5 ms·

American Medical Association, aka physicians

giantg2 5y ago
And what was the legislation? How was it monopolistic in favor of physicians? The AMA does not really represent physicians. Less than 1/4 of doctors belong to the AMA. Many of them do not feel the AMA represents them. The AMA also accepts substantial donations from other sources, including corporate donors and foundations. https://www.physiciansweekly.com/is-the-ama-really-the-voice-of-physicians-in-the-us https://www.physiciansweekly.com/is-the-ama-really-the-voice...
- renewiltord 5y ago
  The lobbying to: A. Limit medical care to being provided by these people B. Limit number of residencies
  - geogra4 5y ago
    I hate this line that's repeated all the time because its simply wrong. Osteopathy has its own residencies and the DO is legally equivalent to an MD
  - giantg2 5y ago
    "Limit medical care to being provided by these people" Who else would provide this care? This licensure is similar to other professions, like lawyers, and really doesn't take very much lobbying since the majority of the public want oversight of these sorts of professionals. Residencies simply haven't kept pace with medical student numbers. They have gone up though. The main question is "where does the funding come from for residency training?". Medicare provides most of that funding, but that is a constrained resource. I find it hard to believe that the AMA lobbied for this provision.
    - long_time_gone 5y ago
      ==Who else would provide this care?== Nurse practitioners. AMA has a whole campaign on their website celebrating it: https://www.ama-assn.org/practice-management/scope-practice/ama-successfully-fights-scope-practice-expansions-threaten https://www.ama-assn.org/practice-management/scope-practice/...
    - renewiltord 5y ago
      You find it hard to believe a thing that the AMA made an overt aim of. Fascinating. Well, I’m out of this conversation.
      - giantg2 5y ago
        Then show me a source.
        long_time_gone 5y ago
        I showed you a source earlier in the thread and you didn't respond. It is the website of AMA, where they celebrate their success in lobbying against any bill that would allow other professionals expanded capabilities. "For over 30 years, the AMA’s state and federal advocacy efforts have safeguarded the practice of medicine by opposing nurse practitioner (NP) and other nonphysician professional attempts to inappropriately expand their scope of practice." Here it is again: https://www.ama-assn.org/practice-management/scope-practice/ama-successfully-fights-scope-practice-expansions-threaten https://www.ama-assn.org/practice-management/scope-practice/...
        giantg2 5y ago
        Ah, that prior comment is dead. So this is a source just saying they oppose inappropriate expansion. That they want PAs and NPs to practice as part of a team that includes a physician. I don't really see this as an issue. I also see PAs, NPs, and nurses as falling into the medical profession and subject to licensing, etc. So I see them as being on the inside of the system, not one of the "other people". What I was specifically looking for was a source about the second part of this thread - the restriction of residency by the AMA.
    - R0b0t1 5y ago
      When asked on the street people always say "yes I want healthcare to be safe" but if you actually see who is lobbying for certification requirements it is always incumbents. If people wanted and needed licensure for health, hair cutting, whatever, you'd expect that they would be at the state house. But they're not.
    - CryptoPunk 5y ago
      >>the majority of the public want oversight of these sorts of professionals. The majority of the public wants whatever they are lobbied to believe they need. The majority also supports the War on Drugs and criminalizing the sex trade, and for the same reason: fear tactics used to convince them that the mere option of doing an ostensibly harmful activity, is to the detriment of themselves and society at large, even though the activity would harm no one but the party engaged in it. Plenty of medical procedures could be done by nurses and other non-physician medical professionals, yet this entire option is barred to the public. There should be a free market, with consenting adults free to choose for themselves who to hire to perform services for them.
