AMA leadership recently posted an opinion column on MedPage Today® explaining what the AMA is doing to protect physicians and their patients during this time of uncertainty and change. They discussed what navigating health care advocacy today means, including balancing multiple priorities—public health, physician practice sustainability, and democratic representation.
This article, which originally appeared May 15, 2025 is reprinted here by permission.
By: Bruce Scott, MD, president of the AMA; Michael Suk, MD, JD, MPH, MBA, board chair of the AMA; Bobby Mukkamala, MD, president-elect of the AMA; David Aizuss, MD, board chair-elect of the AMA.
May 15, 2025
As our nation and profession seek to better understand the forces shaping our government and the impact on public health, we must remember that advancements in medicine and science are seldom made in isolation. They are often the product of strategic collaboration, exhaustive trial and error, and a clear vision to see results as they are—not as we wish them to be. The process can be slow and messy and painstaking, with incremental progress achieved in research laboratories far from the public's view.
The same is true for advocacy in the halls of Congress or state legislatures around the country, where breakthroughs come from years of focused and sustained work, out of the limelight, achieved through collaboration and with a clear vision for success.
The pace of health policy changes that we navigate today with a new administration and Congress stirs strong emotions and raises alarms. It is tempting, especially in times of frustration and concern, to hold a binary view of advocacy: One either denounces changes loudly or suffers accusations of abandoning one's principles.
Yet, that perspective may not fully capture the complexity of the situation. The invocation of "no margin, no mission" as a shorthand for compromise misses the deeper reality: navigating health care advocacy today means balancing multiple priorities—public health, physician practice sustainability, and democratic representation—often under significant political and financial threat.
Since our founding in 1847, the American Medical Association (AMA) has employed a variety of approaches to achieve health policy victories that promote scientific discovery, improve health technology, and advance public health on a broad scale. We have engaged in public battles to educate and build consensus, such as the hard-fought victories to reduce smoking in the 1970s or to increase access to care in the 2000s. Conversely, for decades we have worked behind the scenes to educate policymakers on issues important to patients and physicians and the long-term viability of our healthcare system.
In the current environment, the AMA has strategically chosen to use an informative and collaborative approach in our conversations with the administration and Congress. We believe that educating and communicating directly with public officials—many of whom do not have extensive federal government experience—and building bipartisan consensus around issues critical to public health provides the best opportunity to achieve our goals of a healthy, thriving, and sustainable healthcare system where physicians are free from unnecessary burdens and where all people have the opportunity to achieve optimal health. This vision for health care is rooted in our mission, which calls on us to always work to promote the art and science of medicine and the betterment of public health.
The AMA is not a single-issue organization, nor a monolith. It is, by design, a democracy—one of the few truly representative medical bodies in the world. Every state society and specialty society representing a variety of constituents has a voice through the House of Delegates (HOD), a structure Alexis de Tocqueville would have recognized as a uniquely American experiment: passionate, pluralistic, and resilient under tension.
Like any representative body, our HOD is a vast collection of ideas, opinions, knowledge, experience, and expertise. And so, for every physician calling on the AMA to more loudly denounce or confront the administration or Congress on issues important to them, there are others urging our organization to maintain a measured, strategic course—one that preserves many decades of hard-won influence so that physicians can effectively advocate over the long term.
We must reject voices that oversimplify the AMA's position and advocacy on a host of single issues versus the plurality of challenges before us. Professional associations like the AMA are stewards of both ideals and realities. Fighting for Medicare payment reform, relief from administrative burdens, and advocating for resources and policies that address chronic disease and promote public health can be achieved by building relationships across administrations and congressional terms. This does not dilute the AMA's values; it equips the association to defend them— often quietly, often over the long arc of legislation and regulation.
If the AMA were to sacrifice its strategic standing without deliberation, it would risk permanently weakening the voice of organized medicine. What is gained by standing on principle if one becomes ineffective and unable to fight the next battle?
Deliberative discussions outside the spotlight may not be as satisfying as public protest, but they can be every bit as productive. Advocacy takes many forms, not all of them loud. And leadership often requires the patience and fortitude to build lasting coalitions rather than chase fleeting headlines.
The AMA is made stronger, not weaker, by its internal debates—by welcoming voices calling for immediate action alongside those urging caution. At its best, the AMA reflects the tension-filled but resilient standard of democracy that de Tocqueville so admired: "The greatness of America lies not in being more enlightened than any other nation, but rather in her ability to repair her faults."
To those who perceive the AMA as inactive, the answer is not to walk away, but to lean in. To engage. In June, the House of Delegates will meet. Voices and opinions will be heard. All are legitimate. All deserve respect. And through debate—not unilateral declarations— the path forward will be chosen.
The AMA remains the voice of American medicine because our policies and our values are anchored in science and the broad consensus of our diverse physician community. We are powerful because we are a true democracy where many different ideas and opinions can exist at one time. And we are effective advocates for physicians and our patients because we recognize that breakthroughs almost never occur in silos or overnight. Advancements are the result of steady progress and strategic collaboration, often far from the spotlight.
Bruce Scott, MD, is president of the AMA; Michael Suk, MD, JD, MPH, MBA, is board chair of the AMA; Bobby Mukkamala, MD, is president-elect of the AMA; David Aizuss, MD, is board chair-elect of the AMA.
