portals” such as country, state or specialist societies. The AMA would then leave its direct membership functions behind and derive revenue from the affiliated groups through a “tithing system.” This would mean that the AMA represents many more physicians, even if it does so indirectly.
Dr. A. Tomas Garcia, a Houston cardiologist and member of the SAGE, told CMAJ that the advisory committee had given the AMA “a template” for acting as an advocate for all physicians. “I was trying to represent that there are another 600 000 physicians whose voices are not being heard. And as a lifetime member of the AMA, I have to ask why the other guys aren't joining.”
CMA CEO Bill Tholl says “medical organizations around the world are having to reinvent themselves in an Internet world. It's a straight value proposition. We must provide value for money and we have to refresh our value on an ongoing basis or doctors simply won't send in their cheques.”
The CMA has been more successful attracting members than its American counterpart. Tholl said it currently represents 75% to 80% of practising Canadian physicians, with membership growing by 1000 members a year. It now stands at 54 000 members, roughly 10 000 more than in the mid-1990s.
The situation is about the same in the UK, where the British Medical Association, with 125 000 members, represents 80% of the country's doctors. Membership in the BMA is still growing, but at a slower pace than in the late 1990s. — Milan Korcok, Florida