A battle is brewing between the American Medical Association and Sermo, Inc., a Cambridge, Mass.-based online physician community.

According to a recent survey conducted by Sermo, physicians using the online physician community no longer believe the AMA represents them and have no intention of being AMA members.

Sermo officials said they interviewed 4,156 members and looked at more than 2,000 separate AMA discussions about Sermo over the past three years. They said the majority of those discussions focused on frustration with AMA policy stances.

Key findings of the survey include:

• Seventy-five percent of physicians surveyed are not members of the AMA.
• Eighty-nine percent of physicians claim, "The AMA does not speak for me."
• Ninety-one percent of physicians surveyed do not believe the AMA accurately reflects their opinion as physicians.

Sermo CEO Daniel Palestrant posted a notice indicating he agrees with the majority.

"This is a considerable change of heart, given the high hopes that I had when we first partnered with the AMA over two years ago," he stated. "AMA membership has now shrunk to less than 20 percent of practicing physicians. Declining membership signals longstanding frustration over the AMA's ineffective advocacy on many issues that are critical to the future of medical practice and healthcare. It's now reached the point that the AMA can no longer claim that it represents physicians in this country."

When contacted for a response, AMA Board Member Joseph M. Heyman, MD, posted the following:

“We need to set the record straight on the information in Dr. Palestrant’s post. The truth is that AMA membership numbers are public information, and there has been no precipitous decline in AMA membership over the last two years, as Dr. Palestrant suggests. With about a quarter million members, the AMA is the largest physician organization in the country, and through the AMA House of Delegates, comprised of elected physician and medical student representatives from all state and national medical specialty societies, it is the only physician organization that gives all physicians a voice in the future of medicine.”

Sermo physicians have voiced frustration with the AMA's lack of advocacy on critical issues such as:

• Limiting insurance companies' abilities to deny care;
• Restricting the encroachment of nonqualified healthcare workers into patient care;
• Tort reform and caps on settlements;
• Malpractice insurance reform and adjudication by qualified boards;
• Abolition of CPT codes;
• Allowing physicians to negotiate collectively for an equal footing with insurers; and
• Cost of living increases in insurance reimbursements.

"President Obama needs to meet with working physicians in America to get a true picture of the depth of the issues," said Sermo member Richard A. Armstrong, MD, FACS. "Physicians feel that the AMA and other organizations have become self-serving corporations that no longer function as true advocates for America's physicians and their patients. We are at a pivotal juncture in American medicine and must speak with a clear voice."

Heyman said the AMA is working hard to advocate for physicians in the midst of impending healthcare reforms.

“Our advocacy on behalf of physicians is well documented and unfailing," stated Heyman. “We are actively engaged to permanently fix the broken Medicare physician payment system and have a big victory on that this week. We also continue to advocate for antitrust reform, medical liability reforms, a streamlined insurance claims processing system and so much more to safeguard the patient-physician relationship. As for relationships with insurers, we continue our high-profile fight against insurer abuses that hurt physicians and patients."

“The AMA door is always open to Dr. Palestrant and all physicians who would like to join with us to make a positive difference in medicine -- especially those who feel their views differ from the policies set by the physicians of the House of Delegates. We urge you to join with us to make a positive difference in the lives of physicians and patients in our nation,” Heyman said.