Those Who Can’t, Lobby

The more medicine is immersed in the daily passions of politics, the less serious it becomes.  And it seems like a battle long since lost, as health care is injected into every political fight and agenda dominating the entire media spectrum. 

And wherever there is a flight from seriousness, we may be sure that the AMA will be leading the charge.  Last year these rock stars of mendacity took on racial segregation and homelessness  something they could never fix and have no business talking about (These heroes even cancelled their 2018 convention in San Francisco, because of the health hazards represented by those very same homeless).  Having not fixed those domestic social problems for which they had no ability to solve, the AMA is now intent on (not) fixing the looming threat of climate change. 

“74 medical and public health groups aligned on Monday to push for a series of consensus commitments to combat climate change, bluntly defined by the organizations as ‘a health emergency,'” according to the AP.  The “objective” journalist writing this tells us, “The health organizations’ policy recommendations … represent a back-to-basics approach…”

To what basics does this medical consortium wish to return? 

– “Meet and strengthen U.S. commitments” under the 2015 United Nations climate agreement

– New carbon taxation

– “A plan and timeline for reduction of fossil fuel extraction in the U.S.”

“That the agenda’s endorsing groups do not operate with ‘a political axe to grind’ could help them draw more attention to climate change, said Ed Maibach, director of the Center for Climate Change Communication at George Mason University.”  This is a naked, damnable lie.  This is pure politics, nothing more, and doctors joining hands with this are (once again) selling out their profession in the name of their own phony goodness.

Unable to make the practice of medicine even a little more palatable, unwilling to fight the slightest government intrusion into our professional lives, these self-indulgent morons are now nakedly glomming onto a particular party platform.  It is no defense of the other party to recognize this approach as contemptible.  Allegedly populated by members with scientific training, the AMA et al are trying to fit a white lab coat to a set of unproven ideas whose fuel is ideology, and whose exhaust is …what? 

“’It is important that current and future physicians are able to describe the risks that climate change poses to human health so that they can counsel their patients on how to protect themselves from the health risks posed by climate change,” said AMA Board Member S. Bobby Mukkamala, M.D” (Does he mean more sunscreen PSA’s in Winnipeg, and prescriptions for hip-waders in south Florida?).  Put more honestly, Mukkamala is telling doctors to buy into a particular political advocacy so that they can then lobby their patients.  When not busy trying to stamp a medical imprimatur on the southern border controversy (and encouraging more cross-border communicable disease transmission), the American College of Physicians has published a Climate Change Toolkit to “help reduce energy use and greenhouse gas emissions in your practice.”  Because that has got to be a major concern for overworked clinicians trying to make the next lease payment.

Dishonest is not a strong enough word for this garbage.

Apart from cooking up the latest ICD-11 codes for climate-change related diagnoses, the sellouts in Chicago have no credibility in pushing a non-settled scientific question outside of their expertise, to which they are not applying any critical analysis.  The AMA et al has no idea what the economic ramifications will be to mass fiddling with the energy market that affects pricing in every other good and service.  It is doubtful therefore that they could predict the health consequences for hundreds of millions following any blind policy prescriptions they are pushing.  It would be nice if organized medicine could change the climate for the physicians it claims to represent.  Until the AMA and their little siblings can make a positive difference for their own profession, they should be laughed out of the building.

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Pat Conrad MD

Pat Conrad is a full-time rural ER doc on the Florida Gulf Coast. After serving as a carrier naval flight officer, he graduated from the University of Florida College of Medicine, and the Tallahassee Family Medicine residency program. His commentary has appeared in Medical Economics and at . Conrad’s work stresses individual freedom and autonomy as the crucial foundation for medical excellence, is wary of all collective solutions, and recognizes that the vast majority of poisonous snakebites are concurrent with alcohol consumption. 

  21 comments for “Those Who Can’t, Lobby

  1. July 3, 2019 at 11:31 pm

    Great article, Pat.

    No, climate change is NOT a “health emergency,” despite assertions by AMA and other members of the consortium. See

    And if it were, AMA could do nothing to stop it.

    I’d like to see AMA to do something to halt the destruction of private medicine, instead of collaborating with the Dark Side whenever there’s a money-making opportunity.

