Why can't we be more like the AMA?

[PharmD RPh]

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A physician friend of mine was telling me that the AMA (American medical association) controls supply and demand over med students. He didn't go into much more detail but also noted their powerful lobbying power. Why can't pharmacy structure itself as such? Anyone know more than I do about this topic?

 

[All4MyDaughter]

A physician friend of mine was telling that the AMA (American medical association) controls supply and demand over med students. He didn't go into much more detail but also noted their powerful lobbying power. Why can't pharmacy structure itself as such? Anyone know more than I do about this topic?

I don't believe the AMA controls or accredits medical schools. I'm pretty sure it's the AAMC. They also don't control or accredit residencies. That's the ACGME. I'm also not sure how they would control demand in a free market economy? Not allow hospitals, clinics or other organizations to hire new physicians?

I don't know a great deal about this subject, and what I do know I've learned from working for SDN, but I think you should ask your friend to elaborate b/c his or her observations seem off-base.

 

[owlegrad]

A physician friend of mine was telling that the AMA (American medical association) controls supply and demand over med students. He didn't go into much more detail but also noted their powerful lobbying power. Why can't pharmacy structure itself as such? Anyone know more than I do about this topic?

Money for one. The APhA coffers are a joke compared to AMA. I don't have a source, this is something I heard from my dean. He says there are just not very many pharmacy leaders who want to step up and be involved in shaping the future of pharmacy. The other -related- issue is that pharmacists have a clock in and out type mentality. They don't want to spend their free time advocating for the profession. And finally the money. Pharmacists are just not willing to give their money. Without time, money, or support - what can get done?

 

[PharmD RPh]

I don't believe the AMA controls or accredits medical schools. I'm pretty sure it's the AAMC. They also don't control or accredit residencies. That's the ACGME. I'm also not sure how they would control demand in a free market economy? Not allow hospitals, clinics or other organizations to hire new physicians?

I don't know a great deal about this subject, and what I do know I've learned from working for SDN, but I think you should ask your friend to elaborate b/c his or her observations seem off-base.

I'll ask for more details and report back but essentially he said the AMA tells medical schools how many students to accept and if they need to open more schools in certain areas. After i thought about it for a second, i thought you know what? I dont see a ton of new med schools opening up and a surplus of MDs so they must be doing something different. Thought I would just throw this out there to see if anyone had more info.

 

[All4MyDaughter]

I'll ask for more details and report back but essentially he said the AMA tells medical schools how many students to accept and if they need to open more schools in certain areas. After i thought about it for a second, i thought you know what? I dont see a ton of new med schools opening up and a surplus of MDs so they must be doing something different. Thought I would just throw this out there to see if anyone had more info.

I don't believe the underlined part is accurate, at all. There may be forces influencing the number of med schools and number of students per school, but I don't think it's the AMA.

There have been a number of new medical schools opened in the last decade or so. Most of them (but not all) are osteopathic medical schools, which brings up another point. We have two completely separate systems for accrediting medical schools. I don't think the AMA control allopathic (MD) schools but I *know* they don't control osteopathic medical schools.

 

[PharmD RPh]

I don't believe the underlined part is accurate, at all. There may be forces influencing the number of med schools and number of students per school, but I don't think it's the AMA.

There have been a number of new medical schools opened in the last decade or so. Most of them (but not all) are osteopathic medical schools, which brings up another point. We have two completely separate systems for accrediting medical schools. I don't think the AMA control allopathic (MD) schools but I *know* they don't control osteopathic medical schools.

I don't think we want to open up the allopathic versus osteopathic can of worms on this thread🙂

 

[All4MyDaughter]

I don't think we want to open up the allopathic versus osteopathic can of worms on this thread🙂

Not trying to. But you can't discuss supply/demand in the medical profession without taking into account both parts of the system.

 

[owlegrad]

I don't think we want to open up the allopathic versus osteopathic can of worms on this thread🙂

So I ran a search of "md vs do comic" and this was result number one. I only share it because I feel it greatly contributes to the discussion:

 

[PharmD RPh]

http://www.usatoday.com/news/health/2005-03-02-doctor-shortage_x.htm

Midway down talks about shortage and how AMA tries to limit number of physicians. Doesn't state how though....

 

[All4MyDaughter]

http://www.usatoday.com/news/health/2005-03-02-doctor-shortage_x.htm

Midway down talks about shortage and how AMA tries to limit number of physicians. Doesn't state how though....

