AMA is a democracy in the truest sense of the word

When I was about 6 years old, my parents proudly presented me with a new baby sister. But instead of giving them the enthusiastic response they expected, I said: "I'da rather had a puppy."

Now that I am older and wiser, I understand a little better the irritation my parents must have felt at that moment, at least before they began to laugh.

You see, as president of the AMA, I have often received a similar response from physicians when I proudly present AMA policies, priorities and positions.

Wherever I go, I invariably meet doctors who say, "But I don't agree with such and such policy." Or, "Why doesn't the AMA listen to physicians like me?"

Now, when my sister arrived in this world, I had to accept the inevitable. My parents were not going to take her back to the hospital. I was not going to get a puppy.

But there's nothing inevitable about AMA priorities and policies. All physicians can have their say. It's just that too many of us choose not to participate in organized medicine. So we never learn how to use our voice.

You see, the AMA is a democracy. Active members can use it as a fulcrum to move the whole profession, even the nation, toward change.

Yet the flip side is also true: If we don't participate, we don't get our say, and we don't see results. Instead, we relinquish an important part of our professional power and authority.

Now some of you may be skeptical. So I will say it again: The AMA is a democracy in the truest sense of the word.

Let's start with the AMA as direct democracy.

In the past year, we have created opportunities for our members to shape the Association's priorities, policies and public positions.

For example, through our electronic Member Connect surveys (link), AMA members are making their voices heard on the most important issues affecting their practices and patients.

Here's how.

In 2004, more than 8,300 AMA members used a Member Connect survey to tell us what issues the AMA should focus on in the coming year. Their answers determined our powerful, seven-point agenda for 2005.

This was no one-time offer, either. This summer, AMA members will again shape medicine's national agenda, this time for 2006. Just stay tuned to the Member Connect Web site.

The new survey will be available in mid-August.

The democratic potential of these surveys doesn't end with agenda-setting, either. AMA members also can use Member Connect Resolution surveys to participate in the AMA's policy-making process.

At the last two meetings of the House of Delegates, thousands of AMA members used these surveys to tell the House what they thought about resolutions up for debate.

Survey results were distributed to committees and delegates so they could use this information as they discussed and voted on resolutions. Across each of the issues surveyed, the actions taken by the house largely mirrored our members' opinions.

Member Connect surveys also have allowed the AMA to measure what physicians think about specific, high-priority issues facing medicine. The AMA has used this information in powerful ways.

Consider a recent survey we conducted on Medicare. It asked physicians what they would do should a Medicare payment cut take place in 2006. Significantly, more than a third of physicians reported that, if the cuts occurred, they could no longer afford to accept new Medicare patients.

The results of this survey made headlines across the nation. Likewise, these results are helping us drive home to Congress that a payment cut could seriously harm the Medicare program.

In short, the Member Connect surveys are powerful tools. The feedback they provide helps the AMA strengthen organized medicine and, ultimately, the future of health care in America.

But surveys are not your only option for direct participation in the AMA. For physicians who want to speak out, literally, our new Member Connect Roundtables provide another kind of forum.

At these Roundtables, AMA members across the country meet with AMA leaders in small, interactive groups to ask questions and exchange ideas. Through these exclusive, members-only sessions, we can better understand the issues our members face and how we can work together to address them.

To date, hundreds of AMA members have participated in a Roundtable, and many more are being scheduled around the county.

To find out more about this program, simply check the Roundtables Web site (link).

Even if you don't choose to participate in any of the above programs, you still have a voice at the AMA.

The AMA House of Delegates is made up of doctors from every state medical society, the District of Columbia, all U.S. territories, 110 medical specialty societies and every branch of the uniformed services, as well as the AMA sections and groups. The latter represent medical students, medical staff, resident physicians, medical school deans, young physicians, international medical graduates and minority physicians.

So what am I driving at?

Every physician in America who is part of one of these organizations or groups has representation in the AMA House of Delegates.

So even if you do nothing else, reach out to one of your delegates, whether that person represents your state or specialty society, residents or IMGs. Let that delegate know what you think.

Or go a step further. Get involved in the election process. Vocally support a candidate who shares your perspective on medicine.

Or go even further. Get involved in a physician organization with representation in the house. Then run to be an AMA delegate. If you get elected, you'll see firsthand the passion, commitment and judgment that characterize our delegates and their work.

Whatever you do, I promise you this: Participating in the AMA democracy will bring you many rewards.

You might not get a brand new baby sister. Or even a puppy.

But you will get to use your voice, feel empowered and possibly even change the world.