In the earliest days of the AMA, back when the idea of a national body for medicine was novel and few knew if it would last, the leaders of this organization had the wisdom to begin by carefully laying out the ethical standards that must guide our profession. This was a signal to doctors everywhere that the AMA was ushering in a more responsible and compassionate era for medicine.
To create the Code of Medical Ethics, as it would later be called, the AMA’s leaders drew from history—language and concepts that emerged in the 5th century B.C. with the great Greek physician Hippocrates. The Code would be updated and modernized over the years to keep up with advancements in medical practice, but the core tenets drafted in 1847, which speak to physicians’ responsibilities to their patients, have remained largely unchanged.
As the AMA marks its 175-year anniversary on May 7, I’ve been thinking about the key inflection points for our organization. By making the Code one of our first major acts, it is clear that our leaders solidified the AMA’s standing and reputation as a principled and guiding light for medicine and set the tone for all that would follow.
Since our founding in 1847, the AMA has been the physicians’ powerful ally in patient care and we continuously strive to live up to our lofty mission of promoting the art and science of medicine and the betterment of public health. Recall that the AMA emerged in a time when quackery was rampant and widespread, when numerous unregulated medical schools failed to graduate qualified physicians, and when a patchwork of medical journals existed whose information was not reliable or credible.
This dysfunction fueled the creation of the Code of Medical Ethics, and soon after, pushed the AMA to create the Journal of the American Medical Association, now known as JAMA®, with research also broadly published under the 12 JAMA Network™ journals. Both remain cornerstones of medical practice today, anchoring the broad work of the AMA in science, evidence and respect for the sanctity of the patient-physician relationship. By establishing a board to educate the public about the dangers of quack and unproven remedies in our early years, the AMA committed itself to protecting the public’s health.
Advancing public health
Through policy and advocacy, the AMA has led many of the greatest public health achievements in the last century: from supporting universal childhood vaccines and launching a war on public smoking, to opposing acts of discrimination against patients with HIV/AIDS. More recently, the AMA has supported expanding health care coverage through the Affordable Care Act and other safety-net programs, and we implemented policies to combat systemic racism in health care and other forms of discrimination in medicine.
Today, we fulfill our mission in three important ways: by working to remove obstacles that interfere with patient care, by leading the charge to prevent chronic disease and confront public health crises, and by driving the future of medicine through innovation and improved physician training and education. In short, the AMA represents physicians with a unified voice on the issues that matter most to them, leveraging the power of physician experience and expertise to government and stakeholders across health care.
One of the great strengths of the AMA is our commitment to an internal democratic process that ensures a variety of perspectives, vigorous debate and good policymaking. Twice a year, the AMA convenes its House of Delegates, with representatives from more than 190 state and specialty medical societies. This legislative body develops and adopts policies on health care issues that influence AMA advocacy and medical practices throughout the United States and around the world. By elevating the concerns of physicians and speaking on behalf of the entire profession, the AMA has a tremendous impact in government agencies, Congress, state legislatures and the courts.
This has been invaluable over the last two years as we have provided counsel, support and leadership amid one of the most challenging times for health care in a century. Throughout the COVID-19 pandemic, the AMA has fought for personal protective equipment, financial resources, and telehealth regulatory flexibility on behalf of physicians, and we have helped lead a national effort to build support for COVID-19 vaccines and counter widespread misinformation.
Committed to rectifying wrongs
As we celebrate the AMA’s many contributions to science and public health, we also recognize that there are periods in our long history that we are not proud of. At the point of our founding, AMA leaders made decisions to exclude women and Black physicians from our ranks, contributing to a health care system today that is plagued by inequities and injustices for patients and physicians alike.
In 2008, the AMA concluded a three-year study on the racial divide in organized medicine and publicly apologized for our organization’s past discriminatory practices against Black physicians, an effort we called “a modest first step toward healing and reconciliation.” This is a journey of reflection that continues today with an enterprisewide commitment to rectify past wrongs.
Working in partnership with other leading health organizations, we are educating physicians about the legacy and impact of structural racism in health care and advancing policies and programs to eliminate health inequities. We created a Center for Health Equity to lead these efforts, which range from establishing a new Medical Justice in Advocacy Fellowship to helping launch the national “Release the Pressure” campaign to improve the heart health of Black women.
The AMA’s history is a complicated one, but one constant over 175 years is our commitment to delivering the tools, support and resources physicians need to deliver the very best care to patients. This wouldn’t have been possible without the hard work of generations of AMA employees and the millions of physician members through the years who have dedicated their careers to meeting each moment in medicine—improving the health of communities and the entire nation. In fact, AMA membership is at its highest level since 1996 and has grown for 11 consecutive years.
We are proud of this work. We are humbled by the trust physicians have placed in us, beginning in those first, uncertain days in 1847. By defining what it means to be a physician, by uniting the profession around a common set of ethics and standards, we laid the groundwork for modern medicine. We made a promise to patients and physicians that we still keep today, and all the days to come.