I tried to find out more info from Google. Maybe the AMA controls the AAMC? I'm sure they are influential... I'd like more info too.

 

[Filler]

I'll ask for more details and report back but essentially he said the AMA tells medical schools how many students to accept and if they need to open more schools in certain areas. After i thought about it for a second, i thought you know what? I dont see a ton of new med schools opening up and a surplus of MDs so they must be doing something different. Thought I would just throw this out there to see if anyone had more info.

This is my personal opinion thus I won't bother backing any of it up with facts/figures so you can take it with a grain of salt if you'd like...

1. In terms of new medical schools opening up, you'd be surprised how saturated the health care field is becoming. Just Google a list of MD/DO schools, you'd see a bunch of medical schools you have never heard of, hell even NJ just opened up a second medical school, therefore having Cooper Medical School at Rowan Uni and UMDNJ having both an MD and DO program. Interestingly the state has only 1 pharmacy school at the moment (Rutgers).
2. As with MD saturation, its all subjective. If you take a drive in many suburban and urban areas within the northeast, you would find plenty of doctors within a square mile, now if you took that drive out in rural Kansas it's obviously a totally different ballgame. Not unlike pharmacy.
3. Although AMA is powerful and may even have the power to control the number of seats in med schools (not sure), they got bigger issues to deal with. For instance the nursing lobby is also effecient and growing, creating competition within the field of general practice with the productions of NP's and possibly DNP's (whatever that is.) Then there are the PA's, which is another field that is slowly growing and can also fall into the realm of general practice. Thus even if the AMA is powerful, there are things that they can't control.

 

[iFarm]

As I understand it, the majority of funding for medical residencies comes from public funds.

Anywhere you have public funds, you have lobbyists trying to get what they want.

I doubt it's all the AMA's doing however. Seems like MDs just have more $$ working for their interests.

 

[PharmD RPh]

found some old info see below:


" Profession and monopoly, a book published in 1975 is critical of the AMA for limiting the supply of physicians and inflating the cost of medical care in the United States. The book claims that physician supply is kept low by the AMA to ensure high pay for practicing physicians. It states that in the United States the number, curriculum, and size of medical schools are restricted by state licensing boards controlled by representatives of state medical societies associated with the AMA. These claims ignore the fact that the total number of physicians in the United States increased by 142.3 percent between 1975 and 2008, from about 394,000 to 954,000. Physician workforce growth was much greater than national population growth during this period. As a result, the total number of physicians per 100,000 people in the United States climbed from 180 in 1975 to 314 in 2008 (Source - "Physicians Characteristics and Distribution in the US, 2010 Edition," pages 439, 441 and 451). The book is also critical of the ethical rules adopted by the AMA which restrict advertisement and other types of competition between professionals. It points out that advertising and bargaining can result in expulsion from the AMA and legal revocation of licenses. Restrictions against advertising that is not false or deceptive were dropped from the AMA Code of Medical Ethics in 1980 (See AMA Ethical Policy E-5.02). The book also states that before 1912 the AMA included uniform fees for specific medical procedures in its official code of ethics. The AMA's influence on hospital regulation was also criticized in the book.[28]

 

[meister]

As previously stated, the number of medical schools is determined by the AAMC. More importantly, the number of residency training positions is determined by the ACGME. The number of training spots is the most important choke point for maintaining our current supply of physicians. While I think they should bump the number of training spots, especially in fields like surgery, it's nice that I don't have to worry about finding a job somewhere when I complete residency.

Requiring a 1 year pharmacy residency and limiting the number of training spots would go a long way towards controlling supply for pharmacy.

 

[PharmDstudent]

As previously stated, the number of medical schools is determined by the AAMC. More importantly, the number of residency training positions is determined by the ACGME. The number of training spots is the most important choke point for maintaining our current supply of physicians. While I think they should bump the number of training spots, especially in fields like surgery, it's nice that I don't have to worry about finding a job somewhere when I complete residency.

Requiring a 1 year pharmacy residency and limiting the number of training spots would go a long way towards controlling supply for pharmacy.

Unfortunately, I think that would lead to more schools opening up - which is what we're suffering from right now. If supply is low, for whatever reason, then they will try to pump out more grads to fix it.
That's the corporate pharmacy mindset. Corporations don't want to suffer from a limited supply.
If nothing else, it will be faught to the death. They will not let that happen without a good fight or some kind of loophole like a pharmacist's assistant.

