Friday, June 30, 2023

What's up with the AMA?

All of a sudden, unbidden, my Twitter timeline is on blast from the American Medical Association (AMA).

I am not a member.

I am not a physician.

And even if I were a physician, statistically speaking, I likely wouldn't be a member of the AMA anyway. Fewer than 20% of MD's are.

But the AMA is a pretty powerful lobbying organization, and - if what I'm seeing fly by me on Twitter is any indication - a lot of their lobbying efforts go to going after nurse practitioners, physicians assistants, and other (not-so) allied medical professionals who've been performing tasks that the AMA wants to see reserved for physicians.

I clicked through on one of their tweets and came upon a post the AMA recently put out - Battlefield widens with hundreds of scope-creep bills introduced.

Battlefield widens!

Oooo. Scope creep! Scary!

So the AMA is working state legislatures - aux barricades! - to make sure that their club, with its exclusive membership, is protected. They have all sorts of studies showing that costs go up and quality goes down when and where non-physicians practice medicine. (I only gave one of their studies a glance, but, if I were a betting person, I'd bet that there's plenty of countervailing evidence.

Okay, I don't want an orderly performing brain surgery. At least on  me, anyway.

But in wide swaths of the country, there's a shortage of primary care physicians - and plenty of other specialties. And even if you have a PCP, or have already seen a specialist, you can wait months for an appointment.

So why not "allow pharmacists to test, treat and prescribe medications for conditions such as strep throat or a urinary tract infection"?

And why not let psychologists write prescriptions, as opposed to requiring someone in need of mental healthcare to see both a non-MD therapist and an MD shrink? 

And why not let an optometrist diagnose and write a scrip for pinkeye?

I love my PCP. She's an excellent physician, plus she's a good two decades younger than I am, so I'm hoping she'll see me out the door. (Additional bonus: her husband is my dentist.) But 99.99% of the care I require is pretty routine, and if the day comes when my annual is with a PA or an NP, so be it. Yes, I'd still want my most excellent of doctors to glance at my test results and see if anything jumps out at her. And if anything does jump out, I want to talk to her about it. 

But I'd be happy to see a PA or NP. Or have my local pharmacist take care of a UTI before I'm septic. Or have my PT guy prescribe a test. 

And I suspect the folks who live in "healthcare deserts" are just as happy to see a nurse, a pharmacist, a physical therapist if there's no alternative Marcus Welby available.

Maybe the AMA needs to focus its energies on the physician shortages we're facing, and coming up with ways to expand the ranks. Maybe we need larger med school classes. More med schools. Fewer years spent in med schools. (I've seen a lot about three-year med schools, and six-year undergrad+med school programs.) Ways to get medical care in areas and to populations that for the most part do without. 

Physicians, heal thyselves!

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