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AMA opens door to more specialty society delegates

Last month, the AMA House of Delegates passed a bylaws amendment allowing specialty societies to have more delegates.

What does this mean for the Academy and family physicians?

It means AAFP may have three or more delegates, beginning this year, instead of the one delegate each specialty group already has.

Perhaps last fall you filled out a ballot selecting the AAFP to speak for you within the AMA house. If so, you took part in the new annual process that can give family physicians more say in organized medicine.

In addition to the one delegate each specialty group already has, a group will receive a delegate for each 2,000 ballots cast for the group.

Then, starting in the year 2,000, each society will have the one delegate it already has, plus another for every 1,000 ballots cast for the society.

Why is this change important?

The AMA used to have strong orientation to generalist practice, with the majority of its members being generalists. AAFP Executive Vice President Robert Graham, MD, served on the steering committee for AMA's Study of the Federation, which recommended broadening the base of the AMA house. He says that since the 1960s, the subspecialty orientation in the house has grown. "The influence of generalism diminished, and that diminution caused areas of blindness to creep into organized medicine," Dr. Graham says. Specific problems:

• Relative inaction as more medical school graduates became subspecialists and fewer became generalists. "Over 30 years, we saw communities in America progressively depopulated with generalist physicians," says Dr. Graham. "We in organized medicine could've done something about it. We didn't."
• The rapid and profound growth in the difference of physician income between generalists and procedurally based specialists.
• Not recognizing that as the system became more subspecialized and more expensive, more Americans lost access to basic health services.

"If organized medicine had acted aggressively on those issues in the '50s and '60s, I suspect we would not have seen the fragmentation that the AMA has gone through, because many physicians came to believe it's OK to be narrow and not take responsibility for the greater good," says Dr. Graham.

The annual balloting process should give AAFP and other generalist groups more clout within the AMA to address the blind spots, he says.

• FP Report is published by the AAFP News Department.