Membership at Issue in “New” AMA

The report of the AMA’s Commission on Unity (COU) was a hot topic of discussion, testimony, and finally debate throughout last month’s Interim Meeting of the American Medical Association’s House of Delegates (see story above). The COU was established by the AMA in December 1998 to create a plan that would transform the Federation of Medicine, enabling it to coordinate efforts to represent and advocate for the profession more effectively, and to maintain the “professional infrastructure” that it said was critical to medicine.

The COU report openly stated that “the current federation does not work” and concluded that the basic problem is the way that the “parts” of the federation— the county, state, and specialty societies—interact, not the actual parts themselves.

The COU recommended that a “new system of medical organizations” be created to replace the existing federation. In its new design, the COU’s system would consist of a “core organization” (presumably, but not necessarily, the future incarnation of the current AMA) and a number of “participating organizations” (the current state and national specialty societies). Individual physicians and medical students would gain membership through joining their state and/or national specialty societies. Upon joining a participating organization, membership in the core organization would be required and automatic.

Interestingly, the new system does not include a place for the existing county medical societies, a point that caused considerable concern among delegates attending the meeting.

Also of concern was a provision that would give the core organization the voice of authority, above all participating organizations, on public policy and advocacy. The “core” could, if appropriate, delegate the authority to speak publicly to a state or specialty participating organization, but only on a specific item-by-item basis.

The most controversial issue within the plan seemed to surround members’ dues, which would be paid only to the participating organizations. However, the new system would divert a portion of each member’s dues away from the participating organization and into the coffers of the core organization. The report explained that this transfer would be required, considering that the core organization would have no direct, dues-paying members.