Thanks to the AMA, Organized Medicine Shows Its Hand

Healthcare trade associations and professional societies exist for one reason, and that’s to protect the economic interests of members. They’re guilds. They’re unions. Everything else is window dressing.

Last week, the American Medical Association (AMA) knowingly or inadvertently confirmed what I just wrote — and hope you just read — about healthcare trade associations and professional societies. The AMA released a report called Medicine’s 2026 state policy priorities. The report is based on a survey of 51 state medical societies and associations, including the District of Columbia, and 13 national medical specialty societies and associations.

You can download the full 32-page report here. Or, you can download a two-page executive summary of the report here.

The AMA survey basically asks the state and national medical societies and associations to tell the AMA and the rest of organized medicine what they’re up to this year. In the full report, the AMA said it does this every year. I have no reason to doubt that. But I’ve been covering healthcare for more than 40 years now, and it’s the first time I can recall that the AMA published the survey results. I’ve never heard of the survey. Maybe I haven’t been listening or looking in the right place. It’s my fault, and I’m sorry.

Anyway, the report reveals and ranks 18 legislative and regulatory priorities for this year as identified by the responding societies and associations. Topping the list by a wide margin was scope of practice, cited by 89% of the respondents. This is about other licensed medical professionals performing services and tasks that licensed medical doctors historically perform and bill insurers and other payers to generate revenue for their practices. Scope of practice, or “scope creep,” is an economic threat to the livelihoods of physicians.

Who do physicians blame most for trying to take the food off their plate at the state level? It’s not nurse practitioners (NPs) or physician assistants/associates (PAs) as you might think. It’s pharmacists, cited by 30 state medical societies and associations that said they were going to “work” the pharmacist scope of practice issue in 2026. “Work,” as in preventing legislation or regulations that would give pharmacists the legal authority to “test and treat” patients with minor medical conditions like strep throat.

I wrote about that more than five years ago in this blog post: Primary-Care Physicians versus The World (Mostly Pharmacists, Really). Glad I was right. Sorry to hear it’s still a sore spot for doctors.

From a national and a state level, it was the economic threat from PAs that topped the scope of practice issues that organized medicine will work this year, cited by 37 state and national medical societies and associations. The primary economic threat presented by PAs is legislation or regulations to eliminate or weaken physician supervision/collaboration of PAs by physicians. Docs can bill for supervising and/or collaborating with PAs.

I wrote about physicians hating on PAs in this blog post published in December: The Reasonableness of Physician Assistants. FWIW, this week I had a brief telemedicine visit with a PA by phone, and he handled my minor and obvious medical issue professionally and perfectly without demanding that I see him in person before writing me a prescription or go in for a battery of unnecessary diagnostic medical tests.

The second most-cited legislative or regulatory priority for the medical societies and associations after scope of practice was Medicaid at 72%. The top issue there — shocker — was physician reimbursement, cited by 39 of the responding organizations.

Augmented or artificial intelligence (AI), arguably the hottest topic in healthcare right now, ranked fifth on the list of legislative or regulatory priorities for organized medicine at 64%, with the big issue there being the use of AI by commercial health insurers and other payers. Again, money, not patients.

Public health tied with AI for fifth, also cited by 64% of the respondents. It’s a catch-all bucket for issues such as reproductive health, LGBTQ+ health, tobacco use, vaccines, firearm violence and more. Given the systematic dismantling of our public health system by the Trump regime, you’d think this would be No. 1 on the list of legislative and regulatory priorities for organized medicine. But no.

Did you know that the AMA’s mission statement is to “promote the art and science of medicine and the betterment of public health”? You wouldn’t be able to guess it from this report.

Physician burnout and wellness fell on the list of priorities, 12 out of 18, cited by just 39% of respondents. I always felt that the physician burnout issue was a smokescreen to gain economic leverage in the market for doctors like I said in this monthly column a few years ago: Calling a Physician Burnout Timeout.

Last but not least from a consumer perspective on the list of legislative and regulatory priorities for state and national medical societies and associations? It was mental health and substance use disorder parity, cited by just 19% of the respondents. If you’re counting on organized medicine to fight for better access to high-quality and affordable behavioral health services, you’re going to be even more depressed.

Healthcare is an industry like any other industry. Healthcare businesses like physician medical practices are like businesses in any other industry. Healthcare trade associations and professional societies exist to protect and promote the economic interests of members, just like trade associations and professional societies in any other industry.

My thanks to the AMA for proving the point about organized medicine.

If we want to build a better healthcare system, let’s start with the economic incentives.