  2. Bobby Mukkamala
    July 2, 2019 at 10:42 am

    Howdy. Bobby Mukkamala here. You quoted my in your article. Regarding the health effects of climate change, this is what I am referring to as an example: cardiovascular and respiratory issues related to heatwaves, infectious disease issue changes due to temperature changes, and air quality changes. Clearly the science is not robust but the early indications are that climate change contributes negatively to human health. As an organization that is dedicated to promoting the Art and Science of Medicine, the AMA is working on trying to improve this. There are many issues that effect our patients beyond what gets treated in our exam rooms. Our AMA works on these issues as well.

    • Pat
      July 2, 2019 at 11:02 am

      Dr. Mukkamala, Thank you for reading, and I sincerely appreciate your response.

      While I do not argue that environmental changes can certainly bring on health changes and exacerbate disease states, I read your quote AS an AMA rep, to be one supportive of a particular political viewpoint. My point is that I think the AMA et al have long since become more about political advocacy, under the guise of promoting health, because their main goal is their own survival and self-promotion.

      Pat C.

    • Sir Lance-a-lot
      July 2, 2019 at 11:33 am

      “Our” AMA?

      By “our” I assume you are using Definition #1 of the English second person plural, which is “my group of people over here and me,” rather than Definition #2, which is “you and me.”

      Because you sure don’t mean “you and me” if the “you” you’re referring to is me.

  3. Stephen Rockower, MD
    July 2, 2019 at 10:28 am

    Sorry, I don’t think you know what you are talking about. The AMA did not “cancel a convention” in San Francisco. They have nothing to do with ICD11. They ARE trying to improve the health of people in America through multiple avenues, whether it is climate change, advocating against mid-levels, advocating for vaccines, etc etc etc. To concentrate on one thing as not in the interest of doctors is disingenuous.
    We are in this together. If you think you can change Congress or Public Opinion by spouting into the ether of the internet, fine. But if you join, and get like-minded people to do the same, YOU can change the AMA.

    • Sir Lance-a-lot
      July 2, 2019 at 10:46 am

      If the AMA will assist me with collective bargaining with my employer, then I’ll re-join them.

      Aside from that, they can rot in Hell.
      With the amount of money they’ve socked away, they should be able to make it quite comfy there.

      Their job is not to improve anyone’s health, it is to advocate for me and my colleagues. It is MY job to improve people’s health.

      • Stephen Rockower, MD
        July 2, 2019 at 9:54 pm

        It is my understanding that the AMA is legislatively prohibited from assisting you in that matter, and has been since the anti-trust legislation in the early parts of the 20th century. If you can convince your reps and senators to change that, more power to you. If you are an employee, have you considered joining/forming a union? THAT is where real collective bargaining occurs. Of course, then you can complain about the “union bosses”, but they’ve probably done something for you.
        And I’ll disagree that it isn’t their job to improve health. There is and has always been power in numbers. Join with thousands of like minded docs and you really can change the dynamic.

        • Sir Lance-a-lot
          July 2, 2019 at 10:27 pm

          So then why doesn’t the AMA, which is one of the most effective and highest-spending lobbying groups in the US, lobby for individual physicians in private practice to no longer be subject to anti-trust charges if they combine to fight huge insurers?

          And, since the AMA cannot directly, legally act as a union, why can’t they use their expertise and money to help start a union for all docs across the country, give it professional legitimacy, and help create the publicity needed for it to be adopted? That would obviously benefit the entire profession, and would be better than trying to convince an unrelated or semi-related local (CWA, UAW, Teamsters, CIR) to take on a bunch of doctors when they’ve never even seen a physician contract before.

          I have joined with thousands of like-minded docs:
          I tore up my AMA membership over ten years ago.
          If you can convince me there is one actual practical good reason to join, then I’ll open one of those envelopes with the Chicago return address instead of throwing them all out (and, by the way, why would a reputable organization sometimes put its name on the envelope, but sometimes only its address, as though it’s trying to slip by unnoticed?).

        • RSW
          July 3, 2019 at 11:30 am

          “Join with thousands of like minded docs”

          After the AMA used the RUC to deliberately and probably permanently destroy primary care in this country?

          No thanks.

    • Randy
      July 2, 2019 at 12:06 pm

      Dr Rockower, thanks for your post. I did join the AMA and my experiences have been detailed in past lengthy posts which I won’t rehash.

      Advocating on climate change may be a worthy pursuit, but I see it as the AMA taking its eye off the ball in comparison to its neglect of other issues which physicians face daily.

