Who Is the “Voice” of Physicians?

In a recent press release and blog posting and comments, the physician-oriented website Sermo (Sermo Website) has directly challenged the American Medical Association’s claim to represent physicians, particularly in regard to health reform.  For a long time, the AMA’s membership as a percentage of all practicing physicians has been falling and a number of alternative groups claiming to speak for doctors have come into being.  Sermo is primarily a discussion forum for physicians, allowing them to share views on both medical care issues as well as policy affecting their practices.  On the policy side, it has been accused of a political bias in its leadership and membership, but the forum is open to all physicians so it would seem unlikely that it does not to some extent reflect the views of many physicians.

Whether or not the blog and comments are representative of the wider physician community, they are worth reading to understand what at least some physicians are thinking.  A recent “survey” of physicians on the site, which would have to be judged unscientific by any standards, found that a very high percent of respondents did not believe the AMA spoke for them or most doctors.   According to the survey, doctors are most concerned about limiting insurance company ability to deny care (what they really likely mean is that insurers should have to pay for whatever doctors decide to do or order); restricting the practice scope of non-physician providers; malpractice reforms; eliminating CPT codes, allowing collective bargaining with physicians and providing cost-of-living adjustments in reimbursements.  Some of these, malpractice reform for example, may be consistent with reform goals of ensuring delivery of only appropriate care and reining in cost growth.  Most, however, are in conflict with that objective.  If the Sermo blog and survey do reflect most physicians views, there is likely to be little doctor support for most of the bills being discussed today.