So this group;
Is a ‘guild’ lobbying behalf of doctors and medical students advocating for congressional change in policies. They do a lot.
But their actions seem to mimic a cartel/trust more like (my opinion);
- Closing medical schools. If a Doctor graduates from a medical school and is somehow substandard, than they can either be trained, not be hired. If the doctor were to start their own practice, then they would open themselves up to malpractice should they actually provide substandard care. Closing medical schools limits the creation of doctors and is akin to centralizing power to current established medical schools, thus working for the interests of big hospitals and factions within the AMA.
- Reducing Residency Training via funding from Medicare. Limiting the number of Medicare-Funded Residency slots, means less medical programs that train doctors funded by Medicare. Which implies that less prospective doctors will have training or exposure to both Medicare treatment procedures and some cases partial exposure to billing and administrative processes related to Medicare (Things like medical coding, Electronic Health Records, Medicare billing, and regulations). Which infers that fewer new doctors are able to start their own practice and accuratly navigate systems like Medicare aid and services. (ask yourself, why would a Guild consisting of Doctors actively lobby AGAINST government funded education and training programs for more doctors?)
- Less Residency positions, means less physicians or doctors.
I should clarify, Physicians aren’t always doctors, Nurses and such are also considered as such.
All of this culminated into;
Which the net gain or benefit of Doctors or Physicians are estimated by ChatGPT (so take it with a grain of salt):
But if you ask anecdotal online evidence, it’s a lot higher. Residency positions are a highly sought after thing.
Imagine every cycle, the attrition rate being as high as 99%, implies that the majority of people who go to med school don’t become doctors. Of course, this is a bit of a stretch and an anecdote.
For Students and not-senior-physicians or DO’s, the rate is high per NRMP (National Resident Matching Program);
NIH reports about slightly more than half of applications made it passed the screening process in 2022
And that’s just initial screening, and not following up with Matches for round 1 or 2 or even completion. The attrition rate for completing a medical residency is definitely not zero, so there’s a likely hood that more than half of applicants don’t become doctors.
Which may be related to the fact of limited slots for medical residencies and government funding for such.
Which presents a problem that even the AMA is addressing as a cause for concern;
AMA has since, tried to advocate for more doctors. Like for instance, supporting the Resident Physician Shortage Reduction Act of 2023.
The TLDR is;
As a side note,
AMA has also advocated for a lot of other things regarding Medicare reimbursement and payment calculations and more. So there’s more things for other people to dig.
Additionally there are some circles that are pushing pet theories that the hospital orgs like AAMC is advocating for less doctors. Speculating that the Hospitals or Insurers are corrupting and capturing the Advocacy for doctors to act against their own interests. This theory speculates that Doctors are being used as a Pawn for the interests of the administrative portions of health care to take the flak of public perception while groups like AMA move for these administrative interests. I don’t seem to have any inkling of substantiation as of writing.
Also relevant article to the above: https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/
The Lesson
A group of people got big, wanted to limit the growing demand of doctors for -reasons-, and then were surprised that they had less doctors and wants to reverse.
In true fashion, everything is cyclical. So their lobby for policies provided a sort of bump for number of doctors, which would have to be later compensated for. Just think of it like a growing Sine wave and that it follows the trend of population to some degree. This matter is cyclical.
Hindsight is always 20/20.
Point being, groups eventually form to cohesive collections like guilds or unions, and then advocate for gate keeping to keep their group intake, erecting metaphorical borders, or burning the metaphorical bridge that allowed them to get to where they are and damaging future prospects. Gatekeeping.
This isn’t a new thing. This happens to all groups at some point, and idea of advocacy where it eventually leads to turning inward and having policies that might hurt the group rather than grow it. A Doctor’s Guild advocating for stricter or limiting control of influx of new doctors, is akin to a population of people issuing childbirth limits. The group will inherently dwindle from said policies.
Any Union or Guild starting out might have good intentions (if they’re not astroturfed), but when they grow too big and become complacent, they act as another middle man and gatekeepr for progress on all parts. They are a temporary step in the right direction, but end up being another wall or bump in the long run. It’s very typical with a lot of these collectivist groups.
Also, to note, some people are speculating that AMA is made up of more non-doctors than doctors. I personally am not a fan of guilds or unions that co-opt many businesses, because they don’t represent the voice of the workers, but rather the businesses and corporate interests. It’s further made apparent that if a group were to be operated by many non-doctors yet advocate for ‘doctors’ that it might not fair well for doctors.
To clarify, AMA does not create or enact policies on the government level, they lobby and advocate. Which for some is a big difference, and for others isn’t.
In Closing
I’m just shooting off the cuff.
Do I think AMA is evil? No.
Do some other people think AMA is evil? Yes.
Do most people think AMA is evil? No. most people don’t even know they exist.
Did they do something silly? Yes.
Is their action harming the American public? Most likely.
Is this adding more complications with the Sick Care System? Yes.
I would argue most things after the Flexner Report of 1910’s has privatized healthcare as a special interest and profit motive, and the lack of actual advancement in preventative medicine from denying the analogues of Eastern Traditional medicines, Ayurveda or Traditional Chinese Medicine, is the root blame. Coupled with the new synthetics -poisons and toxins- in our environment from plastic and aluminum to more, means that our health decline is a product of our industrialized revolution and sought after ‘convenience’.
Imagine telling someone that they can heal naturally and maintain homeostasis for non time sensitive life threatening issues. That wouldn’t pay well for a doctor, let alone the hospital, Big Pharma, or insurance companies. They’d rather give you pills while simultaneously denying diagnostics to find root causes (my personal experience).
Anyways, as always,
*Not Valid Financial, Legal, Life, or Any Advice