      • Stephen Rockower, MD
        July 2, 2019 at 9:57 pm

        See Dr. Mukkamala’s post for the reasons for including climate change in our list of concerns. That is only one of hundreds of things the AMA works on for your benefit. Fix Prior Auth, MIPS/MACRA, malpractice issues, insurance issues, hospital governance issues, etc etc etc.

  4. PW
    July 2, 2019 at 9:24 am

    I have decided that next year, I will only pay dues to the ABFP, and only because I have to stay boarded in order to do Independent Medical Evals for the state. As far as AAFP and AMA, they do nothing for me or any other physicians, they are now just political wings of the Liberal establishment. Never cared for ACP at all.

  5. Sir Lance-a-lot
    July 2, 2019 at 8:02 am

    Well, I guess it makes as much sense for me to go to the AMA for a prescription for how to fix the environment as it does for me to go to a nurse when I’m sick…

    • Pat
      July 2, 2019 at 10:52 am

      Hmmm, perhaps it was one of the other Chicago-based medical groups that could have delivered 15,000 attendees and churned $40 million?

      … or this …

      Since ICD-11 isn’t out there yet, that was obviously a joke, albeit very believable. And those sellouts will squeeze every dollar out of it possible.

      We are NOT in this together. The AMA has been the handmaiden of gov’t intrusion into the doctor-patient relationship for over half a century, the lube with which DRG’s, ICD/CPT’s, EHR’s, and yes, the Affordable Care Act have had their way with doctors. They will not defend their own against real, imminent threats, but stage public morality as diversions.

      Waste the last productive decade or two I have in arguing with self-important buffoons who think I should “green” my office while running banks of EHR’s in order to save the planet? Not bloody likely.
      Cheers ?

      • Sir Lance-a-lot
        July 2, 2019 at 11:29 am

        I think you were replying to Steve, Pat, but of course you and I are in agreement.

        What I want to know is how did you get that little martini glass to appear?

        • Pat
          July 2, 2019 at 11:37 am

          That was for Steve. And replying on an iPhone, the little emojis available are a dandy addition.

          • Sir Lance-a-lot
            July 2, 2019 at 4:04 pm

            You kids and your iPhone emoji…

      • Stephen Rockower, MD
        July 2, 2019 at 10:15 pm

        We only wish the AMA meetings are that big. We have 1200-1400 people, and are usually at just one hotel.
        My guess that 15,000 attendees would probably be the Orthopaedic Surgeons, but maybe others are that big also. AAOS is Chicago-based, also. The articles don’t specifically mention which organization.

        ICD-10-11 is a governmental imposed abomination, as many of us will agree.

        We are actively suing the government over intrusion into the doctor-patient relationship with the Gag Rule imposition on Reproductive Health. There is no consensus within the organization about abortion, but having the government restrict what a doctor can and cannot say to a patient is an anathema. Same went for restricting pediatricians asking about gun safety in the home.

        Nothing in this life is perfect, but we are trying as hard as we can to make things better for everybody. As I have said in other venues, this is a democratic organization. If enough docs vote for a change of policy, that becomes the policy of the AMA. I am only 1 delegate. Find out who your delegates are from your state or Specialty Society. Get your friends to join, and take over. We welcome your participation.

        And I’ll gladly have a martini with you. Actually I prefer Scotch, but you get the drift! 🙂

        • Bridget Reidy
          July 3, 2019 at 3:54 pm

          There’s enough evidence that good primary care is superior to multispecialty care, that the number of primaries per population influences health more than the number of specialists. So I’d hardly say they are interested in science!

  6. Thomas David Guastavino
    July 2, 2019 at 7:13 am

    Addressing climate change is like going to the doctor with the vague symptoms of a poorly understand illness and the doctor prescribes a very expensive, experimental treatment with nasty side effects, with no idea what the result will be.
    …..and half the country believes the taxpayer should pay for it.

    • Randy
      July 2, 2019 at 10:59 am

      That’s probably the best analogy I’ve ever read regarding climate change. As physicians we are taught to question studies and lord knows we are presented with enough bad ones, yet we are not supposed to question any studies on climate. If I do I’m called anti-science, despite my initial degree being in chemistry and having a ton of exposure to statistics in the course of my career.

      I actually agree that the Earth is warming and human activity is a part of that. That’s the easy part. The hard part is knowing what to about it.

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