[chimeracoder]

> The AMA for example, does not engage in collective bargaining with the management of a hospital and has no legal right to compel such a thing under the NLRA. The AMA does however lobby politicians and puts its people on medical boards to limit the supply of doctors.

This is a common misconception.

The AMA does not limit the supply of doctors. The AAMC (used to) limit the supply of doctors, but (a) they have been trying for the last 10+ years to increase that, and (b) the actual number of practicing physicians is bottlenecked by funding for residency positions, which is funded by Medicare, not the AMA or AAMC. The AMA has actually lobbied to increase funding for GME, which would increase the supply of practicing physicians.

The AMA does not represent doctors in any meaningful sense - only 25% of physicians belong to the AMA, and only because membership is required for licensing the CPT codes that those doctors need for billing. The AMA does not consistently advocate for physicians' best interests, and in the last couple of decades, it has actually consistently sided against physicians' best interests.

[knucklesandwich]

The AMA _did_ lobby (I should have clarified that they no longer do this) to restrict medicare funding for residency: http://www.nytimes.com/1997/03/01/us/doctors-assert-there-ar...

http://www.nytimes.com/1986/06/29/business/curbing-the-suppl...

At one point the AMA had about 75% of American doctors as members but has declined for various reasons (growth of specialty professional associations, change of employment in which many doctors have gone from private practices to hospitals which has accompanied a change in political objectives, etc.). The AMA probably does still serve as a professional association in the interest of some segment of doctors, but I take your point that it definitely don't work for doctors writ large. This is actually a good example of why professional associations can be inadequate, because they fundamentally are limited to advocacy for a profession instead of working for gains for a workplace.

[chimeracoder]

> The AMA _did_ lobby (I should have clarified that they no longer do this) to restrict medicare funding for residency

...twenty years ago, when we had the opposite problem. It still wasn't some act motivated by the desire to benefit doctors, even if that's the PR spin they used.

> At one point the AMA had about 75% of American doctors as members but has declined for various reasons (growth of specialty professional associations, change of employment in which many doctors have gone from private practices to hospitals which has accompanied a change in political objectives, etc.)

The move away from private practices was not the driving force behind the declining membership of the AMA. Quite bluntly, doctors stopped joining (unless they were forced to) because they did not support the AMA or its objectives. Why pay money to an organization that fights for causes you oppose?

Of course, this is only possible because (most) doctors are not required to be AMA members or pay membership fees if they choose not to, which is not true of people in most unions.

> The AMA probably does still serve as a professional association in the interest of some segment of doctors,

It does - it acts in the interest of the subset of doctors who are serving in administrative roles and are no longer practicing medicine full-time. That is to say, they advocate the interests of hospitals and payers, not practicing physicians.

> This is actually a good example of why professional associations can be inadequate,

It's not that they're "inadequate". It's that, in this case, they are literally fighting against the interests of the group they are (allegedly) advocating.

So really, the AMA is an argument against either professional associations or unions - doctors are unhappy with the AMA, and you certainly don't see them, by and large, advocating unionization in their practices en masse.

[Apocryphon]

Sounds like American doctors need a real union, then.