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Doctors Boo Obama in Chicago

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You would have thought it was Wrigley Field not the Hyatt Regency Chicago.

When President Obama told gathered physicians at the American Medical Association's annual meeting in his home town this month, "I'm not advocating caps on malpractice awards which I believe can be unfair to people who've been wrongfully harmed," he was booed like Chicago Cub Milton Bradey. "Yank him," was probably next.

Who remembered that in 1993 a similar message by his Secretary of State-also a homey-received a standing ovation? (Though the long knives did come out later.)

Of course the 236,000 member AMA which represents a fourth of the nation's practicing physicians, has always been obstructionist-fighting managed care, cost controls, posted fees, politicians, insurance companies, nurses and even a physician "glut" in the past.

But its view of the nation's health problems is just as limited critics say.

AMA

Will headlines after the next AMA meeting read, "AMA Decries Use of Plastic Spatulas," or "Doctors Worried About Increase in Planetary Tilt," asked Mark DePaolis, MD in the Star Tribune in 1994 thanks to the organization's penchant for grappling with cruise ship hygiene and bad physician penmanship.

This year Vitamin D got more play than health care for troops and veterans in two ongoing wars. Hello?

It's not that the AMA doesn't know the issues. It has taken up elder abuse, bullying, corporeal punishment in schools, alcohol abuse, highway safety, binge drinking, medical marijuana, cosmetic sun tanning, medical waste, livestock antibiotics, organ donation, terminal care, physician assisted suicide, women, gay and patient rights, AIDS ethics and patient privacy in the past.

In the 1990's it confronted Big Tobacco-and embarrassment over its own tobacco stock holdings-with a high profile, physician-led "Dump the Hump," Walk a Mile Against Joe Camel parade in Chicago's Loop.

Nor has the AMA shrunk from addressing the "intentional violence" of boxing, violent movies and video games, "private ownership of rapid fire assault rifles" and physician involvement in executions-though a resolution against the death penalty itself was defeated in 2000. (It "wasn't the AMA's business," said Colorado AMA delegate Steven Thorson, MD.)

It's just that some issues are more equal than others.

So even though AMA delegates passed a resolution against direct to consumer (DTC) drug advertising in 1991- the "ads mislead the public and add to the cost of medication," it stated-and even though it reaffirmed the stance in 2001-it's like a competition "to see who can sell more of antihistamines or nasal sprays," said New Jersey AMA delegate Angelo Agro, MD-the AMA reversed itself in 2005 and decided the notorious, ask-your-doctor ads were a First Amendment issue.

And speaking of the First Amendment, the AMA's controversial and semi-hidden practice of selling its physicians' personal prescribing information to marketers was also called "free speech" in recent court rulings in Maine and New Hampshire.

For more than 50 years, the AMA has profited by selling physicians' personal data "to pharmaceutical companies, hospitals, medical colleges and universities, medical equipment and supply companies, and other institutions interested in supplying goods and services to physicians and group practices," it admits on its website. "AMA's Database Licensees are specialized in direct mail, telemarketing, sales call reporting, and other database marketing services," it says.

Physicians are free to opt out of the $50 million a year scheme, censured at the AMA's 2007 annual meeting by Lydia Vaias, MD of the National Physicians Alliance and John Santa, MD of the Prescription Project, a group against such access-if they know about it.

But 40 percent of physicians surveyed by the Kaiser Family Foundation in 2007 didn't-and 74 percent disapproved.

No, the AMA's "issues agenda" is as plain as the drug ads which adorned its website as recently as 2007.

Why, for example, does it resolve this year to go after hormone selling "for-profit Web sites, anti-aging clinics and compounding pharmacies," when it has given hormone giant Wyeth who's hoaxed women into cancer causing hormone therapy for four decades a pass?

Why resolve this year there is "no need" for more research into a vaccine/autism connection and support "universal vaccination" while pledging to explore non-vaccine links further? Maybe green beans?

Why ignore the taxpayer funded warehousing of so many of the nation's children, poor and elderly on "atypical antipyschotics" even as over 20 states sue?

And why ignore the epidemic of veteran suicides and suicides on asthma, seizure, pain and anti-smoking medications approved as "safe"?

No, in a year in which two leading researchers at Massachusetts General Hospital, two at Emory University and one at the University of Minnesota are exposed for conducting checkbook science and pay-for-play drug schemes that promote unsafe drugs, the AMA wants to talk about Vitamin D.

Maybe it's someone else who should get booed.

Martha Rosenberg is a columnist and cartoonist, who writes about public health

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