      - giantg2 5y ago
        "The majority of the public wants whatever they are lobbied to believe they need." Ok, can you show me the lobbying that swayed their opinion on this topic then? If they are just gullible like you claim, then do you think these incapable people will have the capacity to choose well after removing license requirements for providers? "Plenty of medical procedures could be done by nurses and other non-physician medical professionals, yet this entire option is barred to the public." This is not banned at all. Physician assistants and nurse practitioners exist and can perform some medical procedures/tasks. Even pharmacists. Granted I've personally had some negative experiences with some PAs and try to choose actually physicians for most things. "There should be a free market, with consenting adults free to choose for themselves who to hire to perform services for them." That would be nice in many ways, but I can see a downside too. Once someone is found to be incompetent, fraudulent, and harmful, how would they be barred from the profession to prevent the issue from happening to others? Usually things like insurance and bonding are requirements to cover any issues for people in this and other licensed fields.
        CryptoPunk 5y ago
        >>Ok, can you show me the lobbying that swayed their opinion on this topic then? I only deduce it happens. I mean the lobbying happens in ordinary conversations like these, where people with a vested interest in gatekeeping argue it's in the public interest. I'm deducing it happens based simply on the incentives that exist for concentrated interests, in the form of insiders, to engage in it. It also manifests as major political representatives legitimizing said licensure, and rationalizing the principle behind it to the public, in exchange for support from insiders within the regulated industry. >>If they are just gullible like you claim, then do you think these incapable people will have the capacity to choose well after removing license requirements for providers? Yes, because people do far more research for personal consumer choices, where their level of knowledge has a substantial personal impact, than for political positions where their level of knowledge has a minimal impact, or minimal likelihood of impact, on their personal life. >>That would be nice in many ways, but I can see a downside too. Once someone is found to be incompetent, fraudulent, and harmful, how would they be barred from the profession to prevent the issue from happening to others? I don't see how the absence of licensure would prevert courts from issuing restrictions on individuals found guilty of criminal misconduct. The government requiring a conviction in court before restricting someone's right to free association is how it should be. That is what the principles of a free society demand.
  - nradov 5y ago
    You have that backwards. The AMA is actively lobbying to increase the number of residencies. https://www.ama-assn.org/press-center/press-releases/ama-fund-graduate-medical-education-address-physician-shortages https://www.ama-assn.org/press-center/press-releases/ama-fun...
    - renewiltord 5y ago
      Haha this is exactly why point source information is so damaging. The AMA spent years keeping this tightened down by spending money and then they started issuing press releases asking for the opposite (but this time, conspicuously leaving off the money spending). This naïveté is typical of HN. You’d read a press release from ISIS and conclude they’ve built a paradise. You need more knowledge than you can Google up. You need to be aware of what they did and do over the last 30 years. But it’s okay, you can believe falsehoods. No skin off my back.
      - giantg2 5y ago
        Sources?
throwaway4220 5y ago
I say this as an MD: AMA can suck it. I don't pay them and I don't think they represent me or the profession.

