For many years, in fact since I was a newly minted physician in my internship, I was a proud member of the American Academy of Family Physicians (AAFP). I felt that it was an organization that was all about supporting the rights and privileges of family doctors like myself. I thought that it would help advocate for its member physicians and their patients.
Several years ago, I realized how wrong I was. Like many other big organizations, it became too wrapped up in politics and advancing its own interests above those of the people who they are supposed to represent, the ones paying their salaries and financing their lobbying efforts.
The first hint that AAFP was not working for my interests, or those of most of its members, was its impotence in lobbying to fix a horribly flawed payment scheme enacted by the federal government during the Clinton years called the Sustained Growth Ratio (SGR) Formula that artificially tied physician reimbursement not to rational standards like supply and demand, or the cost of providing care, but instead to calculating payments by linking them to flattening the national debt. Every year, the formula dictated that physicians would be paid less, while their costs kept rising. At the 11th hour or so, Congress delayed the cut, which meant that the next year, it would be deeper. This joke went on for almost 20 years. It ended last year when, with AAFP support, Congress passed The Medicare Access and CHIP Reauthorization Act (MACRA). The sycophants at AAFP cheered as something bad was replaced with something worse. MACRA, when fully implemented in coming years, is expected to penalize about 80% of private practices, many out of existence. With friends like this, who needs enemies?
The last straw for me, and many other self respecting family physicians, was the American Academy of Family Physicians endorsement of the so called ‘Patient Protection/Affordable Care Act,” (aka Obamacare). I am still unclear as to what their real motivation was for jumping on the Obamacare bandwagon. Perhaps they were naive, thinking that millions more Americans would actually get the coverage and care that was promised. Maybe it was because they foolishly believed that it would work to funnel more money to its members because it would mean more paying and insured customers. It could be that they are sheep and followed other medical organizations off the cliff who were invested in crony capitalism, like the AMA. Only they know for sure.
I believe it was the final straw in the transformation of the organization from a non-partisan/bipartisan medical society to a left leaning advocacy group. Evidence for this transformation has been abundant since it betrayed its members by supporting Obamacare, which has proven to be so harmful to doctors, patients, hospitals, as well as the federal budget.
They now openly advocate for progressive social issues such as expansion of Medicaid, gun control, and transgender people going into whichever bathroom they want on any given day. For example:
A considerable amount of time at the Congress of Delegates was devoted to discussion of the public health implications of various forms of discrimination. A resolution was passed to support the right of transgender people to use public facilities of the gender they identify with — a right they do not enjoy, for example, in North Carolina. (Medscape Family Medicine online) 10/05/2016
To be honest, doctors like me probably were a catalyst for this metamorphosis of the AAFP to an ultra-PC organization because we voted with our feet. Like so many others, I felt so disenfranchised when they threw their support behind Obamacare, (because it had to be passed before we could find out what was in it) that I could no longer give them material support by paying their hefty annual membership dues. I do not regret my departure for a minute. I was under no illusion that staying would have changed the course.
I chose to look for other medical colleagues with whom I had more in common. I wanted to associate with physicians who placed a high moral value on physician autonomy, advocacy for patient privacy, transparency in medicine, promotion of the free market in healthcare, and freeing physicians from burdens such as sham peer reviews, Maintenance of Certification, etc. I found such a home in the Association of American Physicians and Surgeons. I sleep better at night knowing that I am supporting an organization such as this one has been standing up for patient and physician rights since 1943. In the few years that I have been an AAPS member, they have helped me far more than AAFP ever did. Its members gave me the knowledge and inspiration to follow through on my desire to eliminate third parties from my relationship with my patients. I learned that it was not the end of the world if I no longer paid the extortion money to the American Board of Family Medicine for their bogus seal of approval.
As I began to question the status quo in medicine, I discovered that there were many ahead of me in my journey and that there are several organizations that are working toward the goal of taking back medicine from the government and insurance conglomerates. Docs 4 Patient Care, The Free Market Medical Association, and The Benjamin Rush Institute are all compatriots in this counter-revolution as well. It is my hope that more and more physicians, residents, and medical students wake up and join me in joining them.
Michael A. Ciampi, M.D.