 

[tkim]

The AMA does not control how many medical school seats there are. Not to say that they might have some sway in discussing things with the AAMC, but they don't set the numbers of seats.

The AMA primarily makes money by the sale and licensing of CPT codes.

http://www.healthleadersmedia.com/content/PHY-235669/Sermo-Wars-with-AMA-Over-CPT-Codes.html

 

[PharMed2016]

I don't believe the underlined part is accurate, at all. There may be forces influencing the number of med schools and number of students per school, but I don't think it's the AMA.

There have been a number of new medical schools opened in the last decade or so. Most of them (but not all) are osteopathic medical schools, which brings up another point. We have two completely separate systems for accrediting medical schools. I don't think the AMA control allopathic (MD) schools but I *know* they don't control osteopathic medical schools.

The AOA controls or influences the accreditation of Osteopathic Medical Schools.

 

[VA Hopeful Dr]

The AOA controls or influences the accreditation of Osteopathic Medical Schools.

True, but that's because the AOA holds most (if not all) of the power over training osteopaths. The AMA is almost entirely a political body at this point.

 

[Naidim]

http://www.lewrockwell.com/rockwell/medical.html

tl;dr "To help bring about a higher-paid profession, the AMA in 1904 created the Council on Medical Education, which sought to shut down more than half the existing medical schools by rating them on a scale of A to C. In cooperation with state medical boards composed of what Arthur Dean Boran, head of the council, called the "right sort of men," the AMA succeeded in cutting the number of schools to 131 by 1910, from a high of 166."

 

[chubsley2000]

http://www.lewrockwell.com/rockwell/medical.html

tl;dr "To help bring about a higher-paid profession, the AMA in 1904 created the Council on Medical Education, which sought to shut down more than half the existing medical schools by rating them on a scale of A to C. In cooperation with state medical boards composed of what Arthur Dean Boran, head of the council, called the "right sort of men," the AMA succeeded in cutting the number of schools to 131 by 1910, from a high of 166."

Wow.

"[FONT=Times New Roman, Times, serif]Then there was the problem of pharmacists selling drugs without a doctor's prescription. This was denounced as "therapeutic nihilism" and the American Pharmaceutical Association, controlled by the AMA, tried to stamp out the low-cost, in-demand practice. In nearly every state, the AMA secured laws that made it illegal for patients to seek treatment from a pharmacist. But still common were pharmacists who refilled prescriptions at customer request. The AMA lobbied to make this illegal, too, but most state legislatures wouldn't go along with this because of constituent pressure. The AMA got its way through the federal government, of course."

Don't know how much of that article is true, but pretty interesting read anyways
.

 

[Praziquantel86]

http://www.lewrockwell.com/rockwell/medical.html

tl;dr "To help bring about a higher-paid profession, the AMA in 1904 created the Council on Medical Education, which sought to shut down more than half the existing medical schools by rating them on a scale of A to C. In cooperation with state medical boards composed of what Arthur Dean Boran, head of the council, called the "right sort of men," the AMA succeeded in cutting the number of schools to 131 by 1910, from a high of 166."

That's completely irrelevant. Pre-Flexner Report medical education is a completely different ballgame, and was comprised of many backroom charlatan types competing with legitimate institutions. The AMA has nothing to do with medical education outside of an advisory capacity; ultimate authority rests with LCME and ACGME.

Find references from this millennium if you're looking for a debate.

 

[Naidim]

That's completely irrelevant.

Past events are the best predictors of future events.

 

[tkim]

Past events are the best predictors of future events.

Uh, that's a crock of shyte. The bottom line is that the AMA has no control over the number of medical schools or number of medical school seats, for the multiple reasons listed upthread.

 

[PharMed2016]

I believe there was a small spurt in closure of pharmacy schools a couple of decades ago as it become less lucrative. Among the schools closed was Cornell School of Pharmacy... or that's what I heard from some pharmacist that I worked with. Anyone know more about this?

 

[All4MyDaughter]

I believe there was a small spurt in closure of pharmacy schools a couple of decades ago as it become less lucrative. Among the schools closed was Cornell School of Pharmacy... or that's what I heard from some pharmacist that I worked with. Anyone know more about this?

Here's the real story: http://books.google.com/books?id=jU...=onepage&q=cornell school of pharmacy&f=false

 

[PharMed2016]

Here's the real story: http://books.google.com/books?id=jU...=onepage&q=cornell school of pharmacy&f=false

Now that is positively archaic lol.