The American Medical Association now tells doctors: Use woke language! It’s issued a 54-page guide telling doctors things like, don’t say “equality”; say “equity.” Don’t say “minority”; say “historically marginalized.”
Much of the AMA’s advisory sounds like Marxism: “Expose … property rights … Individualism is problematic … Corporations … limit prospects for good health … people underpaid and forced into poverty as a result of banking policies.”
This is too much even for some on the left, like writer Matthew Yglesias, whose article about the AMA caught my attention.
“Can you imagine anyone actually doing this?” asks Yglesias in my new video. “What would happen if you were in a clinical setting, and somebody starts giving you this lecture about landowners? … Nobody practices medicine like that, and it wouldn’t be helpful to anybody!”
He points out that while the AMA now tells doctors to call poor neighborhoods “systematically divested,” not “poor,” it has long lobbied for things that hurt poor people, like restricting the number of doctors.
The U.S. has fewer doctors than other countries. Per person, Austria has twice as many.
“We have the best paid physicians in the world and the scarcest physicians in the world,” says Yglesias. “That’s not a coincidence.”
Years ago, in most of America, anyone could practice medicine. Licensed doctors didn’t like that. That led to the formation of the AMA.
They’re a trade group, says Yglesias. “They … advance the interests of their members.”
Like the teachers union or dock workers union.
“It’s called a trade association rather than a union,” says Yglesias. “But it’s never been all that different.”
In 1986, the AMA called for smaller enrollment in medical schools, to curb an alleged doctor “surplus.” In 1997, it even got the government to pay hospitals not to train doctors!
Today, the AMA supports rules that make it hard for doctors from other countries to practice here. Foreign doctors must complete a U.S. residency program. They don’t get credit for having practiced abroad.
Such rules preserve America’s doctor shortage. That shortage allows the average doctor to make more than $200,000 a year.
Well-paid doctors can be choosy about where they work. It’s why it’s tough to find a doctor in rural America, says Yglesias.
There are lots of Walmarts and Targets in rural areas because there is no limit on big stores. Walmart and Target compete to serve as many communities as they can.
Likewise, “Restaurants keep time that’s convenient for their customers. Doctors keep hours that are convenient for doctors.”
I asked the AMA for an interview about this, but they declined. They sent us a statement saying they’ve worked to approve “approximately 20 new medical schools.”
Why does the AMA and its “Liaison Committee on Medical Education” even get to approve new schools? I don’t get to approve new TV reporters.
The AMA’s statement claims it supports “increasing … the number of physicians.” If that’s true, it’s long overdue. A study in Annals of Internal Medicine says if there were more primary care doctors, 7,200 lives would be saved.
Since doctors are scarce, more people go to nurses for help. But AMA lobbyists push for laws that require nurses to be supervised by a doctor.
“That makes it much harder to open retail health clinics … (that offer) low-cost, high-convenience treatment,” says Yglesias. “Nurses have a lot of training … there’s a lot of useful stuff that they can do.”
The AMA’s lobbying hurts poor people most.
The AMA doesn’t like talking about that. Instead, it now obsesses about politically correct language, telling doctors, don’t say, “ex-cons”; say “formerly incarcerated.” Don’t say “slaves”; say “enslaved people.”
It’s hard to imagine how that helps patients.
Yglesias concludes, “Getting really obsessed with language politics is a good way to position themselves as the good guys, without addressing their own role in creating these problems.”
4 thoughts on “The Woke AMA”
I have heard the idea before that high physician incomes are the cause of America’s ballooning health care costs. I looked at some numbers to see if that is true.
According to the “National Physician’s Practice Costs and Income Survey, 1975 and 1983-1984”, internal medicine doctors made an average of $53,900 in 1975. From the CPI Inflation Calculator, the CPI (Consumer Price Index) adjustment factor from 1975 to May 2020 is 4.78. So the 1975 pay for internists adjusted to May 2020 dollars is $257,642. From the Bureau of Labor Statistics Occupational Outlook Handbook, in May 2020 the average pay for internists was $210,960. It looks like the real, inflation-adjusted incomes for doctors has actually gone down. Physician pay is not the cause of high health care costs. The AMA has done a poor job of protecting doctor’s incomes.
Even so, we still have the world’s highest paid doctors. What’s wrong with that? We used to have the world’s highest paid everyone. We had the largest and richest middle class in world history. Isn’t that a good thing? I think that is what made America great. Over the last 50 years wage suppression and tax cuts have redirected income away from wage earners to the rich. Wages have stagnated while the fortunes of the rich have skyrocketed. Why is that better?
From “Our World in Data, Life expectancy vs. health expenditure” the United States had costs and life expectancy pretty much in line with other first world countries until the early 1980’s. Then the United States health care system started to go off the rails. Now we have the highest cost and lowest life expectancy. Our infant mortality is also the highest. We have the market based, for profit system that is primarily designed to squeeze as much money out of us as possible. It is not designed for public health. Shareholders don’t care about saving lives, they just want to make money. Insurance companies, hospitals, and Big Pharma are driving our health care costs, not physician pay.
They will be quoting the same words Banks and Loan Officers and Politicians have been using for years. Isn’t equity what you build up in your house? Pretty sure the words Historically Marginalized have something to do with profit and losses. Sounds like they’ve been doing this all along!
As a female physician, I feel marginalized, divested, and partially enslaved by the AMA trying to tell me what words I should use. Doctors get paid more because we postpone income for 4 years of college, 4 years of medical school and 6-8 years of residency before entering practice. If you average that 200k over their working lifespan but include the missed income from training, their income is much lower. Knowing the educational gap between a nurse (2-4 years), physician assistant (4-6 years), NP (4-6 years) and a physician (11-16 years), which would you rather have care for you if you are really sick?
I grew up In NY and have been an avid fan since I was quite young. However in this instance I think you are nearly obfuscating the problem with sensationalism. The publication you are discussing as if it is a manual for Doctors is not intended for them at all. It is the AMAs effort at continuing to take control of healthcare in America. It is their “guidance” for health publications and academia not really for interactions with patients. AMA’s jargon is the style used in public health journals like the Chicago Manual and this level of granularity can be seen as super “helpful” in the world of Public Health. I concur with you that it should not be dictated to us by physicians special interests. How about collaboration across sectors before the edicts?
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