And what was the legislation? How was it monopolistic in favor of physicians? The AMA does not really represent physicians. Less than 1/4 of doctors belong to the AMA. Many of them do not feel the AMA represents them. The AMA also accepts substantial donations from other sources, including corporate donors and foundations. https://www.physiciansweekly.com/is-the-ama-really-the-voice-of-physicians-in-the-us https://www.physiciansweekly.com/is-the-ama-really-the-voice...

renewiltord 5y ago
The lobbying to: A. Limit medical care to being provided by these people B. Limit number of residencies
- geogra4 5y ago
  I hate this line that's repeated all the time because its simply wrong. Osteopathy has its own residencies and the DO is legally equivalent to an MD
- giantg2 5y ago
  "Limit medical care to being provided by these people" Who else would provide this care? This licensure is similar to other professions, like lawyers, and really doesn't take very much lobbying since the majority of the public want oversight of these sorts of professionals. Residencies simply haven't kept pace with medical student numbers. They have gone up though. The main question is "where does the funding come from for residency training?". Medicare provides most of that funding, but that is a constrained resource. I find it hard to believe that the AMA lobbied for this provision.
  - long_time_gone 5y ago
    ==Who else would provide this care?== Nurse practitioners. AMA has a whole campaign on their website celebrating it: https://www.ama-assn.org/practice-management/scope-practice/ama-successfully-fights-scope-practice-expansions-threaten https://www.ama-assn.org/practice-management/scope-practice/...
  - renewiltord 5y ago
    You find it hard to believe a thing that the AMA made an overt aim of. Fascinating. Well, I’m out of this conversation.
    - giantg2 5y ago
      Then show me a source.
      - long_time_gone 5y ago
        I showed you a source earlier in the thread and you didn't respond. It is the website of AMA, where they celebrate their success in lobbying against any bill that would allow other professionals expanded capabilities. "For over 30 years, the AMA’s state and federal advocacy efforts have safeguarded the practice of medicine by opposing nurse practitioner (NP) and other nonphysician professional attempts to inappropriately expand their scope of practice." Here it is again: https://www.ama-assn.org/practice-management/scope-practice/ama-successfully-fights-scope-practice-expansions-threaten https://www.ama-assn.org/practice-management/scope-practice/...
        giantg2 5y ago
        Ah, that prior comment is dead. So this is a source just saying they oppose inappropriate expansion. That they want PAs and NPs to practice as part of a team that includes a physician. I don't really see this as an issue. I also see PAs, NPs, and nurses as falling into the medical profession and subject to licensing, etc. So I see them as being on the inside of the system, not one of the "other people". What I was specifically looking for was a source about the second part of this thread - the restriction of residency by the AMA.
  - R0b0t1 5y ago
    When asked on the street people always say "yes I want healthcare to be safe" but if you actually see who is lobbying for certification requirements it is always incumbents. If people wanted and needed licensure for health, hair cutting, whatever, you'd expect that they would be at the state house. But they're not.
  - CryptoPunk 5y ago
    >>the majority of the public want oversight of these sorts of professionals. The majority of the public wants whatever they are lobbied to believe they need. The majority also supports the War on Drugs and criminalizing the sex trade, and for the same reason: fear tactics used to convince them that the mere option of doing an ostensibly harmful activity, is to the detriment of themselves and society at large, even though the activity would harm no one but the party engaged in it. Plenty of medical procedures could be done by nurses and other non-physician medical professionals, yet this entire option is barred to the public. There should be a free market, with consenting adults free to choose for themselves who to hire to perform services for them.
    - giantg2 5y ago
      "The majority of the public wants whatever they are lobbied to believe they need." Ok, can you show me the lobbying that swayed their opinion on this topic then? If they are just gullible like you claim, then do you think these incapable people will have the capacity to choose well after removing license requirements for providers? "Plenty of medical procedures could be done by nurses and other non-physician medical professionals, yet this entire option is barred to the public." This is not banned at all. Physician assistants and nurse practitioners exist and can perform some medical procedures/tasks. Even pharmacists. Granted I've personally had some negative experiences with some PAs and try to choose actually physicians for most things. "There should be a free market, with consenting adults free to choose for themselves who to hire to perform services for them." That would be nice in many ways, but I can see a downside too. Once someone is found to be incompetent, fraudulent, and harmful, how would they be barred from the profession to prevent the issue from happening to others? Usually things like insurance and bonding are requirements to cover any issues for people in this and other licensed fields.
      - CryptoPunk 5y ago
        >>Ok, can you show me the lobbying that swayed their opinion on this topic then? I only deduce it happens. I mean the lobbying happens in ordinary conversations like these, where people with a vested interest in gatekeeping argue it's in the public interest. I'm deducing it happens based simply on the incentives that exist for concentrated interests, in the form of insiders, to engage in it. It also manifests as major political representatives legitimizing said licensure, and rationalizing the principle behind it to the public, in exchange for support from insiders within the regulated industry. >>If they are just gullible like you claim, then do you think these incapable people will have the capacity to choose well after removing license requirements for providers? Yes, because people do far more research for personal consumer choices, where their level of knowledge has a substantial personal impact, than for political positions where their level of knowledge has a minimal impact, or minimal likelihood of impact, on their personal life. >>That would be nice in many ways, but I can see a downside too. Once someone is found to be incompetent, fraudulent, and harmful, how would they be barred from the profession to prevent the issue from happening to others? I don't see how the absence of licensure would prevert courts from issuing restrictions on individuals found guilty of criminal misconduct. The government requiring a conviction in court before restricting someone's right to free association is how it should be. That is what the principles of a free society demand.
- nradov 5y ago
  You have that backwards. The AMA is actively lobbying to increase the number of residencies. https://www.ama-assn.org/press-center/press-releases/ama-fund-graduate-medical-education-address-physician-shortages https://www.ama-assn.org/press-center/press-releases/ama-fun...
  - renewiltord 5y ago
    Haha this is exactly why point source information is so damaging. The AMA spent years keeping this tightened down by spending money and then they started issuing press releases asking for the opposite (but this time, conspicuously leaving off the money spending). This naïveté is typical of HN. You’d read a press release from ISIS and conclude they’ve built a paradise. You need more knowledge than you can Google up. You need to be aware of what they did and do over the last 30 years. But it’s okay, you can believe falsehoods. No skin off my back.
    - giantg2 5y ago
      Sources?

throwaway4220 5y ago

I say this as an MD: AMA can suck it. I don't pay them and I don't think they represent me or the profession.