Silence of AMA, Other Doc Groups Vexes Some Physicians

At first, Han Yu Stephanie Liou, MD, thought the broken link was a glitch. She had downloaded information on prevention of sexually transmitted infections (STIs) from the US Centers for Disease Control and Prevention (CDC) website for her patients countless times in the past. It wasn’t until she began receiving messages from colleagues asking about missing HIV pre-exposure prophylaxis, LGBT issues, and teen pregnancy information that she connected the dots.

“This is a huge problem. And also? This is honestly kind of bonkers,” the Chicago pediatrician said, recalling how federal health agencies, acting on President Trump’s executive orders, pulled down health data and other clinical information from their websites.

Liou is a board member of Doctors for America (DFA), a left-leaning advocacy group that sued the government to restore the information. In an amicus brief, Liou outlined how she uses CDC websites daily in her work at a federally qualified health clinic. (A federal judge ordered the information restored under a temporary restraining order.)

In contrast, the American Medical Association (AMA), has remained largely silent on health-related Trump administration actions compared with groups like DFA and the American Public Health Association (APHA), which has sued the government for freezing federal aid. 

The nation’s leading physicians’ organization has issued no formal statements on the second Trump Administration’s cuts to medical and scientific research, freezing of global aid, or the confirmation of vaccine-skeptic Robert F. Kennedy, Jr. as Secretary for Health and Human Services (HHS). The AMA has posted YouTube videos with updates on measles, bird flu, and other infectious disease outbreaks.

In a statement, the AMA acknowledged it is “actively engaged” with lawmakers and administration officials to shape policies — but did not provide any details. 

“While early policy proposals and executive actions may spark immediate discussion and reaction, many of these initiatives take significant time to develop or implement, presenting opportunities for the AMA to provide informed guidance and advocacy,” the statement noted.

The California chapter of the AMA, however, urged Congress to oppose cutting $880 billion in Medicaid funding on February 21. 

And the Journal of the American Medical Association and related specialty journals published a joint opinion-editorial condemning the “silencing” of US scientific discourse stemming from Trump administration orders. The peer-reviewed journals are published by the AMA and are editorially independent.

“I respect [the AMA’s] policy making and decision making,” said Georges Benjamin, Executive Director of the APHA. “I believe that many of them are under the mistaken impression that if they are silent on some issues, that they will in some way be rewarded later. And that’s not true.”

HHS officials did not respond to Medscape Medical News’ requests for comment.

“There’s a certain way these legacy organizations like to play in the United States. They write checks to politicians to get access so that they can go and talk about whatever issues they are concerned about,” said Rob Davidson, executive director of the left-of-center Committee to Protect Healthcare.

A Powerful Force, Silenced?

The AMA remains a powerful force in American medicine, due to its size, influence, and long history, said Nancy Tomes, a medical historian at SUNY Stonybrook. 

In the first half of the 20^th century, three quarters of all doctors in the United States joined the AMA, giving the group unprecedented clout. Its lobbying arm could get bills written, passed or sidelined with ease, Tomes said. The AMA also influenced the Executive Branch. New Deal legislation during the Great Depression didn’t contain anything about healthcare because the AMA refused to countenance any hints of socialized medicine, Tomes added.

But the AMA in 2024 is nothing like the AMA from roughly the 1910s through the 1960s, Tomes said.

“The old AMA had so much political power in the United States that they could make presidents quake,” she said. 

Pushback against these and other seemingly heavy-handed tactics in the latter half of the 20^th century diminished both the authority and the luster of the organization. By 2011, only 15% of practicing American doctors were members of the AMA, which allows the organization to wield a substantial amount of power. In both 2016 and 2020, the AMA issued statements supporting the nomination of Tom Price, MD, and Xavier Becerra to head the HHS, although they have not openly spoken out against a particular nominee.

Both Tomes and Benjamin suspect that the AMA is opting to save its political capital to address potential cuts to Medicare and Medicaid, both topping the group’s lobbying agenda. 

“The AMA has some significant issues on the table that will need to be addressed. I suspect that many people felt that it was strategic to focus on the core policy issues,” Benjamin said. “I disagree with that approach, because I think people are policy.”

From a certain pragmatic standpoint, the position makes sense, Tomes said. Speaking out against RFK, Jr probably wouldn’t have swayed the Senate’s vote, she said.

‘Time To Stand Up’

Maybe not, said Paul Offit, MD, vaccinologist and infectious disease specialist at the Children’s Hospital of Philadelphia, Philadelphia, but he believes the AMA still has the moral obligation to say something.

“I think that this is the time to stand up against an administration that is making decisions that are dangerous to the public health. It is concerning when groups clearly interested in the public health stand back,” Offit said in an email.

While this strategy of watch and wait might have succeeded in past eras, the current dangers to American and global public health and medicine are so extreme that this position doesn’t make sense, according to Davidson.

The AMA also risks losing political capital by not acting, Tomes said. 

Davidson said he’s heard from many colleagues who are dropping their AMA memberships in response to the lack of action at the top. 

The American Academy of Pediatrics has issued several statements objecting to potential cuts to Medicaid and the Children’s Health Insurance Program, the removal of data and guidance from federal websites, and expressing concern about the potential separation of immigrant families. 

In response to drastic cuts in grant funding at the National Institutes of Health, groups such as the Society of Thoracic Surgeons, the American Association of Cancer Research, and the Association of American Medical Colleges, all issued statements condemning these actions.

Other large medical organizations, including the Infectious Diseases Society of America and the American College of Obstetrics and Gynecology, declined Medscape Medical News’ request for comment.

The early success of the suits brought by both DFA and the American Public Health Association in at least temporarily blocking White House actions suggests that speaking out can work. DFA’s lawsuit put the organization on the national radar for the first time, generating a surge of membership applications but also death threats, Liou said.

The AAP has never had a lobbying arm, which Liou, also an AAP member, said has impeded the group’s ability to advocate for the nation’s children. She said the statements from AAP are a good thing, but they’re not nearly enough.

“This is not normal. This is not good for public health. I can’t imagine that AAP leadership isn’t worried and upset, just like I am,” Liou said. “We’re bracing ourselves for what’s